How to Reduce the Risk of Heel Ulcers

For every care home supporting older people, avoiding damage or ulceration to vulnerable areas of skin is a major challenge. Heels in particular are at risk of pressure sore development due to the thin layer of tissue below the epidermis and the lack of muscle over the heel bone and the presence of other conditions such as diabetic neuropathy, peripheral vascular disease and COPD can increase the level of risk even further.

When things go wrong, not only can the person in your care suffer pain, reduced mobility and an increased risk of infection, your service can suffer reputational damage and even financial loss. Only last year, a Gloucester care home was subject to legal action from the family of a service user who developed heel ulcers during a 7-week respite stay. The family received substantial compensation for the pain and distress associated with the ulcers which also had a major impact on the victim’s mobility.

In order to adopt a successful approach to the prevention of heel ulcers, all staff caring for at risk older people must be aware of the risk factors and the steps they can take. Read on to learn more about how you can ensure your service users are protected.

Prevent Heel Ulcers

Making sure that your staff are aware of the simple but effective steps they can take to prevent heel ulcers can drastically reduce the risk to your service users. In most cases, the cost of good pressure care is minimal and simply requires a well-organised and consistent approach.

7 Tips to Prevent Heel Ulcers and Skin Damage 

  1. Carry out regular checks: Ensure all care staff know to inspect the heels and feet of at-risk service users during each episode of personal care, to record their findings and to report any concerns to a senior staff member.
  2. Use emollients: Make sure any prescribed emollients are applied to the feet and heels every day to maintain healthy skin. However, remember to ensure that heels are not massaged too vigorously as this can cause skin damage.
  3. Review footwear: Be aware that over-tight socks, stockings or shoes may limit circulation and increase the risk of skin breakdown. Use a larger size if necessary.
  4. Make use of pressure relieving equipment: Simple techniques such as elevating heels using a pillow can reduce risk significantly. Maintaining regular positional changes to remove pressure from the heel will reduce the risk further and also provide an opportunity for skin inspection.
  5. Minimise friction: Agitated or unsettled service users can be at particularly high risk of friction damage so consider the use of anti-friction socks or film dressings to reduce the likelihood of skin damage occurring.
  6. Encourage activity: Encourage service users who are able to lift and move their feet to do so on a regular basis. Even those with memory loss can carry out a range of preventative movements with prompting.
  7. Additional protection: Service users identified as being at particularly high risk may benefit from specialist boots or heel protectors which can be used in addition to your existing preventative measures.

For more on managing risks and complaints like this, Care Quality Matters is your indispensable partner. Claim your free 30-day trial here, and get the latest advice, guidance, tools and resources for care managers.

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