Market reference note: This article draws on sources from both Korea and the United States. Each piece of information is labeled 🇰🇷 Korea or 🇺🇸 U.S. in the text to indicate which country it applies to.
If you are caring for an elderly parent who has been bedridden for a long time due to a stroke or injuries from a fall, you have probably heard the word "pressure injury" at least once. A pressure injury (욕창, 壓瘡) is a condition in which the skin and the tissue beneath it are damaged because the skin is pressed against a mattress or hard surface for an extended period, cutting off blood circulation. It begins as a red patch, but if left untreated it can deepen to the point where bone is exposed, or progress to sepsis and become life-threatening. This may sound frightening, but the vast majority of pressure injuries can be prevented by consistently practicing the right preventive measures.
🇺🇸 U.S. In the United States, more than approximately 2.5 million people are reported to experience pressure injuries every year. Research shows that at any given time, about 31% of older adults living in nursing facilities have a pressure injury, and pressure injuries are found in 5–15% of hospitalized patients as well. Older adults are at particularly high risk because the aging process thins the dermis and epidermis, reducing the skin's resistance to friction. The main risk factors for pressure injuries include limited mobility, inadequate nutrition, reduced sensation, and chronic conditions such as diabetes and cardiovascular disease.
Pressure injuries most commonly develop over bony prominences. When lying on the back, the back of the head, the spine, the tailbone, and the heels are especially vulnerable; when lying on the side, the shoulders, hip bones, and inner knees are at greatest risk. It is important for family caregivers to develop the habit of visually inspecting these areas during bathing or when wiping down the skin. If the skin has turned red, rubbing it with a massage is actually counterproductive — it can further damage already weakened tissue — and should be avoided. Applying a hair dryer or heating pad to a reddened area is also prohibited, as it can cause burns.
The cornerstone of pressure injury prevention is repositioning. The person's position must be changed at least every 2 hours, and nighttime during sleep is no exception. When lying on the back, place a cushion under the calves so that the heels do not rest directly on the mattress. When lying on the side, place a soft pillow between the knees and between the ankles to prevent bone-on-bone contact. Even small wrinkles in the bed sheet create narrow pressure points that irritate the skin, so the sheet should always be pulled taut. Keep the skin dry and clean, and take care not to leave a wet diaper on for too long for older adults who have incontinence. Nutrition also matters. A balanced diet rich in protein and vitamins, along with adequate fluid intake, helps maintain the skin's ability to recover.
🇰🇷 Korea Under Korea's 노인장기요양보험 (Long-Term Care Insurance for the Elderly) system, pressure-injury-prevention assistive devices are covered as benefit items. Pressure-relief mattresses and cushions are among the representative rental items, allowing older adults who have been assessed for a long-term care grade to use them without a financial burden. In addition, through the 방문간호 (home-visit nursing) benefit, a nurse or nursing assistant can visit the home to provide wound care and check skin condition. For older adults with severe bed-bound status who are barely able to turn over on their own, the use of an alternating-pressure air mattress can be explored through the rental programs available under 건강보험 (National Health Insurance) and 장기요양보험 (Long-Term Care Insurance).
🇺🇸 U.S. The U.S. Centers for Medicare & Medicaid Services (CMS) requires nursing homes to prevent the development of pressure injuries among their residents through federal regulation F686. Facilities are held to the standard that pressure injuries must not occur except when clinically unavoidable, and facilities that violate this standard may face legal liability. CMS also has a policy of not making additional payments when a patient develops a new pressure injury during a hospital stay, which creates an incentive for healthcare institutions to prioritize prevention as well. If you are caring for a parent at home, please check with the attending physician or a home health agency to find out whether home health care benefits under Medicare Part A or Part B are available.
Once a pressure injury develops, it takes a long time to heal, and the treatment process causes the older adult considerable pain. Rather than thinking, "Everything seems fine so it should be okay," the most reliable form of prevention is to check the skin's condition right now and build a repositioning routine into daily life. If it feels like too much to handle alone, do not hesitate to seek help from a local 장기요양기관 (long-term care provider) or a home health service professional. Caregivers who are not physically and emotionally exhausted are better able to care for their parents.
Sources: National Library of Medicine (StatPearls, NCBI) pressure injury entry (updated February 2024); Wound Repair and Regeneration 2024 published study (Choragudi et al.); ScienceDirect meta-analysis of pressure injury prevalence among nursing home residents (International Journal of Nursing Studies, 2023); Agency for Healthcare Research and Quality (AHRQ) pressure injury prevention guide; U.S. Centers for Medicare & Medicaid Services (CMS) regulation F686; Korean Ministry of Health and Welfare guidance on the 노인장기요양보험 system; National Health Insurance Service long-term care insurance statutes and assistive device benefit list.
This article was compiled by AI from the sources cited above. We strive for accuracy, but for decisions about your specific situation, please confirm the latest guidance from a professional or the relevant agency.
Note: This article was compiled by AI from the sources cited above. We strive for accuracy, but for decisions about your specific situation, please confirm the latest guidance from a professional or the relevant agency.