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What puts you at risk of pressure ulcers?

Laura Evans

Created on June 30, 2025

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Transcript

What puts you at risk of pressure ulcers?

The less able you are to move around and change positions, the higher the risk of a pressure ulcer. Someone who can sit, stand and walk will have less risk than someone who cannot do these things, or requires help. Your susceptibility to pressure damage also varies depending on the other physical things that can put you at risk and how severe they are.

Our research also shows personal circumstances and situations can impact your risk. They can make it harder to prevent pressure ulcers forming.

You can’t always change physical things and personal circumstance or situations that increase your risk. But there are some changes you can make to reduce your risk or manage your risk. Small changes to your routine can make a big difference and prevent pressure ulcers.

The interactive diagram below brings together things that have an impact on pressure ulcer development. Click on each of the circles to find out more.

How can the interactive diagram help me?

Use the interactive diagram to identify the things that are relevant to you or the person you support. This will help you consider your needs and plan a safe routine to prevent pressure ulcers. It will also help you understand when your risk might change. When risk factors change it is important to adapt your prevention plans.

Things that put you at risk

Personal circumstances and situations increase your risk

Life events

Sudden illness

Daily life changes

Injury

Vulnerable skin condition

Moisture

Pressure area skin pain

Changes in mood

Drugs and alcohol use

Poor circulation

Reduced mobility and activity

Physical things that can put you at risk

Diabetes

Diet and fluid intake

Altered or no feeling/ sensation

Temporary changes in routine

Getting older

Change in care setting/ plan/ support

Gradual or temporary worsening in condition

Development of other long term conditions

Changes in mood

Your mood can affect energy levels and motivation to follow safe routines. Emotional health may also impact self-care.

What can I do to manage this?

  • Find out more prevention
  • MOVES: Plan a safe routine to prevent pressure ulcers
  • View the PUP guide
Drug and alcohol use

Using recreational drugs and consuming excessive alcohol can harm wellbeing and focus on safe routines.

What can I do to manage this?

  • Find out more prevention
  • MOVES: Plan a safe routine to prevent pressure ulcers
  • View the PUP guide
Poor circulation

Inadequate blood flow to pressure areas is a major risk factor. It increases vulnerability because it prevents essential nutrients from reaching the skin and limits waste removal. Poor circulation in the lower legs can greatly affect the heels.

What can I do to manage this?

  • Find out more prevention
  • MOVES: Plan a safe routine to prevent pressure ulcers
  • View the PUP guide
Daily life challenges

Balancing self-care with family and community roles can be tough. This juggling makes it hard to stick to safe routines. It’s not uncommon to feel like you are ‘spinning plates’ to meet all demands.

What can I do to manage this?

  • Find out more prevention
  • MOVES: Plan a safe routine to prevent pressure ulcers
  • View the PUP guide
Moisture

Skin that stays damp for a long time becomes weaker. Factors like sweat and incontinence can increase friction and lead to damage.

What can I do to manage this?

  • Find out more prevention
  • MOVES: Plan a safe routine to prevent pressure ulcers
  • View the PUP guide
Gradual or temporary worsening in condition

Changes in your condition can affect mobility and safe routines which can impact your skin. This increases risks.

What can I do to manage this?

  • Find out more prevention
  • MOVES: Plan a safe routine to prevent pressure ulcers
  • View the PUP guide
Development of other long term conditions

New long-term conditions (e.g. diabetes, arthritis) can impact mobility and complicate your safe routines.

What can I do to manage this?

  • Find out more prevention
  • MOVES: Plan a safe routine to prevent pressure ulcers
  • View the PUP guide
Diet and fluid intake

A good diet and drinking plenty of fluids is important for pressure ulcer prevention, general wellbeing and health. Being very underweight may increase pressure at bony areas – when bones stick out more surrounding skin is more easily damaged. Being very overweight can impact your ability to move and change position

What can I do to manage this?

  • Find out more prevention
  • MOVES: Plan a safe routine to prevent pressure ulcers
  • View the PUP guide
Change in care setting/ plan/ support

Transferring from home to hospital, newly discharged from hospital and between services, or a change in those who provide your support can cause delays and disruption to your safe routine. This may reduce your usual skin care and repositioning routines. If having a pre-planned admission, mention your equipment needs prior to your stay.

What can I do to manage this?

  • Find out more prevention
  • MOVES: Plan a safe routine to prevent pressure ulcers
  • View the PUP guide
Sudden illness

Illnesses (e.g. cold, flu, tummy bug) can reduce activity and affect routine management. Increased sweat or other fluids associated with a temporary illness can weaken the skin and increase friction.

What can I do to manage this?

  • Find out more prevention
  • MOVES: Plan a safe routine to prevent pressure ulcers
  • View the PUP guide
Reduced mobility and activity

Not being able to move as easily or as often is a key risk for pressure ulcers. It causes ongoing pressure on bony areas like the bottom and heels. Your posture, muscle stiffness, fixed joints, spasms and equipment like splints can also heighten pressure in sensitive spots.

What can I do to manage this?

  • Find out more about repositioning posture and equipment prevention
  • MOVES: Plan a safe routine to prevent pressure ulcers
  • View the PUP guide
Life events

Events like moving home, job changes (e.g. change in shift patterns), bereavement, or attending family events can distract from self-care and disrupt routines.

What can I do to manage this?

  • Find out more prevention
  • MOVES: Plan a safe routine to prevent pressure ulcers
  • View the PUP guide
Diabetes

Diabetes can worsen circulation and sensation. Diabetes can particularly put the heels and feet more at risk.

What can I do to manage this?

  • Find out more prevention
  • MOVES: Plan a safe routine to prevent pressure ulcers
  • View the PUP guide
Vulnerable skin

Weaker skin is more at risk of damage from pressure. Weak skin may look red, dry, thin, fragile or moist, depending on the individual. Redness might not be visible in people with darker skin, but you may notice a difference in colour (e.g. purple, bluish, or darker than usual patches). [link to skin assessment and skin care sections

What can I do to manage this?

  • Skin assessment
  • Skin care guidance
  • MOVES: Plan a safe routine to prevent pressure ulcers
  • View the PUP guide
Injury

Injuries can complicate self-care. For instance, a shoulder injury might make transfers more difficult, causing your skin to be dragged and damaged. When an injury occurs sometimes it can involve direct skin damage. For example, a difficult transfer (due to transfer surface height differences) where you catch your skin. If you catch your skin directly it is important to assess your skin to spot if there has been any damage.

What can I do to manage this?

  • Find out more prevention
  • MOVES: Plan a safe routine to prevent pressure ulcers
  • View the PUP guide
Pressure area skin pain

Pain, soreness, or discomfort in pressure areas (if you have sensation) may be a sign of existing or developing damage.

What can I do to manage this?

  • Find out more prevention
  • MOVES: Plan a safe routine to prevent pressure ulcers
  • View the PUP guide
Altered sensation

Neurological conditions such as multiple sclerosis, spinal cord injury and spina bifida can reduce feeling, cause numbness, pins and needles or burning. This limits your ability to sense discomfort, making it harder to notice long periods of pressure.

What can I do to manage this?

  • Find out more about repositioning posture and equipment prevention
  • MOVES: Plan a safe routine to prevent pressure ulcers
  • View the PUP guide
Getting older

Aging can increase risk, especially if mobility decreases and transferring becomes more difficult. Recognising changes as you age will help you adapt and maintain skin health.

What can I do to manage this?

  • Find out more epositioning posture and equipment prevention
  • MOVES: Plan a safe routine to prevent pressure ulcers
  • View the PUP guide
Temporary changes in routine

Travelling, holidays or the weather, can change your usual seating (and cushions), activity or people supporting you. This can increase pressure and friction. New clothing with ridged seams can increase pressure at specific skin points which can cause damage.

What can I do to manage this?

  • Find out more prevention
  • MOVES: Plan a safe routine to prevent pressure ulcers
  • View the PUP guide