It’s not a topic anyone enjoys talking about. But pressure sores are one of the most important and most preventable problems in older age.
They can start as a patch of red skin that looks like nothing much. Left alone, they can turn into painful wounds that take weeks or months to heal and, in some cases, lead to serious infection.
The good news is that with early attention and a few simple habits, many pressure sores can be prevented.
What Is a Pressure Sore?
A pressure sore (also called a pressure ulcer or bed sore) is damage to the skin and the tissue underneath, caused by sustained pressure on one area. Friction and “shear”, which happens when skin is dragged or slides over a surface, can also contribute.
They tend to develop over bony areas, including:
- The base of the spine (sacrum) and the hips
- Heels and ankles
- Elbows and shoulder blades
- The back of the head
- Areas under medical devices or tight clothing
Anyone can get one, but they’re more likely in people who spend a lot of time in bed or in a chair.
Who Is at Higher Risk?
Risk goes up when someone:
- Has difficulty moving or changing position independently
- Spends long periods in bed or a chair
- Has reduced feeling in their skin
- Has poor appetite, low weight or poor hydration
- Experiences incontinence, so skin is often damp
- Is living with diabetes, circulation problems or frailty
- Is recovering from illness, surgery or a fall
- Has dementia and may not be able to say that something hurts
Often it’s a combination of these things.
Early Warning Signs to Look For
Checking skin regularly is one of the most effective things you can do. Look for:
- Skin that is red, or in darker skin tones may look purple, blue or darker than the surrounding skin
- Redness that stays after the pressure has been taken off
- Skin that feels warm, hard, spongy or swollen compared with nearby skin
- Pain, tenderness or itching in a particular spot
- A blister or shiny patch
- Broken skin or an open sore
On darker skin, redness can be harder to see, so touch and feel matter too. Look for differences in temperature or texture and any change in colour compared with the surrounding skin.
If you see signs, don’t rub or massage the area. Take the pressure off it and contact a GP or district nurse promptly for advice.
How to Reduce the Risk at Home
1. Change position regularly. If someone can’t move easily by themselves, they may need help to change position. A healthcare professional can advise how often and how, based on the person’s needs. For people sitting for long periods, even small shifts of weight can help.
2. Use the right equipment. Pressure-relieving cushions and mattresses can make a significant difference. A district nurse, GP or occupational therapist can advise on what’s suitable and how to get it.
3. Keep skin clean and dry. Gently clean skin after incontinence and pat dry rather than rubbing. Use suitable products, and ask a nurse for advice on creams, as not everything helps.
4. Protect heels and bony areas. People who spend a lot of time in bed may need their heels lifted off the surface. Ask a healthcare professional for guidance.
5. Move people safely. Dragging someone up the bed or across a chair causes friction and shear. Moving and handling should be done with proper training and, where needed, equipment such as slide sheets or hoists.
6. Eat and drink well. Good nutrition and hydration help skin stay healthy and heal. If appetite is poor or weight is falling, speak to a GP or dietitian.
7. Check the skin daily. Build it into a routine, such as during washing or dressing. Look carefully at pressure areas and note any changes.
8. Keep clothes and bedding smooth. Wrinkled sheets, thick seams and tight clothing can add pressure points.
When to Get Help
Contact a GP or district nurse promptly if you notice:
- Skin that stays red or discoloured
- A blister, broken skin or an open sore
- Pain in a pressure area
- A new sore that is getting bigger or deeper
Get urgent medical advice, for example by calling NHS 111, if there are signs of infection, such as spreading redness, swelling, pus, a bad smell, fever or the person seems unusually unwell, confused or drowsy. In an emergency, call 999.
Pressure Sores and Dignity
Talking about skin, continence and repositioning can feel awkward, especially for someone who’s used to privacy and independence.
It helps to:
- Explain what you’re doing and why
- Keep the person covered and comfortable
- Offer choices where possible
- Treat it as everyday health care, not something to be embarrassed about
Good care protects both skin and self-respect.
How Home Care Can Help
Prevention works best when it’s part of a daily routine. Depending on the person’s needs and care plan, home care can include:
- Regular skin checks during personal care
- Support with repositioning and moving safely, by trained carers
- Help with continence care, with dignity
- Encouraging meals and drinks
- Working with district nurses and other professionals on equipment and treatment
- Noticing early changes and reporting them quickly
For people with more complex or changing clinical needs, nurse-led complex care at home adds further clinical oversight.
Timely wound and skin care can make a real difference to someone’s wellbeing and plans. You can read how our team supported one client in our case study, Enabling a Client to Continue Travel Plans Through Timely Wound Care.
A Quick Checklist
- Check skin daily, especially heels, hips, spine, elbows and ankles
- Take pressure off red or sore areas and don’t rub them
- Help the person change position regularly
- Ask about pressure-relieving cushions or mattresses
- Keep skin clean and dry
- Encourage food and fluids
- Use safe moving and handling
- Contact a GP or district nurse early if something changes
Final Thoughts
Pressure sores are common, but they’re not inevitable. Most of the time, it’s the simple things that make the difference: regular checking, moving, good nutrition, the right equipment and speaking up early.
If you’re caring for someone who spends a lot of time sitting or lying down, don’t wait for a visible problem. Ask for advice about prevention before skin damage appears.
At Kome Care, our nurse-led team provides person-centred home care across London, with clinical oversight where needs are complex. If you’re worried about a loved one’s skin or mobility, we’re happy to talk through what support could help.
Talk to our team or book a Nurse-Led Care Review.
This article is for general information and is not medical advice. If you are worried about someone’s skin or health, contact their GP, district nurse or NHS 111. In an emergency, call 999.
