Pressure Sore Prevention for Bedbound Loved Ones: A Carer‘s Guide to Daily Skin Checks

---

Introduction: Why Vigilance is Your Greatest Ally

For individuals confined to bed or a chair, their skin is on the frontline. Constant pressure cuts off blood flow, and moisture can break down skin integrity, leading to pressure ulcers (also known as bedsores or decubitus ulcers). These are not merely “rashes”; they are serious wounds that can cause immense pain, lead to severe infections, and drastically reduce quality of life.

The overwhelming consensus in medical and nursing practice is that prevention is not just better than cure—it is the only sustainable strategy. This guide equips you with the fundamental, daily practice that forms the bedrock of prevention: the systematic skin check.

---

Part 1: Understanding the Enemy – What is a Pressure Sore?

A pressure sore is localised damage to the skin and underlying tissue, usually over a bony prominence. It’s caused by prolonged pressure, often combined with shear (dragging forces on the skin) and friction.

The earliest sign is non-blanchable erythema—a red patch that does not turn white when you press it and release. This is a Stage 1 pressure ulcer and your critical warning sign to act.

---

Part 2: The 5-Point Daily Check – A Step-by-Step Routine

Perform this check at the same time each day, ideally during morning care or a change. Ensure the room is well-lit.

1. The Heels and Ankles

Lift each foot clear of the bedding. Look at the back of the heel, the sides, and around the ankle bones. These areas bear tremendous weight and are high-risk.

2. The Tailbone (Sacrum)

This is the single most common site. With your loved one lying on their back, you may need help to gently roll them onto their side. Examine the entire area at the base of the spine. Crucially, ensure this area is kept meticulously dry. Incontinence moisture is a major contributing factor here.

3. The Hips and Sides of the Thighs

Check over the hip bones (the greater trochanters) on both sides. Also, look at the outer thighs. For those who spend time on their sides, these are primary pressure points.

4. The Shoulder Blades and Elbows

When lying on the back, the shoulder blades press down. The elbows can rub against sheets. Check these bony prominences for any redness or grazes.

5. The Back of the Head

Often forgotten, especially for those with limited neck mobility. Gently support the neck and check the occipital area at the back of the skull.

Pro Tip: Use the “finger test.” If you see redness, press the area gently with a finger. If the redness does not blanch (turn white) and then refill with colour, it is a Stage 1 pressure ulcer. Document it and immediately increase preventive measures (e.g., repositioning schedule).

---

Part 3: Beyond the Check – The Complete Prevention Strategy

Checking is only step one. An effective strategy rests on four pillars:

Pressure Redistribution

Reposition your loved one at least every 2 hours. Use pressure-relieving mattresses and cushions.

Skin Care & Moisture Management

Clean skin promptly after soiling. Use gentle pH-balanced cleansers. Pat dry, don’t rub. Apply a moisture barrier cream to protect. This is where your choice of incontinence product is vital. Products designed to minimise moisture regain (rewet) and wick dampness away from the skin, like Zephyrease Care Slips, play a supportive role in a holistic care plan. Remember, regular changes (we recommend every 4–6 hours) are non-negotiable for skin health.

Nutrition and Hydration

Ensure adequate protein, calories, vitamins (especially C & Zinc), and fluid intake. Healthy skin starts from within.

Movement & Circulation

Encourage any possible movement, even passive range-of-motion exercises performed by you.

---

Part 4: Your Free Resource & When to Seek Help

Consistency is key. To help, we’ve created a “Daily Skin Integrity Check & Repositioning Log” for you to download and print.
Download Your Free PDF Checklist Here

Seek immediate professional advice from a nurse or doctor if you notice:

• A persistent non-blanchable red area (Stage 1 ulcer).

• Any broken skin, blisters, or an open wound.

• Signs of infection (increased redness, warmth, swelling, pus, foul odour, or fever).

By making the 5-point check a part of your daily ritual, you are taking the most proactive and powerful step in safeguarding your loved one’s health and comfort.