Nursing Home Bedsores & Pressure Ulcers

Maryland Lawyers for Patients Suffering from Bedsores & Pressure Ulcers

Less mobile seniors are especially vulnerable to bedsores – also called pressure ulcers – because they can spend hours lying in bed or sitting in a wheelchair. If a facility does not follow the proper medical standards and protocols for caring for our elderly, bedsores can develop and lead to additional health complications.

Bedsores are a serious, fast-occurring, and most importantly preventable condition occurring in nursing home residents. The Centers for Medicare & Medicaid Services (CMS) consider bedsores a “never” event, meaning they are clearly identifiable, preventable, and can result in serious consequences. A never event like bedsores is a major red flag of care provider neglect.

What Causes Bedsores?

Bedsores are often the result of neglect, failure to reposition the patient, improper hygiene, improper procedure, insufficient nutrition, and inefficient or outdated equipment at the facility. Fortunately, most cases of bedsores can be treated before permanent damage has occurred.

These are the four major stages of bedsores:

• Stage 1. The sores will not yet be open wounds. It’s common for the skin to be red, inflamed, and painful to the touch. The redness will not blanch when pressed on it with fingers, as skin normally would rebound.
• Stage 2. The skin will break open, wear away, or will form an ulcer causing the area to become tender and painful. The sore will spread into the deeper layers of the skin. Appearance varies from what seems like a scrape or abrasion, blisters, and then forms a shallow wound in the skin. At this stage, it is possible for certain layers of the skin to be damaged beyond repair.
• Stage 3. The sore worsens and spreads into more tissue beneath the skin, forming a small open wound. Fat may be visible in the sore, but you should not be able to see muscle, tendons, or bones at this stage. Pain may no longer be occurring in stage 3 as the nerves have been damaged.
• Stage 4. The bedsore injury is extremely deep, spreading into muscle and bone causing irreversible/extensive damage. As with stage 3, pain may no longer be occurring as the nerves have been damaged. If the bedsore has not been addressed/resolved before stage 4 occurs, the patient could have damage to deeper tissue, tendons, and even their joints.

Where Are Most Bedsores Located?

Bedsores most often develop on skin that covers bony areas of the body and where these areas come in contact with the chair or bed or where their skin rubs together.

For patients in a wheelchair, pressure sores commonly present themselves in the main contact areas with their wheelchair:

• Buttocks
• Tailbone
• Shoulder blades
• Backs of legs
• Backs of arms

For those who are bedridden, bedsores will often occur along:

• Shoulder blades
• Lower back
• Tailbone
• Hips
• Heels
• Ankles
• Sides and back of the head

How Do Sores Develop?

As previously pointed out, the main contributing factors to pressure sores are pressure, friction, and sheer (two surfaces move in opposite directions). Continued pressure on any part of the body will inevitably reduce the blood flow to tissues. Blood flow is essential to delivering oxygen and other nutrients to the tissues. Without these nutrients, the skin and nearby tissues will become damaged and may eventually die.

Risk Factors

People who have difficulty moving or changing positions while seated or in bed are especially at risk of developing bedsores. Risk factors include immobility, lack of sensory perception, poor nutrition and hydration, and medical conditions affecting blood flow. Immobility can have several causes, including poor health, obesity, spinal cord injuries, and more.

Spinal cord injuries and neurological disorders that reduce or eliminate sensation make a person less able to feel their discomfort. This reduced awareness inhibits their ability to recognize the warning signs from the body letting them know to change positions.

A poor diet lacking in nutrients leads to an unhealthy body, including the skin. The tissues can begin to break down.

Diabetes or vascular disease affects blood flow throughout the body and can also increase the risk of tissue damage.

Complications of Bedsores

The complications of bedsores vary from discomfort to life-threatening conditions. They include cellulitis, bone and joint infections, cancer, and sepsis.

• Cellulitis, an infection in the skin and connected soft tissues, can cause warmth, swelling, and redness in the affected area. Those with nerve damage often will not feel the pain in the area affected by cellulitis.
• If left untreated, bedsores can burrow into joints and bones. Joint infections can damage both cartilage and tissue. Bone infections can limit the function of joints and limbs.
• Squamous cell carcinoma is the second most common form of skin cancer and can be caused by long-term, nonhealing wounds.
• In rare instances, bedsores can lead to sepsis, a life-threatening complication from an infection.

When to Seek Help for Bedsores

If you see bedsores on a loved one, or believe they might have one, say something immediately to the home’s management and care provider. If a person is in stage 1 of bedsores, the care providers can alter contributing factors to alleviate pressure on the area. If there is no improvement within two days, seek medical attention for them. If someone is in stage 2, they should seek immediate medical care.

If you or a loved one are under the care of someone else and you notice continued bed sores without proper prevention procedures being implemented, it may be a case of nursing home neglect.

A nursing home patient who is the victim of any form of injury will likely grow fearful of a caregiver. If your loved one is showing signs that indicate fear, such as acting disconnected from family and friends or acting out in a different way, they may be receiving poor and unlawful treatment related to nursing home injuries.

Potter Burnett Law will carefully review the evidence to ensure the patient is placed out of harm’s way. Our Maryland lawyers at Potter Burnett Law have the experience to represent you and your loved ones in cases of nursing home injury and assisted living facility injuries.

Contact us today to schedule a consultation through our online contact form or by calling (301) 804-6784.