How do I prevent bed sores when my parent is in bed or a chair?

Why this is so important

After her fall, Roberta could move around far less. That is when a second danger shows up: pressure sores. A pressure sore is damage to skin and tissue from staying in one position too long. It is also called a bed sore or pressure injury. It most often forms over a bony spot like the tailbone, hips, or heels.

They matter because they are one of the most common paths from a fall to the hospital. An open sore can get infected, and that infection can turn serious fast. The hard truth, and the hopeful one, is that most pressure sores can be prevented with steady, everyday care.

Don't wait for the skin to break

The biggest mistake is waiting until there's an open wound. The first warning sign is a patch of skin that looks red or discolored and does not turn pale when you press it. On darker skin it may look purple or feel warmer, cooler, firmer, or more tender than the skin around it. That is the moment to act — not after the skin opens.

Check the skin at least once a day, more if the person can't move much. Look closely at the tailbone, hips, heels, ankles, shoulder blades, and the back of the head. If you see a spot that won't fade, keep pressure off it and tell the doctor or nurse right away.

The daily basics that prevent them

Change their position often. No one schedule fits everyone. How often depends on how well the person can move, how their skin responds, their health, their comfort, and what they lie or sit on. Ask the care team to set a repositioning schedule for this person. Ask them to change it based on how the skin looks over time. What matters is that pressure is relieved often and never builds up in one spot. Small changes count. Use a pillow to tilt the hips. Float the heels off the mattress with a pillow under the calves, so the heels touch nothing.

Keep skin clean and dry, and manage any moisture from sweat or incontinence quickly, because damp skin breaks down faster. Support good nutrition and fluids — skin needs protein and water to stay intact and to heal. And avoid dragging the person across the sheets, which shears the skin; lift or use a slide sheet instead.

Ask the care team for a wound-care nurse or a skin-care plan early. You do not have to wait for a problem to ask for prevention.

The right mattress — and how to advocate for it

A regular mattress puts pressure on bony spots. Special mattresses and pads spread that pressure out. Medicare covers them as medical equipment in three levels, called groups. The group is matched to the person's risk and to any sore they already have.

Group 1 is a basic foam or gel pad or mattress for someone at risk. Group 2 is powered. It is an alternating-pressure or low-air-loss mattress, for higher risk or for sores that already exist. Group 3 is an air-fluidized bed. It is only for someone who is bedridden with an advanced (stage 3 or 4) sore. It is only covered after a month of other treatment hasn't worked. It usually needs approval from Medicare first.

This is where speaking up matters. Medicare does not cover the powered mattresses automatically. The doctor or wound-care nurse has to write down the risk or the sore, and why a basic surface isn't enough. Ask them directly: which group fits this person's movement and skin, and will you write that down? Don't accept a standard mattress for someone who stays in bed. The right surface, asked for early and written up well, is one of the most helpful things you can do.

Checklist

• Check the skin daily — tailbone, hips, heels, ankles, shoulders, back of head.
• Treat non-fading redness as an alarm; keep all pressure off that spot.
• Ask the care team to set a repositioning schedule for this person — and adjust it based on how the skin responds.
• Float the heels off the mattress with a pillow under the calves.
• Keep skin clean and dry; manage moisture and incontinence quickly.
• Support protein and fluids — skin needs both to stay intact.
• Ask for a wound-care nurse and a skin plan before there's a problem.
• Ask the doctor which pressure-mattress group fits — and to document it.

Common questions