Falls, Infections, Pressure Sores & Incontinence Rash are the most key issues in home care supporting elderly service users, and ones we want to avoid as far as possible!

All of these are sometimes unavoidable but pressure sores in people with mobility is usually an indicator of serious failings, as are frequent falls or infections.

Please read the resources below to understand more and complete the short test at the bottom to demonstrate your knowledge.

Falls, Infections, Pressure Sores & Incontinence Rash

Pressure Sores

The following information has been adapted from the NHS website:

Pressure sores are related to mobility & people with limited mobility are most likely to suffer from them.

Pressure ulcers can affect any part of the body that's put under pressure.

They're most common on bony parts of the body, such as the heels, elbows, hips and base of the spine.

They often develop gradually, but can sometimes form in a few hours.

Early symptoms of a pressure ulcer include:

• part of the skin becoming discoloured – people with pale skin tend to get red patches, while people with dark skin tend to get purple or blue patches

• discoloured patches not turning white when pressed

• a patch of skin that feels warm, spongy or hard

• pain or itchiness in the affected area

A doctor or nurse may call a pressure ulcer at this stage a category 1 pressure ulcer.

The skin may not be broken at first, but if the pressure ulcer gets worse, it can form:

• an open wound or blister – a category 2 pressure ulcer

• a deep wound that reaches the deeper layers of the skin – a category 3 pressure ulcer

• a very deep wound that may reach the muscle and bone – a category 4 pressure ulcer

Pressure sores or pressure areas should be reported promptly and ideally as soon as they are detected. You should report:

• red, swollen skin

• pus coming from the pressure ulcer or wound

• cold skin and a fast heartbeat

• severe or worsening pain

• a high temperature

These symptoms could be a sign of a serious infection that needs to be treated as soon as possible.

Treatments for pressure ulcers depend on how severe they are.

For some people, they're an inconvenience that needs basic nursing care. For others, they can be serious and lead to life-threatening complications, such as blood poisoning.

Ways to stop pressure ulcers getting worse and help them heal include:

• applying dressings that speed up the healing process and may help to relieve pressure

• moving and regularly changing position

• using specially designed static foam mattresses or cushions, or dynamic mattresses and cushions that have a pump to provide a constant flow of air

• eating a healthy, balanced diet

Anyone can get a pressure ulcer, but the following things can make them more likely to form:

• being over 70 – older people are more likely to have mobility problems and skin that's more easily damaged through dehydration and other factors

• being confined to bed with illness or after surgery

• inability to move some or all of the body

• obesity

• incontinence

• a poor diet

It can be difficult to completely prevent pressure ulcers, but there are some things that can be done to reduce the risk.

These include:

• regularly changing position – people who cannot do this independently will need support from carers.

• checking your skin every day for early signs and symptoms of pressure ulcers.

• having a healthy, balanced diet that contains enough protein and a good variety of vitamins and minerals.

It is expected that people with limited mobility will ideally be assisted to move from bed into a chair across the day to reduce the risk of pressure sores.

People confined to bed should change positions several times thoughout the day, i.e. between lying on the back and lying on the sides.