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What Are Bedsores and How Are They Linked to Elder Abuse in Nursing Homes?

Despite being entirely preventable, bedsores remain painful and all too common for many nursing home residents. There are 2.5 million cases annually, and 20-30% of those happen in skilled nursing homes.

We expect our loved ones to receive the best possible treatment and attention in a nursing home. We want them to be comfortable and safe, with access to proper medical care and the physical and emotional support they need. Unfortunately, bedsores are a sign that the nursing home is not providing this level of care.

The aging human body is more susceptible to certain medical conditions, including pressure ulcers or bedsores. Bedsores are most common among elderly individuals who are bedridden or have limited mobility, which can have severe physical and emotional consequences. Bedsores can also be a sign of neglect or abuse.

This blog outlines the risk factors, causes, and prevention methods for bedsores in nursing homes. Additionally, you’ll learn when to contact an attorney if bedsores result from elder abuse.

What Are Bedsores in Nursing Homes?

Bedsores, also sometimes called pressure ulcers or decubitus ulcers, are injuries to the skin and the underlying tissue that result from prolonged pressure on a particular part of the body. These injuries can range from mild redness or discoloration of the skin to deep, open wounds that expose the underlying bone and muscle. 

Bedsores can be very painful and may take a long time to heal, particularly in older adults or those with compromised immune systems.

Bedsore Stages

Stage 1: The skin is intact, but there may be discoloration, warmth, or swelling in the affected area. The affected area may also be painful or itchy. In this stage, the wound hasn’t yet broken through the skin.

Stage 2: The skin is broken, and the wound is open. The wound may appear as a shallow, pink or red ulcer, and look like a blister or abrasion. The surrounding tissue may be swollen or discolored, and the wound may be painful.

Stage 3: The wound is deeper and may extend through the skin and into the underlying tissue. The wound may appear as a deep crater or ulcer and may be surrounded by a rim of dead tissue. The surrounding tissue may be swollen or discolored, and the wound may be painful.

Stage 4: The wound is even deeper and may extend into the muscle or bone. The wound may appear as a large, deep crater, and there may be visible bone or muscle. The surrounding tissue may be severely damaged, and the wound may be very painful.

Unstageable: The wound is so severe in this stage that it cannot be classified using the other stages. The wound may be covered with a thick layer of dead tissue, making it difficult to see the extent of the damage.

It’s important to note that pressure ulcers can progress quickly, particularly in individuals at a higher risk.

Bedsores Causes

Bedsores are caused by a lack of movement or when a person is not repositioned often enough or correctly. The pressure from lying or sitting in one position for too long can reduce blood flow to the skin and tissue, leading to injury.

Other risk factors for bedsores may include:

  • Age
  • Incontinence
  • Poor hygiene
  • Dehydration
  • Diabetes or vascular disease
  • Malnutrition
  • A history of smoking
  • Low body mass

The risk of developing bedsores increases with age as the skin becomes thinner, less elastic, and more prone to injury.

Bedsores’ Four Main Factors

1. Friction

If a patient is frequently repositioned in bed or pulled across the bed sheets without proper lifting techniques, the friction can cause damage to the skin and underlying tissue, leading to a bedsore. Even minor amounts of friction can significantly impact the skin, particularly if it is dry or delicate.

2. Pressure

When an elderly person is immobile or confined to a bed or wheelchair, the constant pressure on specific body parts can reduce blood flow and oxygen to the skin and surrounding tissues. Without adequate blood flow and oxygen, the tissue can become damaged and die, leading to bedsores.

3. Shearing

Shearing occurs when the skin and underlying tissues are pulled in opposite directions, damaging tissue. This can happen when a patient slides down in bed, causing the skin to be pulled in one direction while the underlying bone and muscle remain in place.

4. Moisture

When moisture, such as urine or sweat, is left in contact with the skin for an extended period, it can break down the skin’s protective barrier and increase the risk of tissue damage. The moisture can also increase the likelihood of friction and shearing.

Where Are Bedsores Typically Found on the Body?

Bedsores can develop differently depending on whether or not an individual is wheelchair-bound or bedridden.

For individuals confined to a wheelchair, pressure ulcers or bedsores can develop where the skin is in constant contact with the chair. These areas include the buttocks, tailbone, back of the thighs and arms, spine, and shoulder blades.

When someone is bedridden, pressure ulcers are commonly found on their body’s bony areas, such as the tailbone, hips, elbows, heels, and back of the head. These individuals are at the highest risk for bedsores because they are in the same position for long periods.

How Do Nursing Homes Prevent Bedsores?

Nursing homes have a legal and ethical responsibility to provide appropriate care and attention to prevent bedsores from developing in their residents.

Nursing home staff should regularly assess each resident’s risk for developing bedsores, considering factors like mobility, nutrition, and medical conditions. The assessment should be updated regularly as the resident’s condition changes. Staff must also regularly reposition patients based on their protocol.

Additionally, staff should maintain good skin hygiene for residents, including keeping the skin clean and dry, and using appropriate moisturizers and barrier creams to protect the skin. And patients should have appropriate support surfaces, such as pressure-relieving mattresses and cushions. 

Finally, nursing home staff should ensure residents receive adequate nutrition and hydration to support healthy skin.

Early detection and treatment of bedsores are critical in preventing them from progressing to more severe stages. If bedsores are suspected, they should be evaluated by a qualified healthcare professional to determine the extent of the injury and develop an appropriate treatment plan.

Unfortunately, many nursing homes fail to prevent bedsores due to staffing shortages or inadequate training. This can be medical negligence that results in unnecessary suffering for residents and their families.

If you believe a loved one has been neglected or abused in a nursing home, it is important to seek legal help as soon as possible. Our team at Chain | Cohn | Clark can help protect your or your family member’s rights and ensure they receive the highest quality care possible.

How Are Bedsores Treated?

The treatment method for bedsores or pressure ulcers depends on the severity of the wound. Treatment can range from simple wound care to surgery. Treatment goals are to relieve pressure on the affected area, prevent infection, promote healing, and manage pain. Patients may also require physical or occupational therapy to help them regain strength and mobility.

Mild bedsores can often be treated with simple wound care, which includes cleaning the wound with saline solution, applying topical ointments, and dressing the wound with a bandage or dressing.

More severe bedsores may require more advanced wound care, such as debridement, which removes dead or infected tissue, or negative pressure wound therapy, which uses a vacuum to promote healing.

In some cases, surgery may be necessary to treat a bedsore. Surgical options may include skin grafts or muscle flaps, which involve taking tissue from another body part and transplanting it to the wound site.

Can Bedsores Be Life-Threatening?

Yes, bedsores can be fatal, particularly in severe cases. When left untreated, bedsores can lead to serious complications, such as infection, sepsis, and even death. Bedsores cause 60,000 deaths annually. This is why timely prevention and treatment for bedsores is essential.

Caregivers in nursing homes and other care facilities are responsible for monitoring patients for any signs of skin breakdown and providing appropriate care and attention to prevent pressure ulcers from developing. If a facility fails to provide appropriate care and attention, it can be liable for any resulting bedsores or injury.

If you believe a loved one has suffered neglect or abuse in a nursing home, contact an experienced medical negligence attorney at Chain | Cohn | Clark for help.

Are Bedsores a Sign of Neglect?

If caregivers fail to provide appropriate care and attention, bedsores can be a sign of elder abuse or neglect. Bedsores often indicate a lack of attention to the patient’s needs, which may result from understaffing, inadequate training, or intentional neglect.

However, it’s important to note that not all bedsores result from elder abuse or neglect. Bedsores can also develop in individuals with underlying medical conditions, sometimes despite proper care and attention. 

However, when bedsores develop, it’s crucial to investigate the cause and ensure appropriate measures are taken to prevent them from occurring again:

  1. Document the evidence. Take photos of the bedsores and keep a written record of when they were first noticed, how they have progressed, and any other relevant information. If possible, try to obtain medical records documenting the bedsores’ development.
  2. If possible, talk to your loved one. It’s essential to talk to your loved one and ask about their care. They may be able to provide valuable information about the care they are receiving, including any concerns about the development of bedsores or other health issues. If your loved one cannot communicate effectively, observe their behavior and any signs of discomfort or distress. This can help you identify any issues contributing to the development of bedsores or other health problems.
  3. Report the abuse. Contact the nursing home or care facility where your loved one lives and report the suspected abuse or neglect. Provide them with your documentation and ask them to investigate the situation.
  4. Contact adult protective services. If you are not satisfied with the response from the nursing home or care facility, contact your local adult protective services agency. They can investigate the situation and appropriately protect your loved one.
  5. Contact an attorney. If you suspect that the abuse or neglect results from a behavior or intentional neglect pattern, you should strongly consider contacting an attorney specializing in elder abuse cases. They can advise you on your legal options and help you to pursue a legal claim if necessary.

How to File An Elder Abuse Bedsore Lawsuit

Nursing home bedsores lawsuits are a common malpractice claim in the U.S.; on average, plaintiffs who win their cases receive $250,000 in damages.

An experienced attorney specializing in elder abuse cases can be invaluable in making a case for elder abuse resulting in bedsores. They can help gather evidence, identify the responsible party, negotiate a settlement, or represent you in court.

Depending on the severity of the bedsores, an elderly adult suffering from bedsores may be entitled to compensation for medical expenses, pain and suffering, emotional distress, and other damages related to the abuse or neglect. Compensation can also cover punitive damages if it is proven that the injury was caused by intentional neglect or malice.

Additionally, in California, nursing home neglect falls under the category of personal injury lawsuits, so you have two years from when you suspect that bedsores result from neglect to file your claim.

Chain | Cohn | Clark Can Help You

The first step in filing an elder abuse claim is to talk to a knowledgeable attorney. Our team at Chain | Cohn | Clark can help you assess your legal options and then guide you through the process. Our expert attorneys will advise you on the best strategy to pursue a case against those responsible for harming your loved one.

If you or a loved one have been the victim of bedsore-related abuse or neglect, contact Chain | Cohn | Clark today for a free consultation and to learn more about your legal rights.

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