Bedsores In Nursing Homes

What are Bedsores?

Bedsores are injuries to underlying skin tissue that result from prolonged pressure. They usually develop on bony areas of the body such as the tailbone, buttocks, lower back, hips, ankles and heels when there is prolonged sedentary activity (not moving) without shifting of the pressure away from the damaged skin areas. Locations that are the bony areas of the body.

bedsores on hand
Nursing Home Patient Bedsores on Hand

Medical Name for Bedsores

The medical name for bedsores is Decubitus Ulcers.

Risks If Left Untreated?

Seek immediate medical treatment if you believe that a patient has bedsores.  If not treated, complications from bedsores can include:

  • Cancer of lymph nodes or skin
  • Amputation
  • Joint and bone infection
  • Sepsis
  • Gangrene
  • Necrotizing fasciitis
  • Cellulitis
bedsores on nursing home patient foot
Bedsores on Nursing Home Patient Foot

Patient Risk Factors

Patients with the following risk factors are more likely to get bedsores.

  • Prolonged Immobility, particularly when the mobility is involuntary or due to injury or disability
  • Urinary incontinence (bedsore contamination risk)
  • Fecal incontinence (bedsore contamination risk)
  • Diminished cognitive ability (inability to self-report problems)
  • Diminished mental capacity (inability to self-report problems)
  • Malnutrition
  • Obesity
  • Auto-immune deficiencies
  • Blood clotting disorders

What to Expect From Nursing Home Employees

Nurses and nursing home aides receive training on how to avoid bedsores.

Preventive measures include:

  • Dry bedding and clothing
  • Patient shifting and moving away from pressure points
  • Daily bed checks
  • Keeping pressure away from irritated skin areas

How Many Cases Are Seen Each Year?

Bedsores are common. They are estimated to impact 2.5 million or more patients annually.

bedsore on old woman's ear
Bedsore on Ear of Nursing Home Patient

Should You Be Alarmed?

If a nursing home patient has bedsores, then it should be investigated. Nursing Homes are obligated to provide a standard of care that includes observing and taking action when action is needed.

Legal Negligence Claims and Bed Sores

If you see bed sores on a nursing home patient, be sure to keep a record including times, dates and photographs.  Bedsores are usually a sign of nursing home negligence or neglect by nursing home employees due to a breached duty of care. A claim of nursing home abuse would mean that the nursing home had intent to cause harm.

Either way, legal action may be necessary to ensure that the patient receives a high level of care.  We suggest calling a law firm in the State where the nursing home is location. In New Jersey we suggest calling Gartenberg Howard at (201) 488-4644.

Bed Sore Stages and Legal Action

Bed sores are rated based on the degree of severity on a scale from stage 1 to 4.  We recommend always alerting the nursing home director, medical and professional nursing staff if you see any signs of bedsores.

Bed Sore StageCharacteristicsRecommended ActionLegal SuggestionsImage
1• Bruising or changes in skin color (red areas, black and blue), the presence of irritation at bony (pressure points) on the body including the tailbone, elbows and hips.
• Sensation of itch or pain.
• Shifts in touch sensitivity, reaction to pressure on the skin or changes in temperature. The patient might experience tingling skin or numbness.
• Skin surface may go from feeling firm to soft.
• The patient may not even notice the changes in skin condition.
Preventive care is called for if you see initial signs of bed sores. Discuss the situation with nursing staff and ask about patient hygiene and movement.There is a low likelihood of bringing a legal action for damages. If the bedsores are a sign of a pattern of abuse or neglect, then legal action for negligence makes sense, particularly if it is the only way to get the appropriate and adequate care for the patient. . stage 1 bedsore
2• A stage one bedsore progresses to stage two when there is a visibly open wound. The wound she be treatable over an eight-week period.
• Treatment is needed to avoid a bedsore that needs surgical treatment to relieve any pressure on the sore.
• Seek medical attention as soon as possible including changes in the patient’s routine.
• Patients will need frequent observation to monitor the condition.
If there is an open wound and the fluid has a rancid odor, these are signs of infection requiring treatment such as wound cleaning, disinfection, antibiotics and draining of the wound.
• If the patient or family is incurring added costs due to the stage 2 bedsores, then legal action may be required in order to get compensation for these costs and for any damages.
• Damages for neglect or negligence would be for expenses such as medical costs, financial harm.
One objective of any action would be to prevent any future harm to the patient.
stage 2 bedsore
3• Stage 3 bedsores are of great concern to the welfare of the patient.
• Characteristics include deep ulceration of the skin equal to a thickness equal to surrounding skin tissue.. Each area could be growing in size.
• The ulceration can compromise exposed tendons, muscle and bone.
Removal of any dead skin tissue may require surgical intervention if infection is not stopped.
• If antibiotics and removal of dead skin is not effective in stopping any infection or if healing is not taking place, then surgery may be needed.
• Procedures that move urine or bodily waste away from the infected area may be needed.
• The bedsore area and surrounding skin may require surgical removal.
• Underlying dead bone tissue may also need to be removed.
• When closing the wound a skin graft may be required.
• Stage 3 bedsores are indicative of a nursing home staff that is not providing the appropriate level of care.
• These types of bedsores are ground for legal action on the basis that the facility is not providing the required level of care.
Legal action will seek damages awarded for negligence.
stage 3 bedsore
4Stage 4 bedsore symptoms include the presence of:
• Life-threatening complications and infects such as sepsis.
• Damaged skin and skin loss to the degree requiring surgical intervention
• Bone infection
• Lack of skin sensation
• No utility of tendons, skin, tissue and muscles at the site of the infection or sore
• Bedsores require immediate medical intervention to avoid further skin damage.

• Bedsores can be fatal at this stage due to the risk of infection, particularly if not treated within 8 weeks after they are first identified.

• Once treated with antibiotics and surgery, the patient may require physical therapy.

• Some skin areas may need what is called negative pressure therapy using a vacuum dressing.
Lawsuits on behalf of patients with stage 4 bedsores are common. These type of bedsores are signs that substandard care was provided for a vulnerable patient.
stage 4 bedsore

Resources:

Hiring a Nursing Home Neglect Lawyer for Bedsore Patients

Mayo Clinic

WebMD

MSKTC

Family Doctor

National Institutes of Health

National Pressure Ulcer Advisory Council/

Harvard Health

MedLine Plus