How to Prevent and Treat Tailbone Bedsores: A Caregiver’s Practical Checklist
Caring for someone who is bedridden or spends long hours in a wheelchair requires constant vigilance, especially when it comes to the tailbone area. The tailbone—or coccyx—is a "bony prominence" that bears a massive amount of weight, making it incredibly vulnerable to developing pressure sores (decubitus ulcers).
These injuries can progress from a mild red spot to a serious, deep wound in a shockingly short amount of time. If you are a caregiver, your primary goal is to prevent these sores before they start. However, if a sore has already developed, you need a clear, actionable plan to promote healing and prevent infection. This checklist provides a practical guide for both prevention and treatment to ensure the comfort and health of your loved one.
The Caregiver’s Checklist for Tailbone Health
Effective pressure sore management is built on three pillars: relief, cleanliness, and nutrition. Use this checklist daily to maintain skin integrity.
I. Daily Prevention Routine
[ ] Consistent Repositioning:
In Bed: Reposition the individual at least every two hours. Use a turning schedule to alternate between lying on their back, left side, and right side.
In a Chair: If they are seated, have them shift their weight every 15 to 30 minutes. Encourage them to lean forward or lift their buttocks using the chair arms.
[ ] Thorough Skin Inspection:
Check the tailbone area during every repositioning.
What to look for: Redness, purple or blue discoloration (especially on darker skin), blisters, open skin, or warmth/firmness in the tissue.
Action: If you find a red spot that does not turn white when pressed, keep all pressure off that area immediately.
[ ] Proper Hygiene and Moisture Control:
Cleanliness: Clean the skin immediately after any incontinence episode to prevent urine or stool from damaging the skin barrier.
Moisture Barrier: Apply a thick, zinc-oxide-based barrier cream to the sacral area to protect the skin from moisture.
Drying: Gently pat the skin dry; do not rub, as friction can tear fragile skin.
[ ] Use Pressure-Redistribution Surfaces:
Bed: Utilize a specialized air mattress or a high-density foam mattress designed for pressure relief.
Chair: Use a high-quality gel or air-filled cushion designed for wheelchairs, not a standard pillow.
II. Nutrition and Hydration Plan
[ ] Maintain Proper Hydration: Ensure the individual drinks adequate fluids throughout the day. Dehydrated skin is brittle and breaks down easily.
[ ] Boost Protein Intake: Protein is essential for repairing skin and tissue. Include lean meats, dairy, eggs, or protein supplements in their diet.
[ ] Vitamin and Mineral Support: Ensure their diet includes enough Vitamin C and Zinc, which are vital for wound healing.
III. Treatment for Existing Tailbone Sores
If you identify a sore, immediately contact a healthcare provider for a professional assessment. While waiting for medical advice, follow these steps:
[ ] Strict Off-Loading: Ensure zero pressure is placed on the sore. This may mean the individual must lie on their side only until the sore heals.
[ ] Proper Wound Dressing: Clean the area with saline solution and apply a dressing recommended by a doctor. Common choices include hydrocolloid dressings to keep the wound moist and protected.
[ ] Manage Infection Risk: Keep a close watch for signs of infection, such as increased pain, foul odor, yellow or green drainage, or if the individual develops a fever.
Summary of Stages for Quick Reference
Understanding the severity of the sore dictates the treatment plan.
| Stage | Appearance | Action Required |
| Stage 1 | Redness, warmth, intact skin. | Off-load pressure, keep skin dry and clean. |
| Stage 2 | Shallow open wound, blister. | Consult doctor, use protective dressings. |
| Stage 3 | Deep crater, visible fat. | Professional medical care, debridement. |
| Stage 4 | Deep wound, visible muscle/bone. | Immediate medical/surgical intervention. |
Key Takeaways for Caregivers
The most important tool in your arsenal is prevention. A tailbone sore that is caught at Stage 1 can often be reversed quickly with proper care. However, neglecting the area can lead to severe complications that require surgery or long-term hospitalization.
Trust your instincts. If the skin looks different, treat it as a potential sore and take action immediately. By following this checklist, you are providing the best possible care to protect your loved one’s dignity, comfort, and health.
Understanding Pressure Sores: A Comprehensive Guide to Prevention and Care