You notice a pressure injury on a dying patient's sacrum. What is the best conclusion to reach?

Recognizing a pressure injury on the sacrum of a dying patient often leads to the conclusion of a Kennedy terminal ulcer. This type of ulcer is particularly significant in patients who are approaching the end-of-life phase, as it is typically associated with the physiological processes of dying rather than typical causes of pressure injuries, such as inadequate repositioning or pressure.

Kennedy terminal ulcers are generally located on the sacrum, coccyx, or heels and can appear suddenly. They are characterized by specific features like a butterfly shape and may have a color that ranges from maroon to black. The presence of such an ulcer in an individual who is actively dying indicates the body’s shutting down processes and does not necessarily imply standard wound care issues such as pressure ulcer prevention failures.

While factors like infection and nutrition play a role in overall patient health, in the context of a patient who is nearing death, these aspects may be less relevant to the immediate assessment of this particular injury. This understanding highlights the unique considerations necessary in palliative care settings, where the focus shifts to comfort and quality of life rather than aggressive wound management.