Caregivers & Loved Ones Risk Factors for Pressure Ulcers By Angela Morrow, RN Angela Morrow, RN LinkedIn Angela Morrow, RN, BSN, CHPN, is a certified hospice and palliative care nurse. Learn about our editorial process Updated on December 11, 2020 Medically reviewed Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Luis Cordero, MD Medically reviewed by Luis Cordero, MD Luis Cordero, MD, is a physician advisor at Dallas Veteran Affairs Medical Center and is board-certified in internal medicine. Learn about our Medical Expert Board Fact checked Verywell Health content is rigorously reviewed by a team of qualified and experienced fact checkers. Fact checkers review articles for factual accuracy, relevance, and timeliness. We rely on the most current and reputable sources, which are cited in the text and listed at the bottom of each article. Content is fact checked after it has been edited and before publication. Learn more. by Marley Hall Fact checked by Marley Hall LinkedIn Marley Hall is a writer and fact checker who is certified in clinical and translational research. Her work has been published in medical journals in the field of surgery, and she has received numerous awards for publication in education. Learn about our editorial process Print There are several risk factors for pressure ulcers, the skin sores that typically develop over bony areas, such as the lower spine, hips, and elbows. Also known as bedsores, pressure ulcers are a common problem for palliative care patients as mobility decreases and patients spend more time in bed. Pressure ulcers are painful and can be difficult to treat. Preventing pressure ulcers is critical to maintaining comfort and treating them promptly is essential. But how do you know if your loved one is at risk of developing one? Should you be concerned? Yellow Dog Productions / Getty Images Immobility People at the greatest risk of developing pressure ulcers are those who are immobile. Once a person loses the ability to move and becomes inactive, the risk of developing bedsores increases. Sensory Loss Patients who have experienced loss of sensation as the result of spinal cord injury or neurological disease have an increased risk of developing pressure ulcers. A person without sensory loss can feel pain and will generally feel uncomfortable after spending a lot of time in one position. When the sensory loss occurs, a person may not feel uncomfortable or the need to be repositioned. Changes in Mental Status Likewise, a person with an altered level of consciousness may not feel discomfort or may not be awake enough to physically reposition themselves if they do. Shear Shear is the rubbing of skin and fatty tissues across bones, and it is caused by the combination of gravity and friction. Shear most commonly occurs when a patient is lying with the head of the bed raised. The person’s skeleton may slide down in the bed while the skin and fatty tissues stay in place. This type of force causes damage to the underlying blood vessels, resulting in ulcers with a large area of internal tissue damage and less noticeable damage at the surface of the skin. Friction Friction occurs when two surfaces move across one another. Friction decreases the skin's tolerance to pressure by causing abrasions and compounds the effect of shear. This can happen when a patient slides down in bed or is repositioned in bed the wrong way. Moisture Moisture is a common problem in people who have become incontinent and have to wear diapers. Moisture from sweat can also be a problem. Moisture removes oils from the skin that normally act to protect it and softens the skin’s connective tissues, making the effects of shear and friction more damaging. Incontinence As above, incontinence of bowel movements and urine create moisture on the skin and increase the risk of breakdown. Fecal incontinence has the added risk of damage to the skin from bacteria and enzymes in the stool and also increases the risk of infection. Poor Nutrition Poor nutrition can lead to weight loss which can then increase the pressure on bony areas of the body. Proper nutrition is also important to the healing of pressure ulcers. Age As a person ages, the skin becomes thinner and more fragile, increasing the risk of skin breakdown. If your loved one has any of these risk factors, it's important for you to take steps to prevent a pressure ulcer from developing. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit 2 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Sprigle S, McNair D, Sonenblum S. Pressure ulcer risk factors in persons with mobility-related disabilities. Adv Skin Wound Care. 2020 Mar;33(3):146-154. doi: 10.1097/01.ASW.0000653152.36482.7d Gillespie BM, Walker RM, Latimer SL, Thalib L, Whitty JA, McInnes E, Chaboyer WP. Repositioning for pressure injury prevention in adults. Cochrane Database Syst Rev. 2020 Jun 2;6(6):CD009958. doi:10.1002/14651858.CD009958.pub3