Caring for a bedridden parent at home: bed sores, adult diapers and a daily routine

What bed sores are and why they happen

Bed sores, also called pressure sores or pressure ulcers, are areas of damage to the skin and the tissue underneath. They usually form over bony parts of the body. Three things cause them:

• Pressure: steady pressure on the skin cuts off blood flow, so the tissue is starved of oxygen.
• Friction: skin rubbing against bedding or clothes, which is worse when the skin is damp.
• Shear: when your parent slides down a raised bed, the skin stays still while the body moves, damaging the tissue underneath.

Moisture from sweat, urine or stool makes the skin much more fragile. A pressure sore can develop in as little as two hours.

Your parent is more at risk if they cannot move easily, have incontinence, have lost feeling in part of the body, eat or drink poorly, have diabetes or poor circulation, have recently been in hospital, or are over 70.

The places to check most carefully in someone lying in bed are the lower back and tailbone, buttocks, hips, heels, ankles, shoulder blades, the back of the head and behind the knees.

How to spot a bed sore, including on dark skin

Bed sores are described in stages. Plain-language versions of the international definitions:

• Stage 1: the skin is unbroken, but a patch stays discoloured when you press it. It may feel warm, firm, spongy or painful before the colour changes.
• Stage 2: a shallow open wound or blister with a pink or red base.
• Stage 3: a deeper wound where fat under the skin can be seen.
• Stage 4: a deep wound reaching muscle, tendon or bone.
• Unstageable: the base of the wound is covered with yellow or dark dead tissue, so the depth cannot be seen.
• Deep tissue injury: a dark purple or maroon area, or a blood-filled blister, where the damage is underneath and may get worse quickly.

On dark skin, early redness can be very hard to see. The NHS describes early sores on black or brown skin as patches that look purple or blue. Feel as well as look: a patch that is warmer, harder or more painful than the skin around it is a warning sign.

Preventing bed sores: what works

• Change position regularly. UK guidance says at least every four hours for people at high risk, and many nurses advise about every two hours for someone who cannot move at all. Write down the times
• Use a 30 degree side tilt, supported with pillows, rather than lying flat on one hip
• Keep the head of the bed as low as is comfortable, no higher than 30 degrees where possible, to stop sliding
• Lift rather than drag when moving your parent up the bed
• Keep skin clean and dry. Wash with a gentle cleanser and pat, do not rub
• Use a barrier cream on skin exposed to urine or stool
• Use a pressure-relieving mattress or cushion. A good foam mattress is recommended for people at high risk
• Keep heels off the bed, for example with a pillow under the calves
• Change wet bedding and diapers promptly, and keep sheets smooth and free of crumbs
• Check the skin every day, especially the places listed above
• Help your parent eat and drink well. Poor nutrition and too little fluid both raise the risk

Two common habits do more harm than good. Do not massage or rub red areas, as this can damage the tissue further. And do not use doughnut or ring cushions, which concentrate pressure on the skin around the hole.

What cream is best for bed sores?

This is one of the most common questions families ask, so here is the honest answer.

• Barrier creams are for protecting skin that is still unbroken, especially from urine and stool. They help prevent sores, not heal them. A common example sold in Lagos pharmacies is Sudocrem.
• No cream heals an open or deep bed sore. Open sores need to be cleaned, usually with water or saline, and covered with a dressing that keeps the wound moist. The right dressing depends on the wound and should be chosen by a nurse.
• Antibiotic and antiseptic creams are not routinely recommended for bed sores. UK guidance says not to use them routinely. Antibiotic tablets or injections are for spreading infection, not for healing the sore itself.
• Do not use plain gauze directly on an open sore, and do not try to cut away dead tissue at home.

When to call a nurse or doctor

Get professional help if:

• A red or dark area has not improved within 24 to 48 hours of taking pressure off it
• The skin breaks, blisters or opens
• There is pus, a bad smell, increasing pain, warmth or swelling around a sore
• Your parent has a fever or chills

Seek urgent help, and call 112 or 767 in Lagos, if your parent shows signs of sepsis: confusion or slurred speech, uncontrollable shivering, very fast breathing, skin that is pale, blue or blotchy (on dark skin, look at the palms, soles and lips), or passing very little urine. Older people with sepsis do not always have a high temperature.

Incontinence and adult diapers

Many bedridden people need adult diapers. Change them promptly, wash and dry the skin gently at each change, and use a barrier cream. Disposable underpads (bed pads) under the hips help protect the mattress.

Prices we found on Nigerian retail websites on 3 October 2026, for packs of about ten unless stated:

• Dr Brown's adult diapers: about ₦11,000 to ₦15,250 a pack of ten, or about ₦1,080 to ₦1,500 each. Bulk packs of 100 cost about ₦109,000 to ₦112,000
• Angel adult diapers: about ₦11,900 for 11 pieces, or about ₦1,080 each
• Depend: about ₦98,000 to ₦106,000 for 84 pieces, or about ₦1,170 each
• Tena pants and pads: from about ₦1,640 each, up to about ₦4,400 each for imported pull-up pants
• Disposable underpads: about ₦490 to ₦800 each in packs of 25 to 50

Prices vary a lot between sellers and change often, so compare before buying, and buy in bulk once you know which size and brand fits well. A diaper that is too big leaks, and one that is too small rubs.

A daily routine for a bedridden parent

A steady routine keeps your parent comfortable and helps you notice changes early. A typical day might include:

• Morning: check how they slept, change and wash, check the skin, mouth care, sit them upright for breakfast and medicines
• Through the day: change position at least every few hours, offer drinks regularly, keep heels off the bed, change diapers promptly
• Midday: lunch sitting upright, some gentle movement of arms and legs, company and conversation
• Afternoon: check the skin again, fresh air or sitting out of bed if possible
• Evening: supper, medicines, mouth care, a final skin check, comfortable position for the night
• Night: turn as needed, check incontinence, keep a light on the way to anything they need

Other everyday care that matters

• Mouth care: clean the teeth and mouth twice a day, even if your parent has no teeth. Poor mouth care raises the risk of chest infections
• Eating and drinking: always sit your parent fully upright, keep them upright for about 30 minutes afterwards, give small mouthfuls and check each is swallowed. If they cough or choke when eating, tell the doctor
• Chest: lying in bed raises the risk of chest infections. Encourage a few deep breaths and a cough every hour or so if they can
• Blood clots: being in bed for three days or more raises the risk. Encourage fluids and ankle movements. Call an ambulance if there is a swollen, painful leg with breathlessness or chest pain
• Joints: move arms and legs gently every day, or help your parent to, so joints do not stiffen
• Bowels: fibre, fluids and regular toileting help prevent constipation
• Catheters: if your parent has one, wash where it enters the body daily, keep the bag below the bladder, and call the nurse if it blocks, leaks or the urine contains blood
• Company and dignity: talk to your parent, involve them in decisions, keep them covered during care, and make time for visitors, prayer or music

How Home Care Nigeria helps

Our caregivers turn and reposition your parent, keep skin clean and dry, help with eating, drinking and medicines, and record everything in each visit report. Our registered nurse sets the care plan, checks the skin on visits, and arranges dressings or medical review when needed. For a parent in bed most of the day, our Live-in Care plan provides someone there day and night, with a named relief caregiver on rest days.

Read our guide to caring for a stroke patient at home

Common questions