How to Treat a Suspected Deep Tissue Injury in Hospice Care

As hospice nurses, caregivers, aides, and managers, you are essential in providing compassionate care to patients with various health conditions. One of the challenges you may encounter is deep tissue injuries.

This article will cover the definition, goals, and treatment options for suspected deep tissue injuries, with a focus on the heel and buttocks areas. Understanding how to treat deep tissue injuries, you can help your patients maintain their comfort and dignity while preventing further complications.

how to dress a deep tissue injury in hospice care

What are Deep Tissue Injuries in Hospice?

A deep tissue injury (DTI) is a type of pressure injury that appears as a localized area of discoloration, usually purple or maroon, with the skin remaining intact. In some cases, a blood-filled blister may also be present. The affected area may be painful, firm, mushy, boggy, warmer, or cooler before the discoloration.

What are Common Sites for Deep Tissue Injuries?

Deep tissue injuries often occur in areas with prominent bony structures, such as the heels and buttocks. As a result, deep tissue injury heel treatment and deep tissue injury buttocks treatment are crucial topics for hospice caregivers.

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The Goal of Deep Tissue Injury Treatment

The primary goal when treating a suspected deep tissue injury is to remove the cause, if possible, and prevent further tissue damage. This involves a combination of medical intervention and patient education.

Treatment for Deep Tissue Injuries in Hospice Care

To effectively treat deep tissue injuries, follow these steps:

Step 1: Obtain a Physician’s Order

Always consult with the primary physician before starting any treatment. They will provide specific orders tailored to the patient’s needs.

Step 2: Use Standard Precautions

Ensure you follow all necessary infection control measures, such as hand hygiene and wearing appropriate personal protective equipment (PPE).

Step 3: Cleanse the Area Gently

Using a gentle cleansing solution, carefully clean the affected area. Avoid scrubbing or rubbing the skin, as this may cause further damage.

Step 4: Pat Dry

After cleansing, gently pat the area dry with a soft, clean towel. Do not rub the skin, as this can cause additional injury.

Step 5: Apply a Hydrocolloid Dressing

Once the area is clean and dry, apply a thin hydrocolloid dressing, such as DuoDerm Extra Thin or Tegaderm Clear. This dressing helps to keep the site moist and promotes healing.

Step 6: Change Dressing as Needed

Replace the hydrocolloid dressing once weekly or as needed, according to the physician’s orders and the patient’s condition.

Step 7: Apply Skin Prep for Intact Heels

If treating a deep tissue injury on the heel, apply a skin prep product to protect the intact skin and promote healing.

Step 8: Educate the Hospice Patient and Family

Educate the patient and their family about pressure ulcers and deep tissue injuries. Explain the importance of turning frequently (as the patient chooses/allows) to help prevent further injury. Document the education provided and the response of the caregiver.

Step 9: Document per Agency Protocol

Ensure you properly document the treatment and patient’s response, following your agency’s guidelines

Goals of tissue injury in hospice care

Mattress Recommendation for Deep Tissue Injury Prevention

A high-quality foam mattress can help distribute pressure more evenly, reducing the risk of deep tissue injuries. Consult with the primary physician for specific recommendations based on the patient’s needs.

Additional Resources for Deep Tissue Injury Treatment

It’s crucial to stay up-to-date with the latest research and deep-tissue injury treatment recommendations. Consider referring to the following resources for more information:

As you continue to develop your expertise in deep tissue injury treatment and prevention, remember that your role as a hospice caregiver is invaluable to the well-being and comfort of your patients. Keep learning and growing, and you’ll continue positively impacting the lives of those you serve.


As a hospice professional, understanding deep tissue injury treatment and prevention is crucial to providing the best possible care for your patients. By following the steps outlined in this article and collaborating with the patient, their family, and the primary physician, you can help minimize the impact of deep tissue injuries and improve the overall quality of life for those in your care.


Will hospice provide wound care?

Yes, hospice care includes wound care as part of its comprehensive services. Skilled nurses will assess, manage, and treat wounds, working closely with patients and their families to provide comfort and alleviate pain. The goal is to maintain quality of life while addressing wound complications, such as infections or discomfort.

Does palliative care include wound care?

Yes, wound care is part of comprehensive palliative care. Wound care in palliative settings focuses on managing pain, controlling infection, and preventing complications while promoting comfort and dignity for the patient.

Should you massage a deep tissue injury in hospice care?

Massaging a deep tissue injury in hospice care should be approached with caution. It’s essential to consult with the patient’s medical team, as factors like pain levels, medication, and overall health can influence the decision. A gentle massage by a qualified professional may provide comfort and alleviate pain if deemed appropriate. Avoid aggressive techniques to prevent further harm.

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