Lawyer Resources for Bed Sores

While they take a while to develop, pressure sores (also referred to as pressure ulcers, decubitus ulcers, or bedsores) are a clear sign that long-term care institutions are providing poor care to its residents or patients. Unfortunately, in recent years the number of pressure sores amongst nursing homes, assisted living facilities, and hospital patients has drastically increased. In fact, studies show patients are far more likely to develop pressure sores today than they were a decade ago.

What is the cause behind these pressure sores?

The reason that these pressure sores are associated with inadequate care is because they develop because of unrelieved pressure over an extended period on the bony parts of the body. As the pressure builds up, it restricts the blood flow. As a result, the tissue and skin that does not receive the blood it needs begins to die. This gradually leads to a wound in that area.

Where do these sores develop in nursing home and hospital patients?

Oftentimes these pressure sores will develop in parts of the body that have little tissue or muscle to mitigate the weight of the body. Especially over a longer period, these areas are far more prone to developing issues. Even though these problems may occur anywhere on the body, the most likely areas that these problems may develop include:

The back of the head
The back
The heels
The buttocks

Other factors contributing to the development of decubitus ulcers

The lack of movement and positioning are two major factors in the development of pressure sores, but personal hygiene and the patient’s overall health also play an important role. Dehydration and poor nutrition may hinder the body’s ability to heal and may negatively affect skin health. Oftentimes neglect and maltreatment can lead to a patient sitting in his or her own feces and urine or left in wet bedding and/or clothing. Again, this can deteriorate the skin and lead to the development of pressure sores.

Further complications related to open pressure sores

When the pressure is never relieved and combined with conditions such malnourishment and incontinence, chances of a developing pressure sores increase dramatically. Despite the pain that will accompany these pressure sores, it also opens the door to further serious medical complications. These may include:

Gangrene
Osteomyelitis
Sepsis
Infection
Amputation of affected body part
Death

Early detection is important to the treatment of pressure ulcers

In order to be able to deal with these pressure sores as effectively as possible, it is important to identify them at the earliest possible stage. The deeper tissue they affect, the harder it becomes for the skin to heal. Ultimately, the best thing is to never have these sores develop in the first place.

Hold the facility responsible for the negligent care of your loved one

When someone is in the care of a medical facility or nursing home, it is that facility’s responsibility to ensure that these pressure sores do not develop. Basic prevention methods include:

Regularly moving patients at consistent intervals
Preventing malnutrition and dehydration
Making sure the patients remain dry and clean
Using specialized cushions or mattresses to relieve pressure for high-risk patients

Be aware of the dangers. Bed sores can be fatal.

The majority of the time, pressure sores develop because the facility is not doing an adequate job of providing patient care. Oftentimes the underlying cause is inadequate training of staff or under-staffing. Remember that it is their responsibility to provide adequate care, but being aware of the conditions may make it possible to avoid the problem from developing altogether.

Lawyers Who Take Bed Sore Cases Seriously

There still is a feeling that amongst some in the medical-legal community that bed sore cases simply don’t have much value and aren’t worth prosecuting. To the contrary, Rosenfeld Injury Lawyers recognizes bed sores as one of the most visible signs of poor care in nursing homes and other medical facilities. Typically, bed sores are a tragic emblem of a system that is broken– where patient needs take a distant position after facilities tend to their profitability. We also are mindful of the devastating impact these wounds have on the individual and their family. Our experience litigating bed sore cases has earned us a reputation as attorneys willing to do what it takes to hold facilities fully responsible for these horrendous injuries that can contribute to complications or even death. We invite you to talk with us as soon as you become aware of the presence of a pressure sore on your loved one.

Nursing Homes With Higher Percentage Of Hispanic Residents Have Higher Rate Of Bed Sores

April 11, 2009 | Nursing Home Law Center Staff

A research study concluded by researchers at Brown University concluded nursing homes with a higher Hispanic populations have higher rates of bed sores (also known as: pressure sores, pressure ulcers, decubitus ulcers) than facilities with less minorities. The results are detailed in the Journal of the American Medical Association.

The researchers gathered information from the National Repository of the Minimum Data Set, a federally mandated assessment of all nursing home residents and from the Oscar Database System, a survey of all nursing home residents from the Centers for Medicaid and Medicare Services. Additionally, the Brown study evaluated all nursing home residents over 65 who live in nursing homes in California, New Mexico, Texas, Arizona and Colorado.

The lead researcher of the Brown survey, Vincent Mor, chair of the Department of Community Health, conducted a similar survey in 2007 that concluded African Americans are more likely than whites to live in poor-quality nursing homes. That study found the disparity of care received in predominately African American nursing homes to be worst in the Midwest.

New Jersey Orders Use Of Pressure Relieving Mattresses In Nursing Homes

February 28, 2009 | Nursing Home Law Center Staff

Ray Mullman at the South Carolina Nursing Home Blog recently wrote about one of the most progressive piece of legislation passed in years– the mandatory use of pressure relieving mattresses in New Jersey Nursing Homes to help prevent the development of bedsores.

Unlike normal spring-filled mattresses, pressure relieving mattresses steadily inflate and deflate to reduce the amount of pressure and friction put on bony parts of the body prone that are prone skin break-drown and ultimately development of bedsores (also referred to as: pressure sores, pressure ulcers or decubitus ulcers).

Under the terms of Bill S-1517, nursing home operators must to switch from regular mattresses to pressure-relief mattresses within three years. Nursing home owners would have one year from the bills enactment to begin phasing in the use of pressure relieving mattresses.

Government Report Confirms Pressure Ulcers Harm All Nursing Home Residents; Regardless Of Race, Sex or Age

February 21, 2009 | Nursing Home Law Center Staff

A report released by the Centers for Disease Control and Prevention confirmed what many nursing home residents and employees already know– pressure ulcers are a tremendous problem encountered be nursing home residents of all races, sexes and ages. The report,“Pressure Ulcers Among Nursing Home Resident: United States, 2004” analyzes information from the National Nursing Home Survey which is comprised of more than 14,000 nursing home residents from across the country.

In 2004, more than one in 10 nursing home residents had some form of pressure ulcer within the year. Based on the total number of nursing home residents, that translates to more than 159,000 nursing home residents with pressure ulcers (otherwise known as bed sores, decubitus ulcers, or pressure sores). Stage II pressure ulcers were the most common according to the survey. Over 35% of the nursing home residents with pressure ulcers had more advanced– stage III or stage IV ulcers that required special wound treatment. Even younger nursing home residents, those commonly thought to be somewhat removed from the problem, are at risk according to the report.

The study demonstrates that while it is important to identify nursing home residents who are at risk for development of pressure ulcers and implement preventative techniques, no nursing home resident is immune from risk of developing pressure ulcers and the nursing home staff need to be tuned in to the factors related to pressure ulcer development and treatment.

Pressure Ulcer Treatment: Surgical Debridement

December 17, 2008 | Nursing Home Law Center Staff

By the time a pressure ulcer has progressed to Stage 4, the wound is deep the muscle and bone in the area is involved–usually decayed. Frequently, infection can develop in the dead tissue impeding the healing process.

Advanced stage pressure ulcers need to be free of dead or damaged tissue in order to heal. Even with the most attentive medical care, some pressure ulcer’s require surgical intervention. Surgical Debridement is when a surgeon uses a scalpel to remove the dead tissue, bone and fluid from the area around the pressure ulcer.

Debridement of the pressure ulcer may be accompanied by ‘flap reconstruction’. Flap reconstruction is when tissue is harvested from the persons body to cover the open wound. The goal of the reconstruction is to improve the hygiene and appearance of the wound and and reducing the risk of further infection.

Pressure Sores In Hospitals On The Rise

December 8, 2008 | Nursing Home Law Center Staff

An increasing number of number of pressure sore cases my office is working on involve pressure sores that have developed during a hospitalization. What was once considered a sad symbol of poor nursing home care, is now increasingly associated with poor hospital care. Many of our clients who enter a hospital for acute care, wind up extending their hospitalization due to the development of a pressure sore during their stay.

Federal and State regulations require nursing homes to conduct a thorough assessment of all new admissions. The assessment evaluates the individuals skin integrity and attempts to determine who is susceptible to develop of pressure sores. This initial assessment is designed to help nursing home staff implement preventative pressure sore care.

Hospitals on the other hand, are not governed by the same regulations and consequently are not as attuned to pressure sore prevention. Many hospitals fail to train their staff to identify pressure sore risk and implement policies for pressure sore prevention.

“The Nursing Home Says My Dad’s Bedsores Were Unpreventable…”

October 21, 2008 | Nursing Home Law Center Staff

A blog reader recently wrote, “The nursing home says my dad’s bedsores were unpreventable. Is this the case, or are some bedsores an unavoidable part of living in a nursing home?”

No! The nursing home is lying to your face is is probably trying to cover their own. Bedsores, also called pressure sores or decubitus ulcers, are preventable–with proper screening, early detection, and staff involvement. Bedsores are a widespread problem in nursing homes and hospitals. The development of of bedsores in nursing home patients is really a reflection of poor nursing care than an inevitable part of of the aging process.

Bedsores will likely develop if the nursing home and its staff do not make bedsore prevention a top priority. Nursing homes must do a thorough assessment of residents on admission and on a regular basis during their stay. Following the assessment, the nursing home should develop a comprehensive care plan that specifies what precautionary measures should be in place.

A New Low In Nursing Home Care: A Bedsore On The Head

October 15, 2008 | Nursing Home Law Center Staff

This week my office was contacted by the family of a man who had a stage IV bedsore on his head. The man was a resident at a well-known Chicago nursing home for several years. Bedsores are caused by unrelieved pressure or friction on a patients body. If left untreated, the bedsores can develop from a minor skin irritation to a major would quickly. Due to their ‘open’ nature, bedsores can easily become infected. Bedsores are graded according to their severity, I, II, III and IV, with a stage IV being the most severe.

What makes this situation uniquely horrific is that bedsores generally develop in areas of the body where pressure relief is not always possible– the buttocks, back or heels. Because most nursing home residents lay in bed with pillows and and propped up for meals and washings, development of a bedsore on the head is a particularly frightening finding.

The development of a bedsore on the head essentially screams out the fact that this nursing home could care less about this person. Even though this resident was bed-bound and fed through a feeding tube, the development of a pressure sore on his head should have been noticed if at no other time than when the staff changed the sheets? This facility should be ashamed of itself and every person who works there. I will keep you posted as to developments in this incident involving a new low in nursing home care.

Pressure Sore Video

October 4, 2008 | Nursing Home Law Center Staff

A client emailed me this disturbing You Tube video on pressure sores. The video is graphic, but demonstrates the horrific pressure sores that may develop without proper nursing care. The video has photos of:

Pressure sores on hips
Pressure sores on buttocks

Nursing Home Visits. An Opportunity To Conduct Your Own Inspection.

September 23, 2008 | Nursing Home Law Center Staff

Nursing home visits are great for both residents and their friends and families. Everyone is usually happy to see each other and discuss current world topics, the weather, baseball or food. However, don’t let the smiles distract you from what should be a secondary reason for visiting friends and family members in nursing home–doing a mini inspection.

I’m not talking about getting up on the roof of the nursing home and looking at the quality of the shingles or heading down to the basement to look at the hot water heater. Rather, when visiting don’t be shy about prodding around both the facility itself and on your loved one. Look at the: cleanliness of the facility, look at the food, pay attention to the temperature of the room, look for familiar faces, look at the schedule of activities, chat with the staff–keeping track of all the small parts of your loved one’s environment is the best it can be.

If your family member is bed-bound, pull the sheets back and peek under the robe. Is everything clean? Are their any dry or cracked areas of skin? Is there any unpleasant smell? Does everything look ok? Even the sharpest elderly may lack sensation in areas of their bodies to detect skin irregularities. If something looks wrong– it probably is. Early detection of potentially deadly conditions, such as pressure sores, may save your loved one from pain and embarrassment down the road. You’re not being a pest, you’re being a caring friend or family member looking out for your loved one’s best interest.

Proper Wound Documentation

July 30, 2008 | Nursing Home Law Center Staff

Development of a pressure sore can be devastating for both the individual and his or her family. Frequently, there are questions as to how to properly treat the wound. Before an adequate treatment plan can be developed, it is important to conduct a thorough assessment of the wounds. Below is an assessment compiled by Donna Sardina, RN, MHA, WCC President, Wound Care Education Institute that appeared recently on the McKnight’s website:

What should be included in wound documentation to support appropriate caregiving measures?

Assessment and documentation should be carried out at least weekly. The exception is when there is evidence of deterioration, in which case both the wound and the patient’s overall management must be reassessed immediately.