What Causes Bed Sores in Nursing Home Patients?

By Nursing Home Law Center

WhyBed sores, also known as pressure ulcers, are a painful skin injury that develops due to pressure, friction, or shear. They often develop when a hard or bony part of the body rubs against a hard surface for a prolonged period of time. When this pressure affects tissue, the body does not receive the blood flow it needs, and severe wounds develop. Often, bed sores are a sign of nursing home neglect.

What Are the Most Common Causes of Bed Sores?

Bed sores can develop after one severe episode of pressure against the skin. However, the majority of cases involve frequent and prolonged periods of immobility. Usually, bed sores are most common in patients with limited mobility, such as spinal cord injuries, or people confined to bed rest or a wheelchair.

Three factors contribute the most to bed sore development:

  • Friction. When a person lays in bed for a long time, his or her skin can rub against the bedding or the clothing. This movement, after time, can lead to bed sore development. Moist and fragile skin increase the risk of injury.
  • Shear. This term refers to when two surfaces move against each other in opposite directions, such as skin and bones. For example, elderly people confined to bed rest often have elevated headboards. When a person slides down in the bed, his or her tailbone can shift while the skin covering the tailbone remains in place. This force can lead to tearing and bed sores.
  • Pressure. Prolonged periods of bed rest or sitting in a wheelchair in one position can reduce necessary blood flow to the tissues. Without this blood flow, the skin and tissues can deteriorate and die. As a result, bed sores develop.

Where Do Bed Sores Appear?

Depending on the situation that led to the injury, people can develop bed sores in different places on their bodies. Most often, bed sores appear on bony body parts that have little to no protective fat.

If bed sores develop due to wheelchair confinement, a person can see injuries in the following places:

  • The backs of arms and legs
  • Tailbone
  • Shoulder blades
  • Spine

For a person confined to a bed, common places for bed sores include:

  • Hips
  • Back and sides of the head
  • Lower back
  • Heels and ankles
  • Tailbone
  • Shoulder blades
  • Skin behind the knees

What Are the Risk Factors for Bed Sores?

Certain conditions or environments can aggravate bed sores, including:

  • Certain medical conditions that impact blood flow, such as diabetes and vascular disease, which increase tissue damage risk
  • Spinal cord injuries, leading to immobility and limiting a person's ability to notice bed sore warning signs
  • Poor nutrition, leading to less nutrients to maintain healthy skin and tissues
  • Neurological disorders that impact pain perception, which leads to lower awareness of bed sore pain and warning signs
  • Low hydration, which is also necessary for healthy skin maintenance
  • Immobility, which leads to the bed rest and wheelchair environments that contribute to bed sores

What Are the Different Stages of Bed Sores?

Medical professionals classify bed sores into four phases.

  • Stage I bed sores are the least severe injuries. Usually, the sores only affect the outer skin layer and do not cause damage to the tissue or muscles. The skin remains unbroken.
  • Stage II bed sores are more severe and painful. The sores break the skin, leaving an open wound or blister with clear fluid or pus.
  • Stage III bed sores affect deeper fat tissue. The sores have a risk of infection and may have pus, dead or dying tissue, and a foul odor.
  • Stage IV bed sores are the most severe and complex injuries. The sores are large and deep. They may have an infection, dead and dying tissue, pus, and a foul odor. In the most severe cases, the sores may damage the muscles, bones, and ligaments.

Do you have a loved one with bed sores due to nursing home abuse? Contact Nursing Home Law Center LLC today to receive a free case evaluation.


Related Information

Nursing Home Abuse & Neglect Resources

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