What it is
When a person spends most of their time in bed, certain areas of skin can be under steady pressure or rubbing. Over time this may lead to pressure injuries, sometimes called bedsores or pressure ulcers. They often appear over bony areas such as the tailbone, hips, heels and elbows.
Other wounds can also occur in people with limited mobility. Examples include skin tears, moisture-related skin damage, surgical wounds that are still healing, and wounds linked to poor circulation or diabetes. Each type has a different cause, so the cause matters a great deal.
Pressure injuries are commonly described in stages, from skin that is red and intact to deeper wounds involving tissue beneath the skin. Only a licensed clinician can assess a wound and determine its type and stage after an evaluation.
Caregivers are often the first to notice changes in skin. Knowing what to look for and when to call a professional is a central part of home wound care.
How it’s traditionally been approached
Traditionally, home wound care has centered on a few broad ideas: relieving pressure on vulnerable areas, keeping skin clean and protected from moisture, supporting nutrition and hydration, and watching the skin closely for changes.
Care at home is often shared between family caregivers, home health nurses and the patient's physician. Nurses commonly assess the wound, choose and apply dressings, and teach caregivers what to watch for. Specific approaches differ from person to person and are decided by licensed clinicians.
Supportive equipment, such as specialized mattresses, cushions and positioning aids, has also been commonly used in home settings. For some wounds, clinicians may consider other options, such as negative pressure wound therapy, which is well established. Whether any option is appropriate depends on an individual evaluation.
How the right wound care specialist may help
The right wound care specialist, such as a wound care nurse or a home health clinician, may help by examining the wound, identifying likely causes and explaining what they see in plain language. They may also look at the whole picture, including mobility, nutrition, circulation, medical conditions and the home setup.
A home visit generally involves a skin and wound assessment, a conversation with the caregiver about daily routines, and demonstration of anything the clinician recommends. They may coordinate with the patient's physician and other providers. They can also help caregivers understand what changes should prompt a call.
Questions worth asking a licensed provider include: What caused this wound? What stage is it? What are the treatment options for my loved one? How long might healing take? What does insurance cover, including home health visits and equipment? Who do we call if something changes, and when?
The whole-person view
Body, mind and stress affect each other. Long-term illness, pain, isolation and disrupted sleep can weigh on the person in bed, and caregiver exhaustion can quietly affect the whole household. Stress and low mood may also influence appetite, rest and energy, which are part of overall well-being.
Body-based support, such as the approaches listed through Somatic Experiences, may help some people feel more settled in their bodies during difficult stretches. Talk therapy through Therapists.plus may offer patients and caregivers a place to process worry, grief or burnout. Both are complements to medical care, not replacements for it.
Somatic Experiences: trauma and emotional healing →Somatic Experiences: embodiment and movement →Therapists.plus: mind body connection →
Keep in mind
- Seek medical care promptly for any sign of infection: spreading redness, red streaking, increasing warmth or pain, pus, foul odor, fever or chills, or a wound that is quickly getting worse.
- Call 911 or go to the ER for heavy bleeding, exposed bone or tendon, signs of sepsis such as confusion with fever, or a deep or severely contaminated wound.
- Licensed professionals should guide all wound care decisions. This page cannot tell you what to do for a specific wound.
- If you are a caregiver in distress, call or text the 988 Lifeline for support at any time.
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Keep exploring
Home health & caregiver wound care
Frequently asked questions
What is wound care at home for a bedridden patient?
Wound care at home for a bedridden patient is the ongoing care of wounds, often pressure injuries, for someone who spends most of their time in bed. It typically involves clinicians, such as home health nurses, working with family caregivers. A licensed provider decides what is appropriate for each person.
Why do bedridden patients get bedsores?
Staying in one position can place steady pressure on skin over bony areas, which may reduce blood flow to that skin. Moisture, friction, poor nutrition and other health conditions can also contribute. A clinician can explain the factors involved for a specific person.
When should I call a doctor about a wound on a bedridden person?
Seek medical care promptly if you notice spreading redness, red streaking, increasing warmth or pain, pus, foul odor, fever or chills, or a wound that is rapidly worsening. For heavy bleeding, exposed bone or tendon, or signs of sepsis, call 911 or go to the ER.
Can a nurse provide wound care at home?
Yes, home health nurses often provide wound assessments and care in the home and teach caregivers what to watch for. Availability and coverage depend on the person's situation and insurance. Ask a licensed provider or insurer what applies to you.
Are skin substitutes or amniotic grafts used for home wound care?
Some clinicians consider skin substitutes or amniotic and placental grafts for certain wounds, but they are generally used in clinical settings after evaluation. Their FDA status varies, and most are regulated as minimally manipulated tissue rather than FDA-approved drugs. Coverage differs by product and payer, and amnioticdoctors.com offers further reading on amniotic products specifically.
What should I ask a provider about my loved one's wound?
Ask about the wound's cause, its stage, the treatment options, the expected healing time and what insurance covers. It also helps to ask who to contact if the wound changes and which warning signs need urgent care.
Educational resource. WoundKare shares general information and connects people with independent wound care specialists. It is not medical advice, diagnosis or treatment. Talk with a licensed professional about your health.