Nursing Home Bedsores: Causes & Signs of Neglect

Bedsores are usually a sign of neglect. Nursing homes are required to follow a repositioning schedule for elders who are at risk for bedsores, provide them with the nutrition and hydration to help prevent bedsores, and inspect them for early stages of bedsores and intervene.

The elder abuse lawyers at MSW Law Group explain what bedsores are, how they develop, the risk factors for bedsores, and what to do if your relative develops bedsores at a nursing home.

Bedsores can be serious. If your family member has developed a bedsore, do not wait – call the nursing home lawyers at MSW Law Group for help getting them the care they need.

Do Bedsores Indicate Neglect?

Bedsores are a sign of neglect because they are completely preventable. Bedsores are caused by immobility – the patient cannot shift positions themselves and nursing home staff fail to reposition them regularly. 

What are Bedsores?

Bedsores, the common name for pressure ulcers, are areas of tissue damage beneath the upper epidermal (skin) layers due to prolonged pressure, friction, or shear. 

Common areas for bedsores for patients who lie down for prolonged periods include the back of the head, shoulder blades, lower back, buttocks, tailbone, and the back of the thigh and calf, and the heel. 

Contrary to what the name “bedsore” implies, patients who spend prolonged periods in a wheelchair may also develop bedsores from sitting for long periods of time on buttocks, back of thighs, and back of knees. Patients who do not regularly remove or change their footwear may develop bedsores around their ankles and on their heels and feet.

Legal Rights of Elders in Nursing Homes Suffering from Bedsores

Nursing home patients have the legal right to appropriate medical care in a safe, comfortable, home-like environment. These rights include the right to regular repositioning if the patient is immobile or wheelchair-bound. If nursing home staff fail to follow protocol to regularly reposition these patients, resulting in bedsores, that constitutes neglect.

Patients who are unable to sense pain or who have diminished cognitive capacities may not self-report bedsores, and those patients who are unconscious or nonverbal cannot. It is the nursing home’s responsibility to adhere to a repositioning protocol, catch any bedsores in the early stages, and provide intervention.

Signs of Bedsores

Stage 1

As a bedsore begins to develop, the skin changes color such as a darkening of pigmentation or a redness. The patient may complain the area feels hot, painful, or itchy. The tissue may feel infirm when pressed.

Stage 2

A bedsore progresses to a painful wound that may appear as an open sore, scrape, or blister.

Stage 3

Increased damage below the surface of the skin causes a crater-like appearance in the area.

Stage 4

The wound has increased in size and may involve muscles, tendons, or bones. The patient is at high risk for infection.

If left untreated, bedsores result in deep tissue damage, opening the door to serious complications such as sepsis, bone infections, joint infections, cellulitis, cancer, and even gangrene. Bedsores can be fatal.

Causes of Bedsores

Friction

If a patient’s skin constantly rubs against clothing or bedding, that may damage the skin and underlying tissue. This is a problem in incontinent patients especially because moisture exacerbates the problem.

Pressure

Prolonged pressure on any body part lessens blood flow to the area, damaging tissue.

Shear

“Shear” occurs when two surfaces move in opposite directions, such as when a patient slides down an elevated bed and the tailbone moves but the skin covering the tailbone does not.

Risk Factors for Bedsores

Immobility

If a patient cannot shift themselves, get up, or move at all, or they are unconscious, they are at greater risk for developing bedsores.

Lack of Sensory Perception or Cognitive Decline

If a patient cannot feel the bedsores or lacks the mental capacity to notice and report them, they are at greater risk for developing bedsores.

Incontinence

If a bedsore is wet it will develop more quickly and there is a great risk of infection.

Malnutrition & Dehydration

Patients require adequate hydration and nutrition to maintain healthy skin and to heal if a Stage 1 bedsore develops.

Health Problems Affecting Blood Flow

Diabetes and vascular disease increase the risk of bedsores and allow bedsores to develop more quickly.

Talk with a Nursing Home Attorney about Your Loved One’s Bedsores

The applicable standard of care for nursing homes is to develop and adhere to a repositioning protocol for all patients at risk for bedsores. If your loved one has developed a bedsore, chances are the protocol is inadequate or staff failed to follow it. In either event, it constitutes nursing home neglect.

Call the nursing home abuse attorneys at MSW Law Group to get your loved one the care they deserve.