Bed Sores at Ohio Nursing Homes

Bedsores in Nursing HomesIf your loved one in a nursing home is suffering from bedsores (also known as decubitus ulcers or pressure sores), you are likely facing a quality of care issue. Although federal law requires nursing homes to have bedsore prevention programs, bedsores can become a very serious problem among frail older adults or anyone who is immobile or unconscious and confined to a bed, or left in the same position, for a long period. Incontinent patients are particularly susceptible to bedsores because exposure to moisture from urine increases the risk of damage to the skin.

Sometimes a person at risk for pressure sores is not bedridden, but is confined to a wheelchair or has been wearing a cast for a prolonged time. These people may also be unable to sense pain which further complicates the development of bedsores. To prevent this problem, the patient must be turned, positioned properly and given adequate nutrition and skin care.

What is a bedsore?

Physicians at University Hospitals in Cleveland describe a bedsore as a breakdown of skin and tissue from constant pressure and poor circulation at the site of the sore which develops when the blood supply to the skin is cut off for more than two or three hours. As the skin dies, the sore begins as a red, painful area which eventually turns purple. If not treated, the skin can break open and become infected. Eventually, the bedsore becomes deep extending into muscle and bone. Pressure sores can develop rapidly, but are slow to heal and difficult to treat. They can take days, months, or even years to heal depending on:

  • Severity of the bedsore
  • The patient’s physical condition
  • The presence of other diseases (such as diabetes)

In a worst-case scenario, the condition becomes gangrenous and the patient faces amputation, or even death from renal failure or amyloidosis. Amyloidosis occurs when proteins become insoluble and are deposited in organs and tissues, disrupting normal functions.

Where do bedsores usually originate?

Bedsores most often occur in the bony parts of the body in the tailbone, hip, heels, sides of the knees, ankles, and shoulder blades, but bedsores are also frequently found in the buttocks area, and the back of the head. Treatment may be more difficult once the skin is broken.

Those at risk for developing bedsores, in addition to those confined to bed or a wheelchair or incontinent patients, may include those who exhibit:

  • Poor nutrition or dehydration
  • Spinal cord injuries
  • Hip fractures
  • Dementia
  • Other physical problems

People who are confined to a bed most of the time should be checked daily for areas of redness, the first sign of skin breakdown in the following vulnerable areas: Head and ears, shoulders, hips, lower back and tailbone, heels, ankles and behind the knees. Residents who spend considerable time in a wheelchair need to be examined for bedsores developing in the spine or buttocks areas, on the shoulder blades and on the backs of the arms and legs.

What do bedsores look like?

There are four stages of bedsores, according to the National Pressure Ulcer Advisory Panel (NPUAP) website. Pressure sores are often categorized based on the degree and depth of the ulcer and the degree of skin and tissue loss experienced. They are defined as:

  • Stage 1: (non-blanchable erythema)—A localized area which looks red and irritated and is warm or cool to the touch compared to adjacent tissue. The redness does not diminish when pressure on the site is relieved. The person may also complain of burning, pain or itching in the area, usually a bony prominence. This stage may be difficult to detect in persons with dark skin tones.
  • Stage 2: (partial thickness skin loss)—The affected area has lost skin and looks more damaged. It may have an open sore, abrasion or serum-filled blister or what looks like a red-pink shallow crater or ulcer that is shiny or dry. The person complains of significant pain and may have discolored skin around the wound.
  • Stage 3: (full thickness skin loss)—The area has a crater-like appearance due to damage below the skin’s surface and loss of outer skin layers. The full thickness of the skin is lost, exposing tissue and sometimes subcutaneous fat, but not bones or tendons. Areas of significant subcutaneous tissue can develop extremely deep pressure ulcers at this stage.
  • Stage 4: (full thickness tissue loss)—The affected area is severely damaged and a large wound is present. Muscles, tendons, and bones can be exposed with fascia or joints involved. In the latter case, osteomyelitis or osteitis (inflammation of the bone) is likely to occur.

Can bedsores be prevented?

Most bedsores are preventable. It’s important that nursing home staff members are given proper training in spotting this condition at the early stages.

The requirement to regularly shift patients to prevent bedsores must be performed diligently. Failure to do so is a common form of neglect. By simply adhering to a basic standard of care, nursing homes and assisted living facilities can spare your loved one unnecessary physical and mental anguish. A relative or friend visiting a nursing home can serve as a second set of eyes—advocating for the resident by being alert to the quality of treatment at the facility.

To prevent bedsores and progression of existing decubitus ulcers:

  • Turn and reposition the patient every two hours to minimize pressure, rubbing and friction on the skin
  • Provide soft padding in beds and wheelchairs to reduce pressure
  • Keep the resident’s skin clean and dry
  • Use lubricants where necessary
  • Provide good nutrition including adequate vitamins, minerals, fluids and protein

To treat existing bedsores:

  • Take immediate action as soon as a problem is discovered
  • Remove pressure on the affected area
  • Keep the wound clean
  • Protect the wound with medicated gauze or other special dressings
  • Administer antibiotics and other medications as necessary to treat infection
  • Monitor the bedsore on an ongoing basis and document size, depth and response to treatment
  • Transplant healthy skin to the wound area (on a physician’s recommendation)

It has been established through research that with consistent team effort the risk of bedsores in nursing home patients can be substantially reduced. In fact, Medicare has categorized bedsores as an injury that should never occur in a nursing home. According to Medicare data, the average cost of pressure sore treatment per patient is more than $40,000 and this does not include those cases that become life-threatening and require substantial treatment. Pressure ulcers are not only painful, but can have a devastating long-term impact on the health and quality of life for nursing home residents.

Bedsores can be a form of nursing home abuse

If your loved one in an Ohio facility has bedsores due to the facility’s failure to monitor the situation, you may be able to file a medical malpractice case against that Ohio nursing home. A case can be filed if the resident received improper treatment or if there was an unnecessary delay in treatment causing the bedsore’s condition to become worse. It may not be enough to get the situation corrected by speaking with the supervisors of the facility. It is important to send a message to the facility’s operator that this type of negligence and abuse is not acceptable and will not be tolerated.

At Slater & Zurz LLP, our attorneys have represented many people in bedsore type cases in various care facilities. We use the knowledge and skill our attorneys have gained in more than 40 years of practice to develop strong cases. Please call out firm at 1-888-534-4850 so that our legal team can help your family receive justice and compensation for the injuries you or your relative has suffered.

If you would prefer to contact us in writing, go to slaterzurz.com and fill out a FREE CASE REVIEW form. We will set up a free confidential consultation to discuss any nursing home abuse or neglect that you suspect. It is possible your loved one is experiencing more than one type of abuse or neglect.

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