Christopher Reeve reportedly died from complications resulting from pressure sores, also known as bed sores or decubitus ulcers. If Mr. Reeve, with all his resources and private care developed pressure ulcers, then anyone who can't turn easily and frequently is certainly at risk.

Pressure sores have long been known to be a deadly consequence of poor care. However, even the best care in the world, such as Mr. Reeve had, will not completely eliminate the possibility of a pressure sore developing. Dedicated care can improve the odds, but nothing is certain to prevent the development of a pressure ulcer in someone with compromised circulation and mobility who can't turn and to relieve pressure.

Skin is a living, breathing part of our anatomy. When blood flow is reduced or cut off, skin and the tissue beneath the skin begin to break down. This is what is happening when a bed sore or pressure ulcer begins to form.

Pressure sores most commonly develop on parts of the body with little fat padding between the bones and the skin. The back, sacrum (tailbone), buttocks, elbows, heels, and hips are areas particularly at risk for developing pressure sores because the bones in these areas are close to the skin and there is little padding between the skin and the bone.

Pressure on these areas cuts off the small blood vessels that supply the skin with oxygen and nutrients. If the pressure is not relieved so that blood can flow back, the skin begins to die.

For most people this kind of pressure and lack of circulation becomes uncomfortable, and we move or turn over to relieve the pressure without thinking about it. This is why we turn over at night, even without being consciously aware of the need to shift our weight. A person who can't easily turn or remember to shift weight must be reminded and assisted to do so or a pressure ulcer will begin to develop.

Pressure ulcers can cause serious infection, which is what happened to Christopher Reeve. According to news reports, toxins from the infected ulcer entered his bloodstream, quickly causing organ failure. The most aggressive antibiotic treatment was not sufficient to save his life.

Bed sores are not just something to worry about when someone is in the hospital or a nursing home. Anyone who sits for long periods in the same position, and anyone who is confined to bed is at risk. Because bed sores can have such serious consequences, immediate treatment is necessary for even the smallest sign.

This means that we caregivers have something else to monitor. Whether at home or in a facility, we need to be sure that the skin of our mobility-impaired elderly loved ones is in good condition. Unfortunately, this means that you have to actually take a look - particularly at the lower back and the buttocks. This can be embarrassing for everyone, but it needs to be done.

If you are visiting in a facility, you can ask a qualified staff person to assist you, which can help with the embarrassment factor. If they are not willing it is important to find out why...right away on that visit, not later.

Based on their severity, bed sores are generally classified into four stages:

Stage I: An area of reddened skin which might be painful or itch, and which may feel warm and "spongy" or firm. On individuals with darker skin the affected skin may look shy or flaky, and may have a more purple or blue coloration. Stage I sores usually disappear shortly after the pressure is removed.

Stage II: The wound has opened and looks like an abrasion or a blister. The skin surrounding the wound may be red or purple. If treated quickly and aggressively State II wounds often heal fairly quickly. However, if the person is elderly or has other health issues, healing may take longer and be more difficult. Even these small skin ulcers should be evaluated by a professional. Do not try to treat an open pressure ulcer without medical advice.

Stage III: Damage is no longer just to the superficial area of the skin. The tissue below the skin has been damaged, and the wound is deep and often described as being "crater-like."

Stage IV: Tissue death has progressed to muscle and bone deep under the skin. Damage may involve tendons and joints, as well. Stage IV wounds are extremely difficult, if not impossible, to heal.

Lethal infections from pressure sores usually stem from State III and Stage IV wounds.

Preventing Bed Sores

When it comes to skin injury, prevention is by far the best cure.

Check anyone who is relatively immobile daily for skin changes.

Keep the ski clean and dry. Avoid drying soaps, and use moisturizers to keep skin from becoming too dry.

Change clothing and diapers as quickly as possible after they become moist.

Help shift the body position in bed at least every two hours. Someone sitting in a chair should shift even more frequently.

Encourage your loved one to sit upright in chairs. Sliding forward makes it difficult to change position and places damaging pressure on the tailbone (coccyx). Those who sit for long periods in recliners are especially at risk for pressure ulcers on the coccyx.

Encourage liquids throughout the day, as the skin needs this internal hydration.

Unless instructed otherwise by your physician, offer a well-balanced diet with adequate protein. Do all that you can to assist with blood sugar control if yur patient has diabetes.

Use pillows to prevent pressure on bony areas: Place pillows between the knees and between the ankles; Place pillows under the lower leg to lift heels off the mattress; use pillows to brace the back so your patient does not lie directly on a hip bone. Avoid donuts or ring-shaped pillows. These pillows actually increase pressure on the skin they touch and interfere with good blood flow.

Follow any exercise recommendations you have received, including range-of-motion exercises.

Use medical equipment designed to reduce pressure on the skin: egg crate foam mattress pads, sheepskin pads, gel pads, and alternating air mattresses will all reduce the risk of decubitus ulcers. Remember that these items will not prevent skin sores from developing, but they can help reduce the risk.

Signs of Infection

If you see signs that a bed sore may be infected, seek medical help immediately. Look for:

A bad odor

New tenderness or redness of the area around the ulcer

Warm or swollen skin around the ulcer

Fever, unusual weakness or unusual confusion can be signs that an infection may have spread.