Pressure sores are a common and substantial concern for elderly patients living in care homes, with over 700,000 people affected every year. For the NHS, they are the single most costly chronic wound, and most often occur in patients over 75 years old. However, research shows that over 80-95% of pressure sores can be avoided.

Different ‘grades’ of pressure sore can indicate the severity of the wound, as well as act as an indicator for how long the patient has been immobile. Most of these pressure sores can be prevented by high quality caregiving, so the possibility of an epidemic of poor caregiving quality has not gone unnoticed.

What Are Pressure Sores?

Pressure sores are caused when a patient is immobile for a long period of time, unable to move around or get out of the bed. The constant pressure on one part of the body stops the blood flowing through the skin properly, which causes the skin to break down and form an ulcer.

There are four grades of pressure sore: grade one is bruising or reddened skin; grade two is broken skin and a shallow ulcer; grade three is a deep ulceration; and grade four are ulcers so deep that the skin and muscle has worn away to reveal bone or internal organs.

Grade four pressure sores are extremely difficult to heal, and can be life-threatening due to the potential for infection or complications. In fact, over 500 hospital patients and over 220 care home residents’ deaths were partly due to complications as a result of pressure sores, and for over 100 other patients they were the direct cause of death. Even if the pressure sores don’t cause infections or death, they can be extremely painful for the patient and lead to further immobility, which exacerbates the issue.

How Can Pressure Sores Be Prevented?

The primary method of preventing pressure sores is “good, basic nursing care”, according to Peter Walsh, chief executive of the Action Against Medical Accidents charity. The specific nursing care involved is turning the patient over so that they are lying on different parts of their body throughout the day, not just staying in one position.

Patient Claim Line, a team of medical solicitors, said that pressure sores are one of the most common claims they receive from families related to elderly care, and more work needs to be done to educate care providers and prevent these injuries from occurring.

Some companies are also trying to create technology that can alleviate this condition, given its widespread and serious nature. For example, one company has created innovative mattresses that distribute pressure more evenly across the body.

Another technological approach that has been presented in the past as a solution to issues in caregiving environments is the use of cameras to monitor patient treatment. This idea was initially promoted by the Care Quality Commission (CQC), who later stepped back from full support of a CCTV camera proposal. However, the CQC has set out “responsible steps” for those providers to take who do want to adopt this method of injury prevention.

Taking Action for Bad Caregiving

When a patient is subject to bad caregiving that results in a pressure sore (or has the potential to), there are a number of avenues that can be examined. First, the Stop the Pressure charity provides information for both patients, relatives, and caregivers so that they can first aim to prevent these types of injuries from occurring in the first place. Once an injury has occurred, Stop the Pressure also provides details on steps that nurses and other caregivers need to take to ensure that the wound does not progress and worsen.

If a serious injury has occurred, patients and their families can use the NHS complaints procedure, by writing a letter describing what has happened. Legal action can also be taken against care providers if their care has fallen below a certain standard of expectation or has been negligent.

The NHS process does not need to be started prior to taking legal action, but the process may help to uncover further information about what has happened. This will help patients and their families to decide whether a clinical negligence case is worth pursuing.


At the end of the day, pressure sores are in most cases an unfortunate and easily preventable injury that results from poor quality caregiving and inattentiveness. They can cause great discomfort to patients, and can also result in potentially fatal complications or chronic pain conditions.

Taking steps to prevent these injuries from occurring is an important task for caregivers, health organisations such as the NHS, and companies who can invest in technology-based solutions. Patients and their families should educate themselves on pressure sores, and what to do in the situation that a serious injury does occur.

Content supplied by Jose Calvo


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