Bedsores

in bed with pain

Bedsores, also referred to as pressure sores and decubitus ulcers, are a serious medical problem. Unfortunately, elderly nursing home residents and hospital patients are typically the ones who develop these sores. Decubitus ulcers are painful and result from prolonged pressure on an area of the body that has a bony prominence and a thin covering of flesh. Examples of common pressure sore areas include the tailbone, heels, elbows, and shoulder blades. Bedsores can be caused by a variety of factors, including:

The presence of moisture due to unchanged diapers and wet sheets
Malnutrition and dehydration
Immobility
The failure of care providers to reposition bedridden patients regularly

In order to prevent decubitus ulcers, it is imperative that the resident be turned and repositioned frequently. People that cannot move on their own should be turned and repositioned every two hours in order to prevent skin breakdown.

People who have bedsores suffer immense pain and can even die. In one alarming case, a Pennsylvania nursing home resident suffered a severe decubitus ulcer that was so deep, it penetrated her internal organs and her bowel drained from her hip. She eventually died.

What is more alarming is that most bedsores can be prevented. Additionally, when the sores do develop, most can be cured. Despite this, it is estimated that as many as one-fourth of nursing home residents fall victim to bedsores at some point during their stay. Many elderly nursing home residents are at high risk for developing pressure sores. High risk factors for decubitus ulcers include:

Residents aged 75 and older
Residents needing help with feeding and those totally unable to feed themselves
Residents who have a limited ability to reposition themselves, which may be caused by physical inability or the use of restraints
Residents who cannot sense the need to reposition
Residents who are underweight
Residents who suffer from decreased mental status
Residents with dry skin
Residents who are incontinent
Residents with special medical conditions, including diabetes, cancer, and multiple sclerosis

The law requires that a nursing home must ensure that a resident does not develop bedsores, unless the resident’s medical condition shows that the bedsores were unavoidable.

Many times, however, the development of bedsores is avoidable, and the reason for their development is the negligence of the nursing home. It is also important to note that the law also requires the nursing home to prevent the progression of any bedsores the resident may have at, or during, admission to the nursing home facility.

Bedsore Abuse Prevention Tips

Because most bedsores are preventable, taking measures to prevent them is key.

Because malnutrition and dehydration can cause decubitus uclers, make sure your loved one is getting enough food and water.
Because spending a lot of time in bed makes a person prone to bedsores, nursing home residents should get as much exercise as possible to increase mobility. Consult your loved one’s physician and request placement in a physical conditioning or rehabilitation program that might include exercises to improve strength and endurance, physical therapy, a walking program, or gait training.
Request grab bars and other devices so that repositioning is made easy for the resident.
Take care of your loved one’s skin, or make sure that the nursing home is taking this care. Ask your doctor to suggest a good lotion to keep skin moist and supple.
If your loved one is incontinent, make sure adult diapers are changed regularly and that sheets are dry and clean.
Always pay attention to the ratio of staff to residents. Because understaffing is a problem linked to poor care, you should always be concerned about how many staff members are available to care for your loved one.

If someone you care about has developed a pressure sore while in a nursing home, you should:

Tell their doctor immediately, and discuss causes, cures, and future prevention techniques.
If you are dissatisfied with the way the nursing home is treating current bedsores or how they are trying to prevent future bedsores, you should get your loved one emergency medical help at a hospital immediately. Remember that decubitus uclers are serious and can be life-threatening.

Evaluating Bedsore Injury Claims

The law requires that a nursing home must ensure that a resident does not develop bedsores, unless the resident’s medical condition shows that the pressure sores were unavoidable. In some cases, bedsores can be unavoidable. For example, if a person is terminally ill; semi-comatose or comatose and life sustaining measures have been withdrawn or discouraged, pressure sores may be difficult to prevent.

Many times, however, the development of bedsores is avoidable, and the reason for their development is the negligence of the nursing home.

Each case involving decubitus ulcers is highly individualized and our law firm will review the medical chart for the following information in order to determine if the development of a bedsore was avoidable:

What was the resident’s skin condition before admission to the nursing home?
What medical problems did the resident have? Some medical problems such as diabetes, kidney failure and paralysis place the resident at risk of developing bedsores.
Was good care given in the home, such as turning and proper positioning of a patient, use of devices to relieve pressure such as special mattresses, beds and padding to protect areas at risk for breakdown such as the heels and elbows?
Was the resident kept clean and dry to prevent skin breakdown?
Was the resident receiving adequate nutrition and fluids?
Was the resident identified as being at risk for pressure sores, and if so, was a preventative care plan was implemented?
How many bedsores developed, how severe, and where are they located on the body?
Was a doctor and/or wound care specialist consulted and whether they were actively and consistently involved in treatment?
Is there accurate documentation in the medical chart of assessments of the skin, turning and repositioning, and treatment of the decubitus ulcers?
Are there pictures of the bedsores?
Did the bedsores lead to serious complications such as infection, amputation, and sepsis (the spread of the infection to the bloodstream) that can lead to death?

Bedsores and Understaffing

In most cases involving pressure sores, we often find that the nursing home was understaffed. Examples of nursing home negligence in the development of bedsores include:

Failure to prevent malnutrition and dehydration
Failure to provide adequate treatment and services for incontinent patients
Failure to provide an adequate number of nursing home staff to reposition bedridden patients regularly
Failure to properly supervise staff to ensure that bedridden patients are being repositioned regularly
Failure to properly train nursing home staff to prevent the development of bedsores
Failure to provide proper treatment to promote healing of bedsores