Tips to Prevent Bed Sores for Hospice Patients

When someone you love spends most of the day in bed, you start to see things you never thought about before. A sheet bunches under a hip. Maybe a heel has pressed into the mattress for too long. No one told you that skin needs as much looking after as pills and meals do, and it can feel like one more job in a day that is too full.

Here is the plain answer. Bed sores form when weight stays on one spot too long, and they can start in a few hours. Turning your loved one often and checking their skin each day stop most of them. You can learn how, and your hospice team will show you. This page walks through each step.

What Causes Bed Sores?

Weight and friction. When a body rests on one spot, blood has a hard time reaching the skin there, and the skin starts to break down. Sliding across sheets pulls at the skin and makes it worse. Skin that is thin or damp gives way sooner. Sores often start where bone sits close under the skin.

Where Do Bed Sores Form Most Often?

On the back, the tailbone and the heels take the most weight. On the side, the hips and the elbows do. Shoulder blades and the back of the head are easy to forget. Clothes and sheets can hide a new sore, so look at all of these spots and not just the ones in plain view.

How Often Should You Turn Someone in Bed?

Many care plans set turns about two hours apart, but your hospice nurse will set a schedule that fits your loved one. If pain or sleep gets in the way, the nurse may change the plan so comfort comes first. Small shifts count too. A pillow tucked behind the back or a slight tilt to one side can take weight off a sore spot.

What Is the Safest Way to Turn Someone?

Ask the nurse to show you in person. The main rule is to lift and not drag, because sliding pulls on the skin. A folded sheet under your loved one lets you move them as one. Aim for a gentle tilt on the side, about halfway between flat on the back and flat on the hip, with a pillow behind the back and one between the knees. Bend your own knees and keep your back straight. Keep the head of the bed low when you can, since sitting up tall lets the body slide down the mattress. If your loved one is in pain when they move, tell the nurse before the next turn, because pain relief can be timed to help.

How Do You Keep Heels Safe?

Heels have very little padding. Slide a pillow lengthwise under the calves so the heels float free of the bed. Ask your nurse about soft boots made for this. Skip the ring shaped cushions that look like doughnuts, since they can press hard on the skin around the ring.

What Supplies Help?

Good pillows and special cushions make turning easier and keep weight off bony spots. Many teams also bring a special mattress that spreads weight out, so ask about one early. Renting a hospital bed (many times this is covered by insurance) can also help by allowing you to reposition your loved one to distribute their weight differently throughout the day.

How Do You Keep Skin Clean and Dry?

Wash with mild soap and warm water, then pat dry. Rubbing hurts thin skin. Change damp sheets and clothes right away, and ask your nurse about a barrier cream if wetness is a problem, since incontinence can wear skin down fast. Cotton sheets and clothes breathe well. Smooth out wrinkles and brush away crumbs, because a small fold can leave a mark. Keep the room from getting too warm so your loved one does not sweat. Do not rub or massage a red spot. Rubbing can hurt skin that is under stress.

How Do You Check Skin Each Day?

Pick a set time, such as bath time or when you change clothes. Look at each bony spot and gently feel it. Look for a red patch that stays red after you press it lightly and let go. Skin that feels warmer or firmer than the skin around it is a sign too. A blister or an open spot needs the nurse that day.

What Should You Do If You Find a Bed Sore?

Take weight off the spot right away by turning your loved one to the other side. Call the nurse the same day. Do not pop a blister or put creams from home on the skin. The nurse will clean and cover the sore, and may change the turning plan or bring new supplies. Early sores heal much faster than late ones.

Can Bed Sores Happen Even When You Do It All Right?

Yes. Near the end of life, the body slows down, eating and drinking drop, and skin gets thin. A sore can show up even with careful care. If it does, it tells you about the illness and nothing about your effort. Eating less at this stage is normal, so there is no need to push food. Your nurse can talk with you about what helps.

Who Do You Call With Questions?

Call your hospice nurse about any change in the skin or any new pain, and about any turn that feels unsafe. The nurse can also suggest creams and pillows, plus ways to move your loved one that are safe for you both. No question about skin is too small to ask.