Bed sores may seem like a small problem in nursing homes and care facilities, but if not treated correctly, they can prove life-threatening. Knowing what causes bed sores is the first step to avoiding them.

In the simplest of terms, bed sores are caused by continuous pressure on a bony part of the body for a long period of time. However, different types of pressure can cause bed sores is different situations, so understanding how they form can be important when trying to avoid them.

The first cause of bed sores is prolonged pressure. People in nursing homes and other care facilities may have limited mobility, meaning they sit or lie in one position for a long period of time. Their positions may put them at risk for developing bed sores and caretakers are trained to regularly move their patients to avoid prolonged pressure.

Although the pressure of sitting doesn’t seem like enough to cause harm, circulation can be endangered when one part of the body experiences too much pressure. The tissue under pressure can become compressed, limited blood flow. With a lack of oxygen and nutrients, pressured skin can die within half a day. Once the top layer dies, damage can spread to the deeper layers of the skin. Bed sores can quickly become life threatening if they spread to deeper tissue layers and cause infection.

Areas at risk for pressure-induced bed sores are typically those with little muscle or fat. These areas include the spine, tailbone, shoulder blades, hips, heels, elbows, toes, and ankles.

The second cause of bed sores is shear. Shear is defined as two surfaces moving in opposite directions against each other. This can happen to the body during changes in position if skin is pulled one way while the bulk of the body or limb is moving in another direction. Another common cause of shear happens when patients are laying elevated on a bed or sitting in a chair. If a patient slides down a bed or chair, the shear can jeopardize the blood flow to the shoulder blades or tailbone.

To avoid shear-induced bed sores, patients should be kept laying at 30 degrees or lower and be repositioned as needed.

The third cause of bed sores is friction. Friction can occur in nursing home patients when their older, fragile skin rubs against clothing or bedding. When delicate skin is subject to excess friction, circulation can be compromised, and bed sores can form.

Friction-induced bed sores can be avoided by protecting the skin from friction. This can be done by repositioning patients with limited mobility as well as caring for the skin. Talcum powder may protect the skin from becoming too moist, a condition which may lead to excess friction. Sheepskin boots may also be helpful to protect the heels from friction and elbow pads can be used to protect the elbows. Finally, caretakers should be sure to keep bedding and clothing clean from any debris, particles, or folds which may cause friction.

On paper, steps to prevent bed sores may seem overwhelming and unmanageable. However, bed sores are almost always preventable, so their development may be a sign of neglect. If a patient isn’t experiencing a high quality of care, bed sores may be an indicator. If you suspect that a loved one is not receiving the proper care and is developing bed sores, you may be able to contact a qualified attorney to consider legal action.