Paralysis Bed Sores: Symptoms, Stages and Prevention


While paralysis can be caused due to various reasons, the most common reasons for the same are any form of injury to the spinal cord or head, stroke, and multiple sclerosis.

Home care is a good way of caring for your loved one while also helping them feel comfortable and connected to the family. A professional caregiver can help take special care of bedsores, which is a very important health concern that you need to keep in mind while caring for a paralysis patient. Timely and proper care by a trained caregiver as well as regular monitoring can also help to prevent pressure and bedsores in a paralysis patient.

Bedsores are also known as pressure sores or in some cases, pressure ulcers. These are a type of injury that is caused to the skin as well as the underlying tissue in the area. It happens when there is prolonged pressure on a particular area of the skin over a long period of time. Most paralysis patients find it difficult to move too often and hence bedsores are a major health concern. It happens when there is continual pressure on a particular area, as a result of which the skin and tissue in that particular area suffer a breakdown and blood circulation becomes poor.

When there is a breakdown in the skin and tissues, the area turns red and the patient will develop open sores. In severe cases, the ulcers can damage the muscles and sometimes even the bones that are present in that area under the skin.

Bedsores are most common in those areas where the bones are present, such as the hips, the tailbone, back, elbows, heels, and the ankle.

Patients who have to use the wheelchair too often or are mostly in bed are the ones who have the highest risk of developing bedsores. In such patients, the sensations in the lower part of the body are often not there or are too negligible. As a result, they are not able to understand when the pressure sores first start to develop, and it can be difficult for family members to notice the same.

A professional caregiver is experienced to look for bed sores and understand the first signs, even before the sores actually develop. This allows them to take all preventive measures and communicate with the doctor at the right time.

In wheelchair patients, the most common areas where bedsores may appear are the hips, the tailbone area, the spine, shoulder blades and the back areas of the arms and legs.

In bed patients, the most common areas where bedsores may appear are the back, the back or the side of the head, the shoulder or the shoulder blade, hip, tailbone area, lower back, the area behind the knees, the heels, ankles and even the ear area.

Here are some of the most common symptoms of bedsores, starting from mild to severe stages.

1st Stage

The first stage is often the one where the patient and family members may not realize that a bedsore is building up.

  • The skin will not be broken but there will be redness around the area
  • Those who have a darker skin tone may have some discoloration in the affected area
  • There may be tenderness and pain in the affected area. Some people may also feel a warm or cool sensation around the affected area.

2nd Stage

The second stage will start to show some signs of damage in the affected area.

  • The skin will peel off and be broken, and may also expose some of the underlying skin that can also appear to be broken.
  • The affected area will turn pink or red.
  • The affected area may start to look like one that is filled with some fluid or look like a ruptured blister.

3rd Stage

The third stage is the one where the area is already a wound and may actually also turn into a deep wound.

  • The skin will peel off and may expose some underlying fat.
  • The ulcers will form deep wounds and look open and crater-like.
  • Yellowish dead tissue can be seen at the bottom of the wound.

4th Stage

The fourth stage is the one by which the wound will have a lot of tissue loss.

  • The wound may turn so deep that it often exposes the bones and muscles underneath.
  • The yellowish dead tissue at the bottom of the wound may start to turn dark and crusty.

Hiring a professional caregiver can help take care of the paralysis patient and prevent bedsores. Here are a few ways that a professional caregiver can help your loved one and help to avoid bed sores.

  • Professional caregivers are trained to look for pressure and bed sores even before they appear. They are also trained to monitor the same and move the patient in such a way that it reduces the risk of sores.
  • The caregiver will know how to lift the patient and change the position every few hours. This will immensely help in reducing the pressure on one area and help to avoid pressure sores.
  • When the patient is sitting in a wheelchair, the caregiver can help the patient do pressure relief exercises every half an hour or so. These are ways to redistribute the body weight and as a result, reduce the amount of pressure that is exerted on one part of the skin.
  • The caregiver will also teach the patient a few exercises and ways to pressure relief so that the patient can do these independently even when the caregiver is not around. The way a pressure relief exercise is done, the interval at when it is done and such can make a big impact on the overall health of the patient.
  • Different patients will react differently to bedsores. Some patients may have highly sensitive skin and may develop pressure sores too easily, while others may take more time. The caregiver will be able to understand the same and suggest exercises and pressure relief methods accordingly. Also, the caregiver will help the patient build skin tolerance to avoid bed sores as much as possible.
  • The caregiver will regularly examine your skin and look for early signs of bedsores. Professional caregivers are trained to spot the earliest signs, such as very slight changes in skin color, tenderness, unexplained firmness and such.
  • Regularly check skin areas that are most prone to bedsores and monitor on a daily basis.
  • Check the areas that come in direct contact with the wheelchair or braces.
  • Look for skin near nails and toes to look for any ingrown toenails. Such areas can often develop sores if the nails are cut too deep and develop a wound.
  • At night, the caregiver will help to turn the patient every 2 to 3 hours or so. The carer will also help to make sure that the pillows and pads used on the bed are comfortable enough and will not lead to pressure sores.
  • Depending on what the doctor says, the caregiver will help the patient to sleep in a position where the head is elevated. Not all patients require this position, so the caregiver will work on it only if recommended by the doctor.
  • Professional caregivers are also trained to understand the type of mattress that may or may not be suitable for the patient and will suggest you accordingly.
  • The caregiver will bathe the patient in such a way that areas prone to bedsores are kept clean and dry. As they are trained to clean the genital area in patients, it is easier for them to clean the patient thoroughly, as compared to family members who may find it uncomfortable.
  • Professional caregivers are also trained at helping a paralysis patient get in and out of clothes in such a way that it will not cause any pain or discomfort to the patient. As a result, they can easily help the patient get dressed after they are properly clean and dry.

Bedsores that are in the first and second stages are easier to treat as compared to those that reach the third and fourth stages. The right monitoring and treatment at the earliest signs can often help prevent and treat them completely.

Here are some ways that can help to ease and treat bedsores. Make sure you speak to the doctor and let the caregiver take the required care and steps.

  • Make sure that the patient uses proper mattresses, pillows and other forms of bedding or cushioning so that it helps to disperse the pressure from and on the body in a balanced way.
  • It is very important to regularly change the position of the patient even before there are any signs of a bedsore. Doing so is not enough only to the day, but the patient should also change position through the night.
  • In the initial stage, make sure to wash the affected area with some mild antibacterial soap and water. Using a good moisturizer will also help to prevent the onset of infection, but make sure you first check on the type of moisturizer from the doctor.
  • Some of the bedsores in the initial stage can be cleaned with the help of a saline mix as it will help to remove any dead tissue. Speak to the caregiver or doctor about the same.
  • Do not use any cleaning agent that contains iodine or hydrogen peroxide.
  • A special dressing will be required to keep the affected area covered and prevent infection. The doctor or caregiver will suggest you the right type of dressing based on the type of wound and the size of the same. Some dressing types include foam, gel, film, gauze and other types of dressing.
  • For bed sores that have turned severe, the patient will have to be treated at a medical facility.
  • Make sure the sheets where the patient lies down are regularly powdered to avoid any friction on the skin.
  • While moving the patient, lift the patient and then move, instead of sliding along the surface. A caregiver will be able to do this the right way.
  • Do not place the patient in a position that can exert pressure on one particular part of the body.
  • Monitor the skin and inform the caregiver or doctor immediately in case you notice any deformity or skin discoloration.
  • Help the patient do gentle exercises to avoid weight gain.
  • Include healthy fruits and vegetables on a regular basis.
  • Make sure the patient sleeps well.

Speak to the doctor to understand if the patient can perform basic exercises. There are many exercises that a physiotherapist will suggest that can help a paralysis patient improve muscle strength and mobility. You can book an appointment with our physiotherapists and caregivers at Care24 to help prevent and treat bedsores.

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