Preventing Pressure Sores at Home: How to Check Your Parent's Skin Every Day, Where the Risk Spots Are, and When to Call a Nurse

Preventing pressure sores at home starts with the simplest and most important habit: looking at your parent's skin all over, every day, especially over the bony points that carry weight when they lie or sit. The first sign to catch is a red patch that stays red when you press it with a fingertip, because it means the skin underneath is already being damaged by pressure. The earlier you see it, the sooner you can change position and take the pressure off before the skin breaks down into an open wound. If you see a mark like this, tell a nurse straight away rather than waiting several days to see what happens.

Many families recognise the pattern. You care for your mother carefully every day, bathing, changing, feeding, but nobody has actually looked at her lower back or heels because she lies on her back all day. Then one morning, while wiping her down, you find a red mark at the base of the spine, or a heel that has turned dark, and you wonder why you did not see it sooner. This article is not about treating wounds. It is about checking the skin and catching warning signs early at home: when to look, where to look, what to feel for, how to tell a harmless red mark from one that needs attention, and when to call a nurse or go to hospital.

Quick answer

• Pressure sores come from pressure staying on the same spot for too long, together with shearing from dragging or sliding, moisture, and fragile skin or poor intake of food and fluid.
• Risk spots are where bone lies close under the skin: tailbone, hips, heels, ankles, elbows, back of the head and ears. Which spots are at risk changes with the lying position.
• Check the whole body at least once a day, and look again at the spot that was just lain on every time you change position. The key sign is redness that does not fade on pressing, or skin that feels warm, hard, swollen, or darker than the skin around it.
• Repositioning is still the backbone of prevention. The commonly used practice is about every 2 hours, but it must be adjusted to each person's nurse assessment. No mattress, of any kind, replaces repositioning.
• Lift with a draw sheet, never drag; keep the skin dry and clean; and never massage over redness or bony points.
• Call a nurse when you find redness that does not fade. Go to hospital when the skin opens into a wound, or there is pus, smell, fever, or the skin turns deep purple or black.

1. What causes pressure sores

A pressure sore forms when skin and the tissue under it are squeezed long enough that blood cannot reach them properly. It is not simply a sign of dirt or poor care. Even excellent carers see pressure sores if a person cannot shift position themselves. There are four main factors, and they often occur together.

• Sustained pressure. Body weight presses on the same bony point, where there is little flesh or fat to cushion it, and blood flow is restricted.
• Shear. This happens when the skin is pulled one way while the bone underneath moves another, for example when the head of the bed is raised and your parent slides down toward the foot, or when they are dragged up the bed across the sheet.
• Moisture. Sweat, urine or stool makes the skin weaker and less able to tolerate pressure or friction.
• Your parent's own condition. Thin, dry, ageing skin, being very underweight, eating and drinking little, or feeling less at the skin means they may not notice and shift away from pressure.

The good news is that nearly all four can be influenced by the family in daily routine, without expensive equipment or medical skills. What it takes is consistency, and someone who notices early.

2. Where the risk spots are, by position

Risk spots are the places where bone lies close under the skin and takes the weight in that position, so they change with how your parent usually lies or sits. Check the ones that match their real routine.

• Lying on the back: back of the head, shoulder blades, elbows, tailbone and heels
• Lying on the side: ear, shoulder, the bony point of the hip, inner knees and ankles
• Sitting in bed or in a wheelchair: tailbone, the two sitting bones, and heels
• Lying face down: chest, front of the hips, knees and tops of the feet

The spots families most often miss are the heels hidden under the blanket, the back of the head and ears under the pillow, and skin under tubes and devices, such as an oxygen tube looped over an ear. If your parent wears a splint, a brace or any supportive device, check the skin along its edges too.

3. Checking the skin every day without missing anything

A good check means looking at the whole body at least once a day, and looking again at the spot just lain on each time you reposition. Do not wait for your parent to complain, because many cannot say so or do not feel it at all.

When to check

The easiest moment is the morning wash, when the skin is already uncovered (see our guide to bed baths), then at every diaper change, and again before bed. If several carers take turns, agree who checks which time, and write it down each time.

Five steps

1. Prepare light and hands. Use good light, not dim light. Hands should be clean and warm with short nails. Tell your parent you are about to check the skin, and uncover only the area you are looking at.
2. Look at colour. Compare the skin over each bony point with the skin around it. Look for redness, bruising, purple or darker patches. On darker skin, redness can be hard to see, so notice whether the area looks deeper or darker than its surroundings.
3. Feel temperature and firmness. Use the back of your hand or your palm, gently, and compare with the surrounding skin. A spot that is warmer, swollen, harder, or unusually soft or spongy is a warning sign.
4. Do the press test on redness. If you see redness, press with moderate firmness for a moment with a fingertip, then release. If the skin turns pale and then returns to its colour, it is temporary redness from pressure: keep your parent off that spot and check again. If the colour does not fade when you press, treat it as the first sign of a pressure sore, keep pressure off that spot and tell a nurse. On darker skin, fading is hard to see, so also compare the colour, warmth and firmness of the spot with the skin around it.
5. Ask, and watch the face. Ask whether anything hurts, stings or feels numb. If your parent cannot answer, watch for grimacing or tensing when you touch a spot, and note where.

Important tip: never massage or rub over redness or bony points, even though it is often said to boost circulation. Massage adds pressure and friction to tissue that is already injured. Keep your parent off the spot and tell a nurse instead.

What to record

Keep it simple: one sheet of paper by the bed. Note the date and time, the location, the colour compared with the surrounding skin, whether it faded on pressing, its rough size (a coin is a handy comparison), and who checked.

4. Who is at higher risk

Anyone who must lie or sit in one place for long stretches can develop pressure sores, but these groups need closer checks and an early conversation with a nurse.

• People who cannot move themselves at all, or only very little
• People who are very thin, eat and drink little, or are pale and very weak
• People who wear diapers or often leak urine or stool, so the skin is damp
• People who feel less at the skin, for example after some strokes, or with conditions that damage nerves
• People with poor circulation or swelling
• People who have had a pressure sore before, or who have just left hospital after a long stay
• People who are drowsy or confused and cannot tell you they are uncomfortable

If your parent fits even one of these, ask a nurse to assess the risk at the bedside from the start. A nurse can advise how often to reposition, what equipment might help, and which spots deserve special attention.

5. Repositioning and taking pressure off: what to do and what to ask the nurse

The heart of prevention is never letting the same spot carry the weight for too long, so turning and repositioning is the main daily task. The commonly used practice in hospitals and elderly care is about every 2 hours, but it must be adjusted by a nurse's assessment for each person, so it is not a fixed number.

It is worth knowing that the latest Cochrane evidence review (2026) concludes that repositioning is standard practice, but most of the evidence is of low certainty and there is still no answer on which turning interval works best. That does not mean you can skip turning. It means no single interval suits every patient: use it as a starting point and watch your parent's own skin. If redness appears, reduce pressure on that spot, do not let your parent lie on the red area, and ask a nurse to reassess the turning interval.

For how to turn, how to place pillows and a 24-hour turning chart, read our detailed guide to turning a bedridden parent every 2 hours. This article will not repeat it. For pressure-sore prevention, remember three things: look at the skin that was just lain on at every turn, keep your parent off any red spot, and keep the heels floating off the mattress.

No mattress, of any kind, replaces turning, and people at high risk should have a nurse assess their mattress and equipment needs directly, based on their own skin and body.

6. Shear: lift, do not drag

Skin over the tailbone and heels grazes very easily when dragged across a sheet, and a graze can be the start of a sore. To prevent it:

• Use a sturdy draw sheet or slide sheet. Lift or shift your parent using the sheet, not by pulling on arms or armpits, as a nurse has shown you. With two people, lift together.
• Watch what happens when the head of the bed is raised. Your parent slides toward the foot, dragging the skin over the tailbone. Raise the head only as much as needed, for example at meals, and lower it afterwards.
• Keep the sheet smooth and taut. No creases or crumbs under the body. A ridge in the sheet presses on the skin like a small pebble.
• Watch for hard objects near the body, such as buttons, zips, pockets or straps that may press in when your parent lies on them.

For safe ways to move your parent from bed to wheelchair, including a heavier person, see our guide to transferring from bed to wheelchair.

7. Moisture: keep the skin dry and clean

Skin that stays damp becomes weaker, and pressure sores form far more easily, especially where a diaper is worn.

• Check the diaper at every position change and change it when wet or soiled, not later.
• Clean and pat the skin dry before putting on a fresh diaper. Pat gently, do not rub.
• Choose a diaper or pad that fits well and absorbs well. See our adult diaper guide.
• If your parent sweats a lot, change damp clothing and bed linen.
• If the skin under the diaper is red, sore or peeling, tell a nurse, because moisture rash makes that area more vulnerable.

8. Food and fluid: raw material for healthy skin

Healthy skin needs enough food and fluid. People who are eating less or losing weight are usually at higher risk. In general, aim for enough protein and fluid as advised by the doctor or dietitian looking after your parent. This article gives no amounts, because each person has different kidney, heart or blood sugar conditions to consider.

If your parent is eating less, losing weight steadily, has trouble swallowing, or eats but rarely drinks, tell a doctor or nurse so the diet can be adjusted. For tube feeding, see our guide to tube feeding at home.

9. Long hours in a wheelchair or chair are a risk too

People often think of pressure sores only in bed, but sitting in a wheelchair or chair for long periods is just as risky, because all the weight lands on the sitting bones and tailbone.

• Change position often. Do not let your parent stay in one posture for long stretches. If they can do it themselves, encourage them to lean forward, lean side to side, or lift slightly every so often. If not, help them shift, or take them back to lie down on the bed. A nurse or physiotherapist can tell you how often is right for your parent.
• Sit upright with feet well supported. Slumping or sliding forward adds pressure and shear over the tailbone.
• Check the skin every time your parent gets up, looking at the tailbone and both sitting bones as in step 3.
• Avoid items that make pressure ring-shaped or trap moisture. Rubber ring cushions and water-filled gloves increase pressure around the ring and trap damp, and are not recommended.

If you are choosing a wheelchair, see our wheelchair guide, and ask a physiotherapist or nurse to assess the right sitting position before regular use.

10. When to call a nurse, and when to go to hospital

Assess in two levels, so you neither panic unnecessarily nor wait too long.

Ask a nurse to assess at home if

• You find redness that does not fade on pressing, even after keeping your parent off the spot
• The skin over a bony point is warm, swollen, hard, or unusually soft
• The skin is bruised, or slightly darker than the skin around it
• Your parent complains of pain or stinging at the spot, or winces when it is touched
• The skin is grazed or peeling in a shallow layer
• Your parent is getting thinner or eating less, or the skin is damp more often, and it feels like you cannot keep up

Go to hospital or see a doctor promptly if

• The skin has opened into a wound, a blister or a crater, or you can see tissue underneath
• There is pus, a lot of fluid seeping, or a bad smell
• Redness around the wound is spreading, hot, or very swollen
• Your parent has a fever, chills, is more drowsy, or more confused than usual
• The skin at that spot has turned deep purple or black
• Pain is clearly worse

For a sudden serious change, such as difficulty breathing, loss of consciousness, or being so drowsy they cannot be woken, call 1669 immediately. See our emergency 1669 plan for elderly parents.

Once the skin has opened into a wound, we do not recommend that the family dresses it themselves. Do not try cleaning, applying ointments or covering it according to tips passed around. An open pressure sore needs a nurse or doctor to assess its depth and choose the care first. While waiting, avoid letting your parent lie or sit on the wound, and wait for the nurse's or doctor's advice before putting anything on it.

Mistakes families often make

• Massaging redness to boost circulation. This damages already injured tissue. Keep your parent off the spot and tell a nurse instead.
• Thinking a mattress means turning is no longer needed. No mattress replaces turning. Repositioning and skin checks must continue as the nurse advises.
• Dragging your parent up the bed. The skin over the tailbone and heels can graze from friction. Use a draw sheet and two people if possible.
• Not checking the skin because your parent does not complain. Many do not feel it or cannot say so, and damaged skin is sometimes painless. You have to check every day.
• Waiting several days before telling anyone. The moment skin first turns red is the best chance to fix things in time. Tell a nurse from the first day.

When to bring in a professional team

Checking skin daily, turning on schedule, changing diapers and spotting signs in time is work that goes on around the clock. If the main carer is short of sleep, has a sore back, cannot turn your parent alone, or is unsure whether a mark is dangerous, that is a signal to get help, not a failure. See our article on signs of caregiver burnout and what to do.

• Registered nurse home visit. Assesses skin and risk spots at the bedside, advises on turning intervals and equipment that suit your parent, and shows the family what to look for. 1,800 baht per visit. If a wound needs dressing, nurse wound care starts at 1,200 baht per visit. See home nursing.
• Home caregiver. Helps with turning, positioning, diaper changes, skin cleanliness and skin checks several times a day, following the plan the family and nurse agree. A 12-hour shift (day 08:00–20:00 or night 20:00–08:00) is 1,800 baht per day, or 30,000 baht per month (one day off per week). A 24-hour live-in shift with one caregiver is 2,500 baht per day, or 36,000 baht per month; the caregiver rests when your parent rests, for example after 22:00. If someone must be awake to turn your parent through the night, use two 12-hour caregivers. Daily hire has a 3-day minimum. See elderly home care.

For the wider picture of what bedridden care involves beyond the skin, read caring for a bedridden parent at home: what to look after.

Frequently asked questions

What causes pressure sores?

They come from pressure staying on one spot long enough that blood cannot reach the skin, together with shear from dragging or sliding, moisture, and weak skin or body condition such as being very thin, eating little, or feeling less at the skin. They usually form over bony points such as the tailbone, hips and heels.

What does an early pressure sore look like?

The first sign is redness over a bony point that stays red when pressed with a fingertip. The skin may feel warm, hard or swollen. On darker skin it may look darker or more purple than the skin around it rather than red. If you see this, keep your parent off the spot, do not massage, and tell a nurse.

The skin is red but fades when I press. Should I worry?

That is temporary redness from pressure. It is a warning that the spot is taking too much weight. Change position so it is not lain on, then look again at the next round. If it clears as normal, there is no need to worry. If it keeps coming back in the same place, talk to a nurse about turning intervals and positioning.

Do I need to check the skin every day, and when?

Check the whole body at least once a day, and look again at the spot just lain on at each position change. Convenient times are during the bath or wash, at diaper changes and before bed. Write it down so everyone who takes a turn sees the same picture.

Once a pressure sore has opened, can the family dress it?

We do not recommend it. If the skin has opened into a wound, a nurse or doctor needs to assess the depth and choose the care first. Cleaning, applying products or covering it yourself based on what you have heard may make it worse. While waiting, keep your parent off the wound.

Do I always have to turn every 2 hours?

Every 2 hours is the commonly used practice, but not a number that fits everyone, and the research itself cannot yet say which interval is best. Ask a nurse to tailor the interval to your parent's skin and comfort. See how to turn in turning a bedridden parent.

If we have a special mattress, can we stop turning?

No. No mattress, of any kind, replaces turning and skin checks. If your parent is at high risk, ask a nurse to assess the mattress and equipment that suit them directly.

Talk to the KIN HomeCare team

If you are worried whether a red mark is dangerous, or you would like a nurse to look at the skin and show you how to check at the bedside, tell our team about your parent's situation. We help you work out which service fits, and we send caregiver profiles for you to review before work begins.

• Home caregivers, home nursing and equipment: call 061-881-9399
• Home physiotherapy: call 095-767-6307
• LINE @KINHOMECARE
• Free consultation. The team helps you work out which service fits. We serve families nationwide, and work normally starts within 2–3 days.

This information is general knowledge for families and does not replace the advice of your parent's own doctor.

Written by Orrathai Boontuang, RN (licence 5311192883) · Medically reviewed by Dr. Kamolchat Choktanomsup (licence 40854) · Prices as of September 2026; please confirm with our staff before booking.