VTE (Blood Clot) Prevention in Care Homes: A Care Staff Guide

Venous thromboembolism — blood clots that form in the deep veins, usually in the leg, and can travel to the lungs — is often thought of as a hospital problem, linked to surgery and post-operative recovery. In reality, care home residents carry a similarly elevated risk, driven by the same underlying factor: prolonged immobility. Research comparing nursing home residents to the general population has found substantially higher rates of VTE, reflecting how closely a typical care home resident's risk profile can mirror that of a hospital inpatient.

Why care home residents are at particular risk

The core risk factors for VTE — reduced mobility, being confined to bed or a chair for extended periods, older age, and often several chronic health conditions at once — describe a significant proportion of care home residents as a matter of course, not as an unusual exception. A resident recovering from a recent hospital stay carries elevated risk for a period afterwards, sometimes for months, which means VTE risk doesn't end the moment someone is discharged back into a care setting. This overlap between hospital-level risk factors and everyday care home life is exactly why VTE prevention deserves the same deliberate attention in care homes that it already receives in hospitals.

Recognising the signs of DVT and pulmonary embolism

Deep vein thrombosis (DVT) typically presents with throbbing pain in one leg — rarely both — usually in the calf or thigh, along with swelling, skin discolouration, and sometimes visibly swollen veins in the affected leg. These signs should never be dismissed as ordinary swelling or discomfort in an older resident without at least a prompt clinical check, given how serious an undiagnosed and untreated clot can become. The more urgent warning sign is pulmonary embolism, where part of a clot breaks away and travels to the lungs — this requires an immediate emergency response if a resident with any DVT-type symptoms also becomes short of breath or develops chest pain, since this combination indicates a potentially life-threatening complication in progress.

What actually reduces the risk

Prevention research consistently shows that a significant proportion of clots linked to immobility are preventable through a combination of risk assessment and appropriate preventive measures. For care home residents, the most accessible prevention measures are ones care staff can genuinely support day to day: encouraging regular movement and repositioning rather than long, unbroken periods of sitting or lying still, supporting good hydration since dehydration measurably increases clot risk, and following any prescribed use of compression stockings correctly and consistently, since a stocking worn incorrectly or removed early provides little of its intended benefit. For residents at higher risk, a clinician may also prescribe preventive anticoagulant medication, which needs to be administered accurately and monitored in line with anticoagulant safety practice already familiar to care staff from other medicines.

Risk assessment and communication at transition points

VTE risk should be specifically considered whenever a resident is admitted from hospital, since discharge information should include their individual VTE risk status and any preventive measures already started. This information needs to transfer clearly to the receiving care home, not get lost among the wider volume of discharge paperwork — a resident discharged on a preventive anticoagulant, or one who was assessed as high risk but not started on treatment, both need that information acted on immediately rather than rediscovered days later during a routine medicines check.

Building movement into daily routines

For residents with limited mobility, regular repositioning and encouraged movement — even simple ankle exercises or a short supported walk — genuinely reduces VTE risk, and this connects naturally with existing moving and handling practice, where staff are already trained to support safe repositioning. Building VTE awareness into that existing skill set, rather than treating it as a separate topic, helps ensure prevention becomes a routine part of everyday care rather than something only considered after a resident has already developed symptoms.

Frequently asked questions

Should every immobile resident wear compression stockings? Not automatically — compression stockings should be prescribed based on an individual risk assessment, since they carry their own contraindications for some residents, such as those with certain circulation problems.

How urgently should suspected DVT symptoms be escalated? Promptly, the same day — DVT symptoms shouldn't wait for a routine GP visit, given the risk of the clot progressing or breaking free before treatment starts.

Does VTE risk reduce once a resident has settled into long-term care? Not necessarily — ongoing immobility, age, and chronic health conditions mean VTE risk can remain elevated indefinitely for many residents, which is why prevention needs to be a continuous part of care rather than a one-off admission check.

Recognising VTE as a genuine, ongoing care home risk — not just a post-surgical hospital concern — helps staff catch early warning signs and embed simple, effective prevention into everyday care.