An older adult client who is 5 feet, 4 inches (163 cm) and weighs 145 lb (65 kg) is admitted to the long-term care facility. The client sits for long periods in a wheelchair and has bowel and bladder incontinence. The client can feed themself and has a fair appetite, eating best at breakfast and poorly thereafter. The client does not have family members living nearby and is often noted to be crying and depressed. The client also frequently requires large doses of sedatives. Which factors place the client at risk for developing a pressure ulcer