Pressure Sores in the Elderly: Prevention, Signs, and Care (2026)

ElderHearth offers general information, not medical advice. A deep or open pressure sore needs professional wound care; ask your parent's doctor or a wound-care nurse.

When a parent spends most of the day in a bed or a chair, one of the quiet dangers is the one on their skin. Pressure sores in the elderly (also called bedsores or pressure ulcers) can begin within hours over a bony area, and once the skin opens they are slow, painful, and sometimes dangerous to heal. They are largely preventable, and the prevention is mostly steady, low-tech care a family can give.

What are pressure sores in the elderly?

A pressure sore forms when steady pressure on one spot cuts off blood flow to the skin and the tissue beneath it. Starved of blood, the skin begins to break down. It happens fastest over bony areas where there is little padding: the tailbone and lower back, the hips, the heels, the elbows, the shoulder blades, and the back of the head. Friction (skin dragging on sheets) and moisture make it worse.

The danger is how quickly it starts. In a frail, immobile older adult, the earliest damage can begin in a matter of hours of unrelieved pressure, often before anyone sees an open wound.

Who is most at risk

Pressure sores cluster in a predictable group, and knowing the risk is half of preventing it. The highest risk is a parent who:

• Cannot move or reposition themselves, because they are bedbound, use a wheelchair, or are recovering from surgery or a hip fracture.
• Has poor nutrition or is underweight, which leaves less padding and slower healing.
• Deals with incontinence or moisture, which weakens the skin (see incontinence in the elderly).
• Has thin, fragile skin, diabetes, or poor circulation, which all speed the damage.
• Cannot feel or report discomfort, as with advanced dementia or reduced sensation, so the body's usual "shift your weight" signal is lost.

The early warning signs, and why dark skin needs a closer look

Catching a pressure sore in its first stage is what keeps it from becoming an open wound. Check the bony areas daily and watch for:

• A patch of skin that looks discolored and stays that way when you press it (healthy skin briefly turns pale, then pink again; early pressure damage does not).
• Warmth, firmness, swelling, or tenderness over a bony spot.
• Skin that feels different from the area around it.

One point that gets missed: on darker skin, early pressure damage does not show as red. It may look purple, blue, or darker than the surrounding skin, so rely on warmth, firmness, and pain as much as color. Any of these signs means relieve the pressure on that spot now and watch it closely.

How to prevent pressure sores in the elderly

Prevention is far easier than treatment, and it comes down to a handful of habits done consistently.

• Reposition on a schedule. This is the single most important thing. Shift a bedbound parent's position at least every two hours, and a parent sitting in a chair every 15 minutes to an hour. Set a timer so it actually happens.
• Take the pressure off the surface. A pressure-redistributing mattress or overlay, and a proper wheelchair cushion, spread the load. Medicare may cover a therapeutic support surface as durable medical equipment when it is medically necessary, often alongside a hospital bed.
• Protect the heels and bony points. Heels are especially vulnerable; a pillow under the calves to "float" the heels off the bed helps, as do cushions between the knees and ankles, and a daily look at the feet (see foot care for the elderly) catches heel damage early.
• Keep skin clean and dry. Change and clean promptly after any incontinence, use a barrier cream, and never leave skin damp.
• Feed the skin. Enough protein, calories, and fluids give the skin what it needs to stay intact and to heal. Appetite is often poor, so small, frequent, protein-rich meals matter.
• Reduce friction. Lift rather than drag when repositioning (our guide to lifting a parent safely shows how), keep sheets smooth, and avoid raising the head of the bed higher than needed, which causes sliding.
• Check the skin every day, especially the bony areas, so you catch stage one before it becomes stage two.

What not to do

Two old habits do harm. Do not massage a reddened area over a bony spot; it can worsen the damage to fragile tissue. And do not wait to see if a discolored patch clears on its own while the pressure continues; relieve it and monitor instead.

When to call the doctor

Get medical help for any open sore, blister, or broken skin over a pressure area, and urgently for signs of infection: fever, spreading redness or warmth, pus, a bad smell, or the sore getting rapidly worse. A pressure sore is not just a skin problem; a deep one can reach muscle and bone and lead to a serious, even life-threatening infection. Deep or open sores need professional wound care, so do not try to manage them at home alone.

Frequently Asked Questions

What causes pressure sores in the elderly? Sustained pressure on one spot cuts off blood flow to the skin, usually over bony areas like the tailbone, hips, and heels, and the tissue breaks down. Immobility, poor nutrition, moisture from incontinence, thin skin, and poor circulation all raise the risk.

How often should you reposition someone to prevent bedsores? At least every two hours for a bedbound parent, and every 15 minutes to an hour for someone sitting in a chair. A timer or a written schedule helps make it consistent, which is what actually prevents sores.

How fast do pressure sores develop? Quickly. In a frail, immobile older adult, the earliest skin damage can begin within a few hours of unrelieved pressure, often before an open wound appears, which is why daily skin checks and regular repositioning matter so much.

Can pressure sores be dangerous? Yes. A deep pressure sore can reach muscle and bone and become infected, and that infection can turn serious or life-threatening. This is why prevention and catching them early are so important, and why open sores need professional care.

A last word

Of all the parts of caring for a parent who can no longer move easily, pressure sores in the elderly are among the most preventable, and prevention turns on something small and repeated: the turn of a body every couple of hours, a pillow under the heels, a dry and cared-for skin, a daily look at the places pressure gathers. None of it is dramatic, and most of it never gets noticed, which is exactly the point. The sore that never forms is the quiet proof that someone was paying attention.

If you would like help setting up a care routine for a parent on bed rest, you are welcome to reach out.

Sources

• MedlinePlus, Pressure sores.
• Mayo Clinic, Bedsores (pressure ulcers).
• Agency for Healthcare Research and Quality (AHRQ), Preventing Pressure Ulcers.