Impaired skin integrity is one of the most common and most costly problems facing the institutionalized elderly. Risk assessment tools provide the nurse with an efficient and systematic means of identifying those clients at high risk for pressure ulcer development. Pressure ulcer risk assessment tools are usually based on a combination of the following variables: mobility, continence, mental status, activity, nutrition, or physical status. Further testing and comparison of the various pressure ulcer risk assessment tools in the elderly population is needed to establish relative scientific and practical merit.