What Are Nursing Home Bedsores?
Bedsores, also called pressure sores or pressure ulcers, are skin tissue injuries caused by pressure that happens over a period of time. They mainly occur in people who are unable to move around well on their own and spend most of their time in a bed, chair, or wheelchair — especially nursing home residents with mobility problems.
It is important to take steps to prevent bedsores in nursing homes and seek treatment if any develop. While most nursing home bedsores heal with treatment, they can cause life-threatening health risks without prompt medical attention.
Nursing home staff are trained to prevent bedsores, so residents who develop them could be victims of neglect or abuse. In these cases, a nursing home abuse lawyer can help. These specialized attorneys can help you get money from the nursing home and staff members responsible for the bedsore.
Causes of Bedsores in Nursing Homes
In many cases, bedsores in nursing homes are the result of nursing home abuse and/or neglect.
The Mayo Clinic has identified a few common ways in which bedsores develop, which all involve the interruption of blood flow to the skin.
Bedsores may form due to:
- Pressure: The lack of blood flow caused by constant pressure on the skin can stop oxygen and other nutrients from getting to skin tissue. This can damage and destroy the tissue.
- Friction: If moist skin (especially the first layers of skin) rubs against clothing or bedding, it can become damaged.
- Shear: When two surfaces move in opposite directions, it’s known as shear. This could occur when a bed is elevated at the head, causing the resident to slide down the bed while skin over the bones stays in place.
Risk Factors for Nursing Home Bedsores
Nursing home bedsores are common in residents who cannot change positions easily.
Higher risk people include those who suffer from:
- Immobility: Limited mobility might be due to health problems, spinal cord injuries, or other causes, and increases the risk of bedsores.
- Incontinence: Because moist skin can be more easily damaged, residents who don’t have control over their urinary function may be more at risk.
- Lack of sensory perception: People who cannot feel pain because of a brain or spinal cord injury might not be aware of the pressure being placed on their skin.
- Poor nutrition and hydration: Without enough fluids, calories, protein, vitamins, and minerals, skin tissue breaks down easier.
- Medical conditions affecting blood flow: Diabetes and heart disease can affect blood flow, which is known to increase the risk of developing bedsores.
Where Do Nursing Home Bedsores Usually Occur?
Bedsores in nursing homes tend to form on areas of the body that do not have much fat and/or muscle. They are common near bones and joints.
|Where Bedsores Occur|
|Wheelchair-bound residents:||Bedridden residents:|
|Tailbone or buttocks||Back or sides of the head|
|Shoulder blades and spine||Heels, ankles, and skin behind the knees|
|Backs of arms and legs||Shoulder blades, hips, lower back, or tailbone|
Stages of Bedsores
Medical professionals break bedsores down into four stages, from stage 1 (least severe) to stage 4 (most severe). The different stages help doctors to provide the most appropriate treatments and give patients a better idea of how long it will take to recover.
Stage 1 Bedsores
Stage 1 bedsores include an area of redness without breaks in the skin. The redness does not disappear right away, but stage 1 bedsores usually heal in a few days once the pressure is relieved.
Stage 2 Bedsores
Stage 2 is the most common stage of bedsores in nursing homes, according to the CDC. These may look like abrasions, blisters, or shallow craters. Harvard Medical School notes that stage 2 bedsores usually heal within six weeks.
Stage 3 Bedsores
In stage 3 bedsores, deep craters form in the skin, and a loss of tissue is visible. It may take over six months to fully treat this type of bedsore.
Stage 4 Bedsores
When a bedsore reaches the fourth stage, there is damage to the bone, muscles, and joints, and a large amount of skin has died. Like stage 3 bedsores, patients may need more than six months to recover. Stage 4 bedsores can cause deadly infections or require limb amputation.
What Are the Symptoms of Bedsores in Nursing Homes?
Some common warning signs of bedsores in nursing homes include:
- Patches of skin that feel cool or warm to the touch
- Pus drainage from wounds
- Strange changes in skin color or texture
- Tender areas of the skin
The most common way to measure the severity of nursing home bedsores is by the depth of soft tissue damage.
Complications From Nursing Home Bedsores
- Infections: Infected bedsores can cause fever, chills, confusion, racing heart, and weakness. Infections from nursing home bedsores can also make their way into joints and bones, damaging cartilage and tissue. Others may develop cellulitis, an infection of the skin and soft tissue that causes warmth, redness, and swelling.
- Cancer: Some wounds that do not heal can lead to squamous cell carcinoma, a type of skin cancer.
- Sepsis: In very severe cases, nursing home bedsores can turn into sepsis. This is a potentially life-threatening condition that occurs due to an existing infection.
Nursing home staff members know how to treat bedsores before they cause serious health problems. If the staff members fail to do so, they should be held legally responsible for any complications that a resident develops from a bedsore.
In 2019, the family of a woman who developed a serious bedsore in a hospital was awarded $5 million in a jury trial. The family claimed the hospital failed to prevent the bedsore, causing the woman to suffer greatly in the last months of her life.
How To Prevent Bedsores in Nursing Homes
Taking steps to prevent bedsores in nursing homes is very important. Nursing home residents and their loved ones should ensure the following is happening on a regular basis.
To prevent bedsores, residents can:
- Shift weight frequently (about once per hour)
- Ask for help if needed to reposition
- Perform “wheelchair pushups,” in which they use their arms to lift off the seat
- Select cushions or mattresses that relieve pressure
- Adjust a bed’s elevation to no more than 30 degrees
- Wash skin with a gentle cleanser and pat it dry
- Protect skin with a moisture cream
- Inspect skin every day to look for warning signs of bedsores
Treatment of Bedsores in Nursing Homes
Treating nursing home bedsores may be done by a general health care provider or wound care team, depending on the bedsore stage.
Treatment may include:
- Antibiotics to treat infections
- Ensuring proper nutrition
- Keeping bedsores clean
- Negative pressure wound therapy
- Protecting the bedsores with medicated gauze
- Removing damaged, infected, or dead tissue (debridement)
- Removing pressure
- Transplanting healthy skin to the wound area (skin grafts)
It is important that the bedsore is carefully watched. Size, depth, and response to treatment should be properly monitored and documented.
Nursing Home Bedsore Statistics
In a 2009 data brief, the CDC provided some alarming figures about bedsores in nursing homes.
Nursing home bedsore statistics from the CDC include:
- About 159,000 nursing home residents (11%) had bedsores in 2004
- Residents under 65 years old were more likely to have bedsores than older residents
- Those staying for a year or less were more likely to have bedsores than those with longer stays
- One in five residents with recent weight loss had bedsores
- 35% of those with stage 2 bedsores or higher needed special wound care services
Legal Compensation for Nursing Home Abuse Bedsores
According to the National Ombudsman Reporting System (NORS) data, almost 200,000 complaints were filed in 2014 involving abuse, neglect, or exploitation of nursing home residents.
It is critical to monitor the care your loved one receives. Warning signs — such as bedsores in a long-term care facility — should never be taken lightly, as they are often a red flag for ongoing nursing home neglect or abuse.
If you suspect nursing home abuse bedsores, it is important to take action without delay. Get a free case review now to protect your loved one from harm.