What First-Time Caregivers Should Know About Bedsores

Bedsores, also known as pressure sores, are the most common kind of skin ulcers in Singapore. As many as 183 per 100,000 people in Singapore suffer from bedsores. In most cases, bedsores are often seen in those who are bedridden or sit in wheelchairs for long periods of time.

For first-time caregivers, bedsores can seem like quite a daunting challenge without proper knowledge about wound care and ways to reduce your loved one’s risk of getting these pressure injuries. Here’s where our Homage guide to bed sores for first-time caregivers comes in handy — read on and learn more.

What are bedsores?

Bedsores, also known as pressure ulcers, are injuries to the skin and underlying tissues that occur due to prolonged pressure, friction, or shearing forces. They usually develop over bony areas such as the hips, heels, and tailbone, and can range from mild redness to deep tissue damage. Bedsores are classified into four stages based on the severity of tissue damage:

• Stage 1: In this stage, the skin has not broken and appears red, blue or black. It also does not blanch (turn white) when pressed. The affected area may feel warm, tender, or itchy.
• Stage 2: In this stage, the outer layer of the skin breaks down, forming a shallow, open sore or blister. The surrounding skin may be red, swollen, or tender.
• Stage 3: The pressure sore extends through the full thickness of the skin and into the underlying tissues, such as muscle or fat. The wound may appear as a deep crater with a foul odour.
• Stage 4: The pressure sore extends through all layers of the skin and into the underlying tissues, including muscle, bone, and tendons. The wound may expose bone or other structures and can lead to serious complications such as infections or osteomyelitis (bone infection).

What causes bedsores?

Bedsores develop due to prolonged pressure exerted on the skin and underlying tissues, which reduces blood flow and oxygen supply to the area. This can be caused by a variety of factors, including:

1. Pressure

Prolonged pressure on bony areas such as the hips, heels, and tailbone can cause blood in the area to be pressed out. Over time, it can lead to tissue damage.

2. Friction

Rubbing or friction against the skin, especially when combined with moisture, can cause the layers of the skin to break down.

3. Shearing

Shearing happens when the skin is dragged and pulled on the surface, causing blood vessels to stretch and tear over time.

When a person is not positioned properly and is unable to adjust their own resting position, they may begin sliding down from their pillow or headrest while lying down.

Signs of bedsores

As bedsores happen due to pressure, these injuries happen on different parts of the body depending on how your loved one is positioned.

Source: Healthhub

Here are some signs of bedsores you can watch out for:

For wheelchair users or those who sit for long periods of time:

• Shoulder blades
• Elbow
• Tailbone
• Buttocks
• Heels
• Balls of the foot

For those who lie down for a long period of time:

• Back of head
• Shoulder blades
• Elbow
• Tailbone
• Buttocks
• Heels

What are the signs of an infection?

Bedsores can get infected if the wound is exposed to bacteria or if it is not cleaned properly. Some symptoms of infected bedsores include:

• Foul-smelling pus
• Redness and warmness at the site of the bed sore
• Swelling around the wound
• A fever
• Chills

What can you do to help prevent bedsores?

As bedsores can lead to severe complications and may require hospitalisation or skin grafts, preventing bedsores is crucial. Here are things you can do to help with preventing bedsores.

1. Turn your loved one often

If your loved one is lying down, turning them every 2 hours can help redistribute pressure and prevent the development of bedsores.

2. Ensure that your loved one is resting in a comfortable position

Keeping your loved one’s head raised only at a 30-degree angle, rather than on a higher incline, can also help to reduce pressure on their necks, as well as the skin and underlying tissues on the rest of their body.

For those who are lying on their sides, using soft pillows that you have around the home to provide cushioning between your loved one’s knees and ankles can help minimize discomfort.

As for wheelchair users, a soft cushion can help to reduce pressure on the buttocks and the tailbone.

3. Keep your loved one’s skin clean 

If your loved one’s skin has been in contact with urine or faecal matter, it is important for you to help them clean up as soon as possible. You may do so by wiping their skin with a clean towel and warm water or a disposable wet wipe.

Controlling moisture is also important for preventing other skin conditions, such as irritation, ringworm, and skin infections, from happening. Do dry your loved one’s skin well after sponging them or helping them with their showers.

4. Inspect your loved one’s skin at least once a day

Incorporating a thorough check of your loved one’s skin condition can be helpful. A convenient time to do so might be during a shower, or when you are helping them to get dressed.

If you spot potential bedsores or those that are just beginning to form, do seek help from a doctor immediately. With early intervention, you can reduce the likelihood of your loved one’s bedsores worsening.

5. Use soft and absorbent fabrics for your loved one’s bedlinen and clothes

Using bedlinen and blankets made of absorbent fabric, such as 100% cotton, may make a difference in how comfortable your loved one feels.

Additionally, wearing soft and loose clothing can also reduce skin chafing and help with bedsore prevention.

What should I do if my loved one has a bedsore?

If your loved one already has bedsores, it’s important to seek medical attention right away.

Treatment may involve cleaning and dressing the wound, as well as using antibiotics or other medications to prevent infection.

In some cases, where the bedsores are severe, surgery may be necessary to remove dead tissue, close up the wound site, and promote better healing.

Equipment that can help prevent bedsores

The best thing to do for your loved ones is of course to help them prevent getting bedsores in the first place. While you can make use of what you have around your house to help your loved one feel more comfortable, you can also consider purchasing the following equipment:

1. Support Wedges

Using support wedges, which are usually triangular-shaped pillows, can help alleviate pressure and friction, especially for those who are bedridden or lying down. 

2. Pressure Relief Air Mattresses

Pressure relief air mattresses can also help to alleviate pressure and friction on body parts when immobile for long periods of time. These air mattresses, which have air pockets, can better distribute your loved one’s body weight.

This mattress can make lying down more comfortable for those who have stage 1 or stage 2 bedsores.

Additionally, you may rent electric beds with alternating pressure relief mattresses from hospitals or stores instead of purchasing them.

Price range: $100-$454 (Estimated)

Where to buy: Shopee | Lazada |

Where to rent: Easy Wheels | Medpro

3. Ankle, Heel, and Elbow Protectors

Certain areas of the body, such as our ankles and elbows, are more susceptible to pressure injuries. Cushioned protectors that can be attached to your loved one’s body can reduce the pressure placed on these specific body parts. If your loved one already has a wound on these areas, these can also be helpful in relieving their discomfort and pain, protecting their injury sites from chafing or further pressure.

Price range: Around $5-$20 

Where to buy: Shopee | Lazada 

We hope that this guide has been helpful for you to learn more about bedsores, especially if you have a loved one who is suffering from them. 

Caregiving can be difficult, but it doesn’t have to be a journey that you take on on your own. Our trained Care Pros, which includes local caregivers and trained nurses, can lend a hand, including your loved one’s night care needs and giving you a break with respite care. If you need assistance, our Care Advisory Team are always available to help you with your queries.