Nursing Home Neglect: Primary Cause of Bedsores

According to the Agency for Healthcare Research and Quality (AHRQ), more than 2.5 million people in the United States develop pressure ulcers, or bedsores, each year. Bedsores are injuries to the skin and underlying tissue that result from sustained pressure on the skin. They are accompanied by an array of medical complications; some of these complications, such as cellulitis and sepsis, can be fatal. Although nursing home staff are responsible for taking steps to prevent patients from developing bedsores, negligent providers endanger and inflict preventable injuries on innocent victims every day.

Bedsores: What Are They and What Causes Them?

Pressure ulcers develop from prolonged pressure on the skin, so they are most common in patients who have certain medical conditions that cause them to struggle with moving or changing positions. Sometimes bedsores take hours to develop, at others, they develop over the span of a few days. The Mayo Clinic reports that patients who use wheelchairs tend to develop pressure ulcers on their tailbone or buttocks, shoulder blades and spine, and the backs of their arms and legs that rest against the chair. Patients who have to stay in bed usually develop pressure ulcers on the back or sides of their head, their shoulder blades, their hip, lower back, or tailbone, and their heels, ankles, and the skin behind their knees.

There are several stages of bedsores. The stages depend on the degree of damage that the bedsore has caused to the patient’s skin and tissue(s). In very severe cases, bedsores can cause deep injury to muscle and bone. Here are the four stages of bedsores:

• Stage 1: The area appears red and is warm to the touch. On darker skin tones, the area may have a blue or purple tint. The patient may experience pain, burning, and/or itching
• Stage 2: The area looks more damaged and may have an open sore, scrape, or blister. The patient experiences significant pain and the skin surrounding the wound may also be discolored
• Stage 3: The area has a crater-like appearance due to damage that has occurred below the skin’s surface
• Stage 4: The area is severely damaged and a large wound is present. Muscles, tendons, bones, and joints can be involved. Infection also presents a significant worry at this stage

Certain risk factors contribute to a patient’s chances of developing bed sores, including immobility resulting from injuries, illness, or poor health, incontinence, poor nutrition and/or hydration, medical conditions that affect blood flow, and a lack of sensory perception. Nursing home staff are responsible for assessing a patient’s risk level, performing regular physical exams, utilizing proven prevention methods, and providing medical treatment to patients affected by pressure ulcers whenever it is necessary.

Complications

Depending on their severity, pressure ulcers can create a range of complications for patients. Here are just a few examples of complications that people with bedsores may experience:

• Bone and joint infections. The infection from a bedsore can burrow into a person’s joints and bones. Joint infections, or septic arthritis, can cause further damage to the patient’s cartilage and tissue. When someone develops a bone infection (or osteomyelitis), it reduces the function of their joints and limbs
• Though fairly rare, skin ulcers sometimes cause sepsis in patients
• Long-term, nonhealing wounds, or Marjolin’s ulcers, can develop into a type of squamous cell carcinoma
• Cellulitis is an infection of the skin and connected soft tissues. It causes warmth, inflammation, and swelling to the affected area. People with significant nerve damage usually do not feel pain in the area affected by cellulitis
• Amputation of the affected limb or limbs

How Providers Should Protect Patients from Developing Pressure Ulcers

Bedsores can take days, weeks, months, or even years to heal all the way. To prevent patients from developing bedsores, it is critical that nursing home staff regularly employ the following methods:

• Assist the patient with shifting their weight frequently (approximately one time per hour)
• Patients who are able to perform “wheelchair pushups” should; wheelchair pushups involve a patient using their arm strength to lift themselves off the seat of the wheelchair
• Select cushions or mattresses for wheelchairs or beds that reduce and relieve pressure
• Do not elevate hospital beds to a position above thirty degrees
• Keep skin clean and dry at all times
• Protect skin with moisturizing cream
• Perform daily skin inspections in order to make sure that bedsores are not developing

Treating Bedsores

Not only are bedsores extremely painful when they develop, but treatment is also difficult, complicated, and not without its own unique risks. Some of the common kinds of treatments for bedsores of different stages include antibiotics to fight off infections, dressings to help heal the ulcer, removing damaged, infected, or dead tissue (debridement), negative pressure wound therapy, transplanting healthy skin to the wound area (skin grafts), protecting bedsores with medicated gauze, and removing pressure on the affected area. Similar to healing, treatment can take days, weeks, or months to complete.

Negligent Nursing Homes: When to File a Claim

Current estimates suggest that more than 1.2 million residents live in the tens of thousands of nursing homes across the country. Over the next few years, more and more people will have family members who are moving into assisted living facilities as the population continues to age. In the best circumstances, nursing homes and assisted living facilities offer trustworthy, good care to patients. However, inadequate staffing, improper training, a lack of supervision, deviating from the accepted standard of care and other factors often result in cases of nursing home negligence.

Bedsores are some of the most pervasive symptoms of nursing home negligence, since they are avoidable when providers give proper care to patients. Nursing home residents are protected from abuse and neglect under federal law. Nursing homes are legally obligated to grant residents certain rights and protections, including freedom from abuse and neglect, access to proper medical care, freedom to file complaints without retribution, and more. When a nursing home deviates from the accepted standard of care and causes harm to a patient, like in the cases of bedsores, it is advisable to file a legal claim.

At Galfand Berger, our attorneys have represented victims of medical malpractice for over 75 years. If you would like to learn more about filing a legal claim because of your or your loved one’s injuries, someone at our firm can help. Contact a representative online now.

Philadelphia Medical Malpractice Lawyers at Galfand Berger, LLP, Representing Injured Victims Since 1947

If you sustained injuries resulting from negligent medical care and you would like to pursue a full and just recovery of damages, contact the Philadelphia personal injury lawyers at Galfand Berger LLP today. Call us at 800-222-USWA (8792) or fill out our online form for a free consultation. Located in Philadelphia, Bethlehem, Lancaster, and Reading, we serve clients throughout New Jersey and Pennsylvania, including Allentown and Harrisburg.