{"id":8993,"date":"2026-10-15T12:12:34","date_gmt":"2026-10-15T16:12:34","guid":{"rendered":"https:\/\/carepatrol.com\/baltimore\/?p=8993"},"modified":"2026-10-15T18:06:55","modified_gmt":"2026-10-15T22:06:55","slug":"preventing-treating-pressure-ulcers-a-clinically-grounded-guide-for-caregivers","status":"publish","type":"post","link":"https:\/\/carepatrol.com\/baltimore\/preventing-treating-pressure-ulcers-a-clinically-grounded-guide-for-caregivers\/","title":{"rendered":"Preventing and Treating Pressure Ulcers: A Clinically Grounded Guide for Caregivers"},"content":{"rendered":"<h2><em>CarePatrol of Baltimore | Protecting Seniors Through Better Care<\/em><\/h2>\n<p><em>By Paula Sotir<\/em><\/p>\n<p>Pressure ulcers\u2014also known as pressure injuries or bedsores\u2014affect more than <strong>2.5 million Americans each year<\/strong> (Agency for Healthcare Research and Quality [AHRQ], n.d.). These wounds can develop quickly, especially in older adults with limited mobility, and may lead to serious complications such as infection, hospitalization, and decreased quality of life (National Institutes of Health [NIH], n.d.).<\/p>\n<p>Pressure injuries can develop quickly and are largely preventable. Early action protects residents and maintains COMAR compliance.<\/p>\n<p>The good news: <strong>Most pressure ulcers are preventable<\/strong> with consistent, evidence\u2011based care.<\/p>\n<h2><strong>\u00a0Why Pressure Ulcers Matter<\/strong><\/h2>\n<p>Pressure ulcers occur when prolonged pressure reduces blood flow to the skin and underlying tissue. The National Pressure Injury Advisory Panel (NPIAP) notes that injuries can develop in <strong>as little as two hours<\/strong> when pressure is not relieved (NPIAP, n.d.). Pressure ulcers are a source of pain and potential infection. Prevention and management are important for healthy outcomes.<\/p>\n<p>Understanding early detection and prevention methods are essential for caregivers.<\/p>\n<h3><strong>SECTION 1: Evidence\u2011Based Pressure Ulcer Prevention<\/strong><\/h3>\n<ol>\n<li>\n<h4><strong> Repositioning: The Most Important Strategy<\/strong><\/h4>\n<\/li>\n<\/ol>\n<p>Turn every 2 hours (bed). Reposition every 1 hour (chair). Float heels at ALL times.<\/p>\n<p>This aligns with national clinical guidance:<\/p>\n<ul>\n<li>Repositioning every <strong>2 hours<\/strong> reduces pressure injury incidence in bed\u2011bound patients (NIH, n.d.).<\/li>\n<li>Wheelchair users should shift weight <strong>every 15\u201330 minutes<\/strong> (NPIAP, n.d.).<\/li>\n<\/ul>\n<p><strong>Caregiver actions:<\/strong><\/p>\n<ul>\n<li>Use pillows or wedges to offload bony areas.<\/li>\n<li>Keep heels elevated (\u201cfloating\u201d).<\/li>\n<li>Avoid positioning directly on reddened skin.<\/li>\n<\/ul>\n<ol start=\"2\">\n<li>\n<h4><strong> Daily Skin Checks<\/strong><\/h4>\n<\/li>\n<\/ol>\n<p>Johns Hopkins Medicine recommends <strong>daily skin inspection<\/strong> for at\u2011risk individuals (Johns Hopkins Medicine, n.d.). New redness or wound\u2026 worsening condition\u2026 signs of infection should be reported.<\/p>\n<p>Look for:<\/p>\n<ul>\n<li>Non\u2011blanchable redness<\/li>\n<li>Warm, cool, firm, or boggy areas<\/li>\n<li>Blisters or skin breakdown<\/li>\n<li>Purple or dark areas (especially in darker skin tones)<\/li>\n<\/ul>\n<ol start=\"3\">\n<li>\n<h4><strong> Moisture &amp; Incontinence Management<\/strong><\/h4>\n<\/li>\n<\/ol>\n<p>Moisture weakens skin and increases friction. Moisture\u2011associated skin damage significantly increases pressure injury risk (Lachenbruch et al., 2016).<\/p>\n<p>Best practices:<\/p>\n<ul>\n<li>Cleanse gently with pH\u2011balanced cleansers.<\/li>\n<li>Pat dry\u2014never rub.<\/li>\n<li>Apply moisture\u2011barrier creams.<\/li>\n<li>Use breathable incontinence products.<\/li>\n<\/ul>\n<ol start=\"4\">\n<li>\n<h4><strong> Nutrition &amp; Hydration<\/strong><\/h4>\n<\/li>\n<\/ol>\n<p>Adequate nutrition is essential for skin integrity and wound healing. The Mayo Clinic and Cleveland Clinic emphasize protein, hydration, and micronutrients (Mayo Clinic, n.d.; Cleveland Clinic, n.d.).<\/p>\n<p>Evidence shows:<\/p>\n<ul>\n<li>Protein intake of <strong>1.25\u20131.5 g\/kg\/day<\/strong> supports wound healing (Cereda et al., 2015).<\/li>\n<li>Vitamins A, C, E, and zinc aid tissue repair.<\/li>\n<\/ul>\n<p>Encourage:<\/p>\n<ul>\n<li>Lean proteins<\/li>\n<li>Hydration<\/li>\n<li>Fruits and vegetables rich in antioxidants<\/li>\n<\/ul>\n<ol start=\"5\">\n<li>\n<h4><strong> Support Surfaces<\/strong><\/h4>\n<\/li>\n<\/ol>\n<p>AHRQ recommends pressure\u2011redistributing surfaces for high\u2011risk individuals (AHRQ, n.d.).<\/p>\n<p>Examples:<\/p>\n<ul>\n<li>Alternating\u2011pressure mattresses<\/li>\n<li>Medical\u2011grade foam overlays<\/li>\n<li>Gel or foam wheelchair cushions<\/li>\n<\/ul>\n<p>These reduce pressure but <strong>do not replace repositioning<\/strong>.<\/p>\n<ol start=\"6\">\n<li><strong> Avoid Friction &amp; Shear<\/strong><\/li>\n<\/ol>\n<p>Shear occurs when deeper tissues slide while the skin stays in place. NIH guidance recommends keeping the head of the bed at <strong>\u226430 degrees<\/strong> unless medically necessary (NIH, n.d.).<\/p>\n<p>Prevent shear by:<\/p>\n<ul>\n<li>Using draw sheets<\/li>\n<li>Avoiding dragging during transfers<\/li>\n<li>Maintaining proper bed positioning<\/li>\n<\/ul>\n<h3><strong>SECTION 2: Treating Pressure Ulcers When They Form<\/strong><\/h3>\n<p>Documentation must reflect changes in condition, interventions implemented, and the resident\u2019s response to treatment.<\/p>\n<ol>\n<li>\n<h4><strong> Stage the Wound Correctly<\/strong><\/h4>\n<\/li>\n<\/ol>\n<p>NPIAP\u2019s staging system is the national standard (NPIAP, n.d.):<\/p>\n<ul>\n<li><strong>Stage 1:<\/strong> Non\u2011blanchable redness<\/li>\n<li><strong>Stage 2:<\/strong> Partial\u2011thickness skin loss<\/li>\n<li><strong>Stage 3:<\/strong> Full\u2011thickness skin loss<\/li>\n<li><strong>Stage 4:<\/strong> Exposed bone, muscle, or tendon<\/li>\n<\/ul>\n<p>Accurate staging guides treatment and regulatory compliance.<\/p>\n<ol start=\"2\">\n<li>\n<h4><strong> Cleanse the Wound Properly<\/strong><\/h4>\n<\/li>\n<\/ol>\n<p>NIH wound\u2011care guidelines recommend:<\/p>\n<ul>\n<li>Cleansing with <strong>normal saline<\/strong><\/li>\n<li>Avoiding cytotoxic agents unless directed by a clinician (NIH, n.d.)<\/li>\n<\/ul>\n<ol start=\"3\">\n<li>\n<h4><strong> Use Appropriate Dressings<\/strong><\/h4>\n<\/li>\n<\/ol>\n<p>Modern dressings maintain moisture balance and protect the wound.<\/p>\n<p>Evidence\u2011based options include:<\/p>\n<ul>\n<li>Hydrocolloid (minimal drainage)<\/li>\n<li>Foam (moderate drainage)<\/li>\n<li>Alginate or hydrofiber (heavy drainage)<\/li>\n<li>Antimicrobial dressings (infection risk)<\/li>\n<\/ul>\n<ol start=\"4\">\n<li>\n<h4><strong> Offload the Area Completely<\/strong><\/h4>\n<\/li>\n<\/ol>\n<p>Do NOT lay on red areas.<\/p>\n<p>Healing cannot occur if pressure continues.<\/p>\n<ol start=\"5\">\n<li>\n<h4><strong> Monitor &amp; Document Progress<\/strong><\/h4>\n<\/li>\n<\/ol>\n<p>A COMAR\u2011aligned process includes:<\/p>\n<p>Measurements (L x W x D)\u2026 drainage\u2026 tissue type\u2026 periwound skin\u2026 pain\u2026 improving\/stable\/worsening.<\/p>\n<p>Residents and facilities are protected when documentation is consistent. Progress notes should clearly indicate whether the wound is improving, declining, or stable. Clinicians should compare current findings to prior assessments.<\/p>\n<p>Indicators of improvement include reduction in size, increased granulation tissue, decreased drainage, and intact surrounding skin.<\/p>\n<p>Indicators of decline include increased size, necrotic tissue, worsening drainage, or signs of infection.<\/p>\n<ol start=\"6\">\n<li>\n<h4><strong> Know When to Refer<\/strong><\/h4>\n<\/li>\n<\/ol>\n<p>Refer early and often to prevent progression and maintain compliance.<\/p>\n<p>Refer to wound\u2011care specialists if:<\/p>\n<ul>\n<li>The wound worsens<\/li>\n<li>Drainage increases<\/li>\n<li>Odor develops<\/li>\n<li>Signs of infection appear<\/li>\n<li>Healing stalls<\/li>\n<\/ul>\n<p><em>Early referral improves outcomes <\/em>(Thomas, 2006).<\/p>\n<h3><strong>SECTION 3: Practical Tips for Caregivers<\/strong><\/h3>\n<p>\u2714 Keep linens dry and wrinkle\u2011free \u2714 Avoid tight clothing or thick seams \u2714 Use a turning schedule \u2714 Communicate changes immediately \u2714 Document every wound assessment \u2714 Engage in ongoing caregiver training.<\/p>\n<h3><strong>SECTION 4: How CarePatrol of Baltimore Helps<\/strong><\/h3>\n<p>CarePatrol of Baltimore helps families identify senior living communities that:<\/p>\n<ul>\n<li>Follow evidence\u2011based pressure\u2011injury prevention protocols<\/li>\n<li>Maintain strong COMAR\u2011aligned documentation<\/li>\n<li>Provide consistent repositioning and offloading<\/li>\n<li>Train staff to recognize early signs of skin breakdown<\/li>\n<li>Collaborate with specialized wound\u2011care providers<\/li>\n<\/ul>\n<p>Our mission is to ensure your loved one receives safe, proactive care\u2014because <strong>aging well means healing well<\/strong>.<\/p>\n<p>Save our <a href=\"https:\/\/carepatrol.com\/baltimore\/%f0%9f%a7%a1-caregiver-checklist-preventing-wounds-in-older-adults\/\">Caregiver Checklist: Preventing Wounds In Older Adults\u00a0<\/a><\/p>\n<h3><\/h3>\n<h3><strong>\u00a0Reference List<\/strong><\/h3>\n<p><strong>Government &amp; National Agencies<\/strong> Agency for Healthcare Research and Quality. (n.d.). <em>Preventing pressure ulcers in hospitals.<\/em> https:\/\/www.ahrq.gov\/patient-safety\/settings\/hospital\/resource\/pressureulcer\/index.html <a href=\"https:\/\/www.bing.com\/search?q=%22https%3A%2F%2Fwww.ahrq.gov%2Fpatient-safety%2Fsettings%2Fhospital%2Fresource%2Fpressureulcer%2Findex.html%22&amp;utm_source=copilot.com\" target=\"_blank\" rel=\"noopener\">(ahrq.gov in Bing)<\/a><\/p>\n<p>Centers for Disease Control and Prevention. (n.d.). <em>Skin care and pressure injury prevention.<\/em> <a href=\"https:\/\/www.cdc.gov\/?utm_source=copilot.com\" target=\"_blank\" rel=\"noopener\">https:\/\/www.cdc.gov<\/a><\/p>\n<p>National Institutes of Health. (n.d.). <em>Pressure ulcers.<\/em> https:\/\/medlineplus.gov\/pressureulcers.html <a href=\"https:\/\/www.bing.com\/search?q=%22https%3A%2F%2Fmedlineplus.gov%2Fpressureulcers.html%22&amp;utm_source=copilot.com\" target=\"_blank\" rel=\"noopener\">(medlineplus.gov in Bing)<\/a><\/p>\n<p>National Pressure Injury Advisory Panel. (n.d.). <em>Pressure injury staging.<\/em> https:\/\/npiap.com\/page\/PressureInjuryStages <a href=\"https:\/\/www.bing.com\/search?q=%22https%3A%2F%2Fnpiap.com%2Fpage%2FPressureInjuryStages%22&amp;utm_source=copilot.com\" target=\"_blank\" rel=\"noopener\">(npiap.com in Bing)<\/a><\/p>\n<p><strong>Major Research Hospitals<\/strong><\/p>\n<p>Cleveland Clinic. (n.d.). <em>Pressure ulcers.<\/em> https:\/\/my.clevelandclinic.org\/health\/diseases\/15106-pressure-ulcers <a href=\"https:\/\/www.bing.com\/search?q=%22https%3A%2F%2Fmy.clevelandclinic.org%2Fhealth%2Fdiseases%2F15106-pressure-ulcers%22&amp;utm_source=copilot.com\" target=\"_blank\" rel=\"noopener\">(my.clevelandclinic.org in Bing)<\/a><\/p>\n<p>Johns Hopkins Medicine. (n.d.). <em>Pressure sores.<\/em> https:\/\/www.hopkinsmedicine.org\/health\/conditions-and-diseases\/pressure-sores <a href=\"https:\/\/www.bing.com\/search?q=%22https%3A%2F%2Fwww.hopkinsmedicine.org%2Fhealth%2Fconditions-and-diseases%2Fpressure-sores%22&amp;utm_source=copilot.com\" target=\"_blank\" rel=\"noopener\">(hopkinsmedicine.org in Bing)<\/a><\/p>\n<p>Mayo Clinic. (n.d.). <em>Bedsores (pressure ulcers).<\/em> https:\/\/www.mayoclinic.org\/diseases-conditions\/bed-sores\/symptoms-causes\/syc-20355893 <a href=\"https:\/\/www.bing.com\/search?q=%22https%3A%2F%2Fwww.mayoclinic.org%2Fdiseases-conditions%2Fbed-sores%2Fsymptoms-causes%2Fsyc-20355893%22&amp;utm_source=copilot.com\" target=\"_blank\" rel=\"noopener\">(mayoclinic.org in Bing)<\/a><\/p>\n<p><strong>Peer\u2011Reviewed Journals<\/strong><\/p>\n<p>Cereda, E., et al. (2015). Efficacy of nutritional interventions for pressure ulcer healing. <em>Annals of Internal Medicine.<\/em> https:\/\/pubmed.ncbi.nlm.nih.gov\/25984843\/ <a href=\"https:\/\/www.bing.com\/search?q=%22https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F25984843%2F%22&amp;utm_source=copilot.com\" target=\"_blank\" rel=\"noopener\">(pubmed.ncbi.nlm.nih.gov in Bing)<\/a><\/p>\n<p>Lachenbruch, C., et al. (2016). Moisture and pressure ulcers: A systematic review. <em>Journal of Wound, Ostomy &amp; Continence Nursing.<\/em> https:\/\/pubmed.ncbi.nlm.nih.gov\/26808392\/ <a href=\"https:\/\/www.bing.com\/search?q=%22https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F26808392%2F%22&amp;utm_source=copilot.com\" target=\"_blank\" rel=\"noopener\">(pubmed.ncbi.nlm.nih.gov in Bing)<\/a><\/p>\n<p>Thomas, D. (2006). Prevention and treatment of pressure ulcers: What works? <em>Journal of the American Medical Directors Association.<\/em> https:\/\/pubmed.ncbi.nlm.nih.gov\/16413476\/ <a href=\"https:\/\/www.bing.com\/search?q=%22https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F16413476%2F%22&amp;utm_source=copilot.com\" target=\"_blank\" rel=\"noopener\">(pubmed.ncbi.nlm.nih.gov in Bing)<\/a><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>CarePatrol of Baltimore | Protecting Seniors Through Better Care By Paula Sotir Pressure ulcers\u2014also known as pressure injuries or bedsores\u2014affect more than 2.5 million Americans each year (Agency for Healthcare Research and Quality [AHRQ], n.d.). These wounds can develop quickly, especially in older adults with limited mobility, and may lead to serious complications such as&hellip;<\/p>\n","protected":false},"author":210,"featured_media":8994,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"categories":[10,51,24,12,11,9,1,78],"tags":[42,25,26,22,28,29,30,20,31,32,80,33,36,67,64,59,16,71,70,72,73,81,39,40,41,74,79],"class_list":["post-8993","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-caring-for-seniors","category-clinical-resources","category-maryland-specific-resources","category-owner-voices","category-resources-information","category-senior-living-communities","category-uncategorized","category-wound-care","tag-againg","tag-aging","tag-aging-well","tag-assisted-living","tag-care-advisor","tag-caregiver","tag-caregiver-support","tag-carepatrol-baltimore","tag-cargiver","tag-cargiver-support","tag-comar","tag-community","tag-group-living","tag-long-term-care","tag-medicaid","tag-medicare","tag-paula-sotir","tag-preventative-care","tag-prevention","tag-prevention-strategies","tag-rehabilitation","tag-safety","tag-senior-care","tag-senior-living-advisor","tag-standards-of-care","tag-therapeutic-care","tag-wound-care"],"acf":[],"_links":{"self":[{"href":"https:\/\/carepatrol.com\/baltimore\/wp-json\/wp\/v2\/posts\/8993","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/carepatrol.com\/baltimore\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/carepatrol.com\/baltimore\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/carepatrol.com\/baltimore\/wp-json\/wp\/v2\/users\/210"}],"replies":[{"embeddable":true,"href":"https:\/\/carepatrol.com\/baltimore\/wp-json\/wp\/v2\/comments?post=8993"}],"version-history":[{"count":4,"href":"https:\/\/carepatrol.com\/baltimore\/wp-json\/wp\/v2\/posts\/8993\/revisions"}],"predecessor-version":[{"id":9003,"href":"https:\/\/carepatrol.com\/baltimore\/wp-json\/wp\/v2\/posts\/8993\/revisions\/9003"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/carepatrol.com\/baltimore\/wp-json\/wp\/v2\/media\/8994"}],"wp:attachment":[{"href":"https:\/\/carepatrol.com\/baltimore\/wp-json\/wp\/v2\/media?parent=8993"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/carepatrol.com\/baltimore\/wp-json\/wp\/v2\/categories?post=8993"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/carepatrol.com\/baltimore\/wp-json\/wp\/v2\/tags?post=8993"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}