How do I prevent pressure sores when someone is dying?
Pressure sore prevention near death should protect skin while keeping the person as comfortable as possible.
Pressure sore prevention near death should protect skin while keeping the person as comfortable as possible. Regular turning, clean dry bedding, pressure-relieving equipment and gentle skin care may help, but the plan may need to change if movement causes pain or distress.
Ask the palliative care team, nurse or aged care staff to show you what to do. The right approach depends on the person's skin, pain, weight, movement, continence, nutrition, circulation and stage of dying.
General information: This page gives general information for people in Australia. It cannot tell you exactly what is happening in one person's situation. If you have concerns about a symptom, medicine, treatment decision or change in someone's condition, contact their doctor, palliative care team, nurse or other treating health professional.
Why pressure sores happen
Pressure sores, also called pressure injuries, happen when skin and tissue are damaged by pressure, shear or rubbing. People who are bedbound, very weak, incontinent, not eating or drinking much, or unable to move themselves are at higher risk.
Near death, circulation is poorer and skin may be fragile. Damage can happen quickly.
What may help
The team may suggest:
- small position changes
- pillows to support the body
- keeping heels off the mattress
- a pressure-relieving mattress or cushion
- smooth sheets without wrinkles
- absorbent pads for urine or faeces
- barrier cream if advised
- gentle washing and patting dry.
Do not massage red or damaged areas. Rubbing can make fragile skin worse.
Comfort may change the plan
If turning causes pain, breathlessness or agitation, tell the team. Near the end of life, comfort may be more important than a strict turning schedule.
The team may suggest smaller tilts, fewer moves, better equipment, or timing care after prescribed pain medicine.
Check skin gently
Look at pressure areas when care is already happening, rather than waking or moving the person only to inspect skin. Common areas include the bottom, hips, heels, ankles, elbows, shoulders, back and back of the head.
Report redness that does not fade, blisters, broken skin, swelling, heat, bad smell, bleeding, black areas or increasing pain.
When to get help now
Contact the palliative care team, GP, nurse or aged care staff if there is broken skin, spreading redness, bad smell, bleeding, severe pain, fever, or if turning and skin care are causing distress.
Call 000 if there is a sudden life-threatening emergency and no end-of-life plan telling you what to do.
You may also want to read
- How often should I turn someone who is dying in bed?
- Do I need to keep turning someone if moving them causes pain?
- How do I change sheets when someone cannot get out of bed?
- What equipment can I get to help care for someone dying at home?