The Risk of Decubitus Ulcers—Resident Abuse and Negligence in Nursing Homes

Decubitus ulcers, also known as bedsores or pressure sores, are a serious problem in nursing homes today—a leading cause of nursing home injury that affects nearly one million Americans every year. Decubitus ulcers develop when the blood supply to a resident’s skin is cut off, due to unrelieved pressure on the skin, from staying too long in one position without movement or shifting weight.

All stages of decubitus ulcers are preventable, as long as nursing home residents are provided with appropriate care. Elderly residents in nursing homes who are immobile or confined to wheelchairs are some of the most vulnerable to pressure ulcers, and the frequency of these sores can be seen as an indicator of the quality of care in many nursing home facilities. Many advanced decubitus ulcer cases are often the result of nursing home abuse and neglect, and can end in wrongful death.

According to data from the National Nursing Survey from 2004, one out of ten nursing home residents in this country have pressure sores. Of the study’s 1.5 million nursing home residents evaluated, 159,000, or 11%, had pressure ulcers. Around sixty thousand people die each year from complications of some of the more advanced stages of bedsores.

When residents are left lying or sitting for long periods of time in the same position, their skin begins to break down, and pressure sores can quickly develop. Pressure ulcers commonly develop over bony areas that are close to the skin and are less padded by muscle and fat—like heels, ankles, hips, tailbones, shoulders, elbows, backs, and the back of the head. One small irritation can quickly develop into a crater that is painful, difficult to heal, and can become a life-threatening nursing home injury.

Pressure sores are classified by four stages of severity: from the earliest signs in Stage I, to the most serious signs in Stage IV:

• Stage I: Pressure ulcers start to develop an area of redness on the skin that with pressure does not turn white. These irritations should be treated immediately by the nursing home staff, and physical movement should be initiated, in order to prevent the more advanced stages of decubitus ulcers.

• Stage II: A scrape or skin blister forms an open sore—a result of skin tissue breakdown. The skin around the sore may be irritated and discolored, and the wound may become infected. The wound must be cared for immediately in order to prevent further deterioration that leads to the third and fourth ulcer stages.

• Stage III: The skin continues to breakdown, and the wound develops into a shallow crater where there is a greater degree of tissue loss and soft tissue damage beneath the skin’s surface.

• Stage IV: The crater becomes deeper, damaging the muscle and bone, and as well as possibly the joints and tendons. At this stage, the decubitus ulcer causes extensive damage to the deeper structures under the skin, and can lead to significant pain and serious infections like osteomyelitis—a bacterial inflammation of the bones, or sepsis, a blood infection.

The primary goal of decubitus ulcer treatment is preventing it before the ulcers develop. If a nursing home resident is bedridden, in a wheelchair, immobile with diabetes, has circulation problems, incontinence, or has mental disabilities, they should be checked daily for pressure sores, and moved every two hours to relieve pressure.

If a Maryland resident becomes injured or dies because the nursing home neglected to protect the resident from decubitus ulcers, the nursing home could be held liable for Maryland nursing home negligence or wrongful death. Our attorneys at Lebowitz and Mzhen, LLC represent victims and their families who wish to recover personal injury compensation from nursing home negligence and harm. Contact us today.

National Institutes of Health, (NIH): Medline Plus: Pressure Ulcer Research

The AGS Foundation for Health and Aging: Pressure Sores

National Institutes of Health, (NIH): Medline Plus: Osteomyelitis

Related Web Resources:

NCHS Data Brief: Pressure Ulcers Among Nursing Home Residents: United States 2004

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