A pressure injury can begin quietly: a patch of redness on a heel, a sore area over the tailbone, or skin that feels warmer or firmer than the surrounding area. For a person who spends long periods in bed or sitting in a chair, pressure injury prevention is not an occasional check. It is part of the everyday routine that protects comfort, dignity and independence.
Pressure injuries are sometimes called pressure sores or bedsores. They happen when pressure, friction, shear or moisture damages the skin and underlying tissue. They can develop quickly in people with limited movement, reduced sensation, poor circulation, continence needs or poor nutrition. The reassuring part is that many injuries can be avoided when families and care teams notice risks early and make practical changes that suit the individual.
Who may need extra pressure injury prevention?
Anyone can develop a pressure injury, but risk increases when a person cannot change position easily by themselves. This may be after surgery, during rehabilitation, with frailty or long-term illness, or when living with conditions that affect mobility, sensation or understanding of discomfort.
People with dementia may be at particular risk if they cannot explain that they are uncomfortable, forget to shift their position or become unsettled during personal care. A person who is incontinent may also have fragile skin because prolonged contact with urine or stool can weaken its natural barrier. Thin, dry or bruised skin needs careful handling too.
Pay close attention to bony areas where the body meets a mattress, chair or footwear. These commonly include the heels, ankles, hips, tailbone, elbows, shoulder blades, knees and the back of the head. In a wheelchair or armchair, the buttocks and backs of the thighs also need regular checks.
Start with a realistic daily skin check
A brief skin check is one of the most useful habits in pressure injury prevention. It is usually easiest during washing, dressing, continence care or changing into nightwear. Look for redness, purple or blue discolouration on darker skin tones, swelling, broken skin, blisters, dry cracks, warmth, hardness or complaints of pain and itching.
Do not assume that redness will settle simply because the person has had a rest. Pressing a red area may help a trained professional assess whether it blanches, but it is safer for family carers not to rely on this test alone. If there is persistent discolouration, pain, a blister, an open area or skin that looks unusual, remove pressure from the area and seek advice promptly from a GP, district nurse, tissue viability nurse or another appropriate healthcare professional.
Keep notes if you are concerned. A simple record of when a mark was first seen, where it is and whether it has changed can make clinical assessment quicker and clearer. Avoid rubbing or massaging a sore area, as this can cause more tissue damage.
Repositioning: regular, gentle and personalised
Changing position reduces the time that any one area of skin is under pressure. The right schedule is not identical for everybody. It depends on the person’s mobility, skin condition, comfort, medical needs, mattress, chair and ability to move independently. A nurse or occupational therapist can help create a safe repositioning plan where the risk is higher.
For someone in bed, small position changes may be enough at times: adjusting the head and shoulders, supporting the legs or moving from one side to the other with pillows placed carefully to protect knees and ankles. Heels are especially vulnerable. They should be free from pressure where possible, with support placed under the calves rather than directly beneath the heels.
For someone sitting out, encourage regular weight shifts if they can do so safely. A supportive chair, correctly fitted wheelchair and suitable pressure-relieving cushion can make sitting more comfortable, but no cushion replaces movement and skin checks. If a person slides down in bed or a chair, their skin can be pulled across the surface. This is known as shear and can damage deeper tissue even when the skin initially looks intact.
Use handling aids and ask for support when needed. Dragging a person across bedding, pulling under their arms or making a rushed transfer can cause skin tears and strain both the carer and the person receiving care. Slide sheets, transfer aids, adjustable beds and properly chosen mobility equipment can reduce that effort. Always follow product instructions and professional moving-and-handling guidance.
Make the bed and chair work harder
Comfort is not only about softness. A surface should spread pressure appropriately, support good posture and allow the person to move or be repositioned safely. A pressure-redistributing mattress may be suitable for people at risk, while a higher-specification alternating system may be recommended for some individuals with greater needs. The choice should reflect a clinical assessment, body weight, mobility and whether an injury is already present.
Keep bed linen smooth, dry and free from crumbs, creases or objects such as remote controls. Thick layers of ordinary pillows, folded duvets or makeshift padding can interfere with posture and may increase pressure in unexpected places. Purpose-designed cushions and mattress systems are made for specific care uses, so check dimensions, weight limits, cleaning instructions and compatibility with the bed or chair before use.
Protect skin from moisture, friction and everyday irritation
Continence care is central to skin protection. Prompt changing after episodes, gentle cleansing and careful drying can reduce irritation. Use products intended for delicate skin and follow advice from a continence nurse or pharmacist about barrier creams. Too much of a thick product can make it difficult to assess the skin, so apply only as directed.
Choose clothing and nightwear that are soft, breathable and easy to change. Seams, tight waistbands, rough fastenings and clothing that bunches underneath the body can cause discomfort. Easy-dressing garments can make changes less stressful for a person with reduced mobility and reduce the pulling and twisting that can happen during dressing. For people who remove clothing repeatedly or need support with continence routines, specialist anti-removal designs may help maintain warmth, dignity and a more settled routine when chosen sensitively.
Friction often happens during transfers, dressing and turning. Keep movements slow, explain what you are doing and encourage the person to take part as much as they comfortably can. Even a small amount of independent movement supports circulation, confidence and function.
Food, fluids and comfort are part of skin care
Skin needs nourishment and hydration to stay resilient. A reduced appetite, difficulty swallowing, illness, weight loss or dehydration can all increase risk. Offer drinks regularly if this is safe for the person’s condition, and provide meals and snacks that suit their preferences and dietary plan.
If someone is losing weight without trying, eating very little, coughing during meals or struggling to drink, speak with their GP, nurse, dietitian or speech and language therapist. Nutritional supplements should be used on professional advice rather than as a substitute for assessing the cause of poor intake.
Pain, low mood and tiredness can also make it harder for someone to reposition or engage with care. A person may sit still because standing hurts, because they fear falling or because they do not want to inconvenience anyone. Asking simple questions such as “Are you comfortable here?” and “Would you like to change position?” can reveal needs that are otherwise missed.
When to seek urgent advice
Contact a healthcare professional quickly if you notice broken skin, a blister, a wound, spreading redness, blackened tissue, increasing pain, heat, swelling, discharge or an unpleasant smell. Seek urgent medical help if the person is unwell, feverish, confused or showing signs of infection.
Do not try to treat a suspected pressure injury with home remedies, adhesive dressings chosen at random or pressure-relieving equipment alone. A wound needs the right assessment, and the underlying causes - pressure, moisture, poor nutrition, limited movement or illness - must be addressed together.
A care routine that protects dignity
The most effective routines are usually the ones that fit naturally into the day. Check skin during washing, use comfortable clothing that makes changes easier, keep the chair and bed set-up safe, and build movement into familiar moments such as getting ready for breakfast or settling down for the evening. Share the plan with relatives, visiting carers and care-home staff so that everyone understands what to look for and how the person prefers to be supported.
At Ferrucci Comfort, we believe practical care equipment should make everyday routines feel more manageable, not more clinical. A well-chosen mattress, cushion, mobility aid or easy-dressing garment can support safer care, but the person remains at the centre of every decision. Small, consistent actions can protect not only the skin, but also the comfort and confidence that make home feel like home.
