Nursing Home Lawyer PA

Pressure Ulcers

Many nursing homes lack the basic staffing levels, staff knowledge, and resources to provide necessary care to maintain skin integrity. In many cases, these deficient practices result in painful and debilitating pressure ulcers, also known as bed sores.

“If he has a bedsore, it’s generally not the fault of the disease, but of the nursing.”

Florence Nightingale

Pressure ulcers are frequently the result of poor care, or even outright neglect, by the nursing home.

Pressure ulcers develop when the blood supply from capillaries supplying the skin and underlying tissues are constricted enough to hinder perfusion and lead to tissue death. Bony areas of the body, such as the hips, heels, tailbone, shoulder blades, spine, and ankles are the most prone to developing pressure ulcers. Skin breakdown can occur in several ways. First, it can occur when there is an ongoing pressure to a body part. For example, a resident who is placed on their side in bed and cannot turn themselves will have pressure on their hip from their body positioning. Without staff intervention to roll them at regular and frequent intervals, the pressure can result in skin breakdown. Another cause of skin breakdown is friction, or when the skin rubs against another surface, such as bedding. Shearing occurs when two surfaces move in the opposite directions; A common example is when a resident whose upper body is elevated in bed slides down the bed. While a shear injury will not be seen at the skin level because the injury happens to the tissue beneath the skin, it is often coupled with friction injury that is seen on the skin’s surface.
Residents who have medical conditions that limit their ability to change positions are at higher risk for developing pressure ulcers. Often times, these residents spend much of their day idle and unattended in a bed or chair. Nursing homes who neglect to consistently and frequently execute a turning and repositioning strategy fail to prevent pressure injuries for their residents. Additionally, residents who have neurological conditions that prevent them from feeling discomfort from lack of movement are at a greater risk of bedsores. Incontinence is another risk factor to bed sores, as urine and stool that are not cleaned up promptly can leave the skin more vulnerable to breakdown. It’s no surprise that residents who are not toileted or are not provided with incontinence hygiene for long intervals of time develop bed sores. Lastly, residents who are not assisted to maintain proper nutrition and hydration are also more prone to skin breakdown.
Pressure ulcers are can be painful and embarrassing to a resident, while also leaving them at risk for complications. Open areas on the skin leave a resident at risk for infections since the skin breakdown is not properly cared for by nursing staff. Cellulitis is defined as an infection of the skin and soft tissues. Signs of cellulitis include warmth, redness, and swelling at the site of the infection. Cellulitis frequently is treated with oral antibiotics and pain relievers, but more serious infections may dictate the need for intravenous antibiotics. When an infection reaches deeper levels and affects joints or bones, a resident is said to have developed the complication of septic arthritis (joint infection) or osteomyelitis (bone infection). These types of infections frequently require intravenous antibiotics to resolve and are sometimes so severe that amputation is needed.

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If your loved one developed a bed sore during a nursing home stay, you should take action immediately. Contact a nursing home attorney if you believe that your loved one’s pressure ulcer was the result of poor care or neglect.