Pressure Sores Nursing Home Lawyer
Pressure sores – also called bedsores, pressure ulcers, or decubitus ulcers – affect up to 2.5 million patients each year, leading to a wide array of complications including pain, scarring, infections, surgery, and permanent disability. They are entirely preventable, yet they lead to an astonishing 60,000 deaths a year, oftentimes due to negligence and lack of proper care, treatment, or attention.
These skin wounds occur when someone remains in the same position for too long without moving. Damage occurs to the skin, especially over bony areas, as well as to underlying tissue due to prolonged pressure against that part of the body and lack of proper blood circulation. These sores commonly form in areas such as hips, backs, elbows, ankles, and heels. They are painful and, if not treated correctly, can become infected and lead to serious complications.
Is your loved one suffering from improperly treated or unhandled pressure sores? Get a case review by contacting us at (818) 808-0048.
Risk Factors Among the Elderly
Those with the highest risk of developing pressure injuries are the elderly in nursing homes or hospitals who are immobile in beds or wheelchairs. Not only does skin become thinner, lose elasticity, and become much more fragile with age, but there are a myriad of other risk factors that can put the elderly at a critical disadvantage when it comes to bed sores.
The most common risk factors include:
- Immobility. This might be due to poor health, spinal cord injury, arthritis, hip fractures, Parkinson’s disease, and other causes.
- Incontinence. Skin becomes more vulnerable with extended exposure to urine and stool.
- Lack of sensory perception. Spinal cord injuries, neurological disorders and other conditions can often result in a loss of sensation. This inability to feel pain or discomfort can make the patient unaware of warning signs and the need to change position.
- Malnutrition and dehydration. Maintaining a healthy diet with enough fluids, calories, protein, vitamins and minerals is essential to keeping skin healthy and preventing the breakdown of tissues.
- Chronic conditions affecting blood flow. Health problems that can affect blood flow, such as diabetes and vascular disease, oftentimes increase the risk of tissue damage.
What Causes Pressure Sores?
Bed sores form in areas of the body that have the least amount of padding of muscle and fat, particularly right over a bone.
If the patient is bedridden, the most common sites for bed sores are:
- Coccyx (tailbone)
- Sacrum (bone at the base of the spine, above the tailbone)
- Hipbones
- Heels of feet
- Elbows
- Shoulders and shoulder blades
- Areas of the head (such as the ears) that touch the bed surface or pillow
If the patient is in a wheelchair, the highest risk areas are:
- Tailbone and buttocks
- Backs of arms and legs where they touch the chair
- Along the spine (where vertebrae protrude)
- Part of the pelvis that supports a person while sitting (known as the ischial tuberosity)
The most common cause is pressure due to immobility (hence the blanket term “pressure sore”). But this type of skin damage can also occur from friction caused by a caregiver transferring a body, for example, from a bed to a wheelchair or vice versa, and also from something called shearing, which is when a patient slowly slides or slumps down in a bed or chair over time. This makes the skin slide in the direction opposite of the bone and supportive tissue, which can lead to stretching and tearing.
Warning Signs and Stages
Bed sores can form very quickly – in as little as 2 to 3 hours after blood supply is cut off to the skin. What may seem like a mild, innocuous skin irritation in the beginning can quickly develop into a painful open wound, so it’s important to know the warning signs for early detection:
- Variations in skin color: An irritation to the skin will initially manifest itself through a change in color. Patients with lighter skin may exhibit red or pink marks and patients with darker skin may exhibit blue or purple marks.
- Changes in skin temperature: If the skin feels unusually warm, it could be a sign of an inflammation. Conversely, if it feels unusually cool, it might mean that there is little or no blood flow to the affected area. Both of these could be signs of a developing bed sore.
- Changes in skin texture: The affected area may feel soft, or spongy to the touch. It may also feel hard, flaky, or ashen, in contrast to surrounding areas.
- Odd sensations in affected area: The patient may feel burning, itching, tingling, numbness, or pain in certain parts of their body.
- Bruising: If an elder falls and develops a deep bruise over an area of the body that is prone to pressure sores, it should be closely monitored because the already damaged tissue can quickly turn into a sore or a wound.
If left untreated, the skin can break open and the affected area can develop an infection, or worse, become deep enough to extend into the muscle and bone.
The severity of a pressure sore is divided into four major stages:
- Stage 1: The skin is intact but has changed in color, temperature, and/or texture. Pain, burning, or itching are common symptoms. When pressed on, the spot doesn’t get lighter in color, meaning less blood is getting to the area. This is the mildest stage and only affects the upper layer of your skin.
- Stage 2: The skin breaks and forms an open wound, a shallow ulcer with pink tissue in it, or a pus-filled blister. The area may be warm and swollen, is painful, and may ooze a clear fluid, blood, or pus.
- Stage 3: Characterized by a deeper ulcer that looks like a crater and may have a bad odor (by this stage, the sore has gone through the second layer of skin and permeated the fat tissue). Visual signs of infection can include red edges, a thin scab, yellow “slough” tissue, pus, odor, or heat.
- Stage 4: The sore is big, deep, and extends down to the bone, tendon, or muscle (which may be visible at this stage). Skin may have turned black and shows obvious signs of infection (discolored edges, pus, heat, odor, and/or drainage). Eschar (dead tissue), slough, scab may also be present.
The first sign of a pressure sore indicates that proper medical protocol should be instituted to treat and handle it. This includes keeping the skin, clothing, and bed dry and using repositioning techniques to relieve the pressure. If this protocol is not done, the sore can rapidly deteriorate into more severe stages.
Complications of untreated or poorly treated pressure sores can include:
- Bone infection (osteomyelitis)
- Blood infection (sepsis)
- Gangrene
- Amputation
Grounds for a Pressure Sore Lawsuit
Given how rampant bedsores are in nursing homes, one would think that they’re hardly preventable. Nothing could be further from the truth. Bedsores are easily preventable if the staff adheres to standard practices such as regularly using repositioning techniques, providing good skin care, padding wheelchairs and beds with cushions to reduce pressure when necessary, and maintaining a healthy, balanced diet for residents. Beyond that, basic care and attention and a keen eye for any warning signs can go a long way.
Severe pressure sores are an obvious indication that these required preventative measures haven’t been taken and that the institution has failed to provide the most basic care, which is a dangerous form of elder abuse. This type of neglect should be investigated and legal action can be taken on behalf of the injured individual.
We’re Here to Help. Contact Us Today!
At Berberian Ain, LLP you can count on our elder abuse attorneys for dedicated and skilled legal support on this matter. Our attorneys have plenty of experience dealing with pressure sore cases in nursing homes and will fight for justice on your behalf. If you or a loved one has been on the receiving end of improper care or attention when it comes to pressure sores, contact Berberian Ain LLP today or call (818) 808-0048 to schedule a free initial consultation with one of our lawyers.