When families entrust the care of their loved ones to a nursing home, they expect the facility to provide a safe and healthy environment. Unfortunately, many nursing home residents suffer from a preventable yet serious condition: pressure sores, also known as bedsores. In fact, they are so common that according to a study by the Centers for Disease Control in 2004, out of all nursing home residents, more than 1 in 10 had a pressure sore (Park-Lee & Caffrey, 2009). These painful wounds can lead to severe infections and even death if not properly treated. Understanding the causes of pressure sores, their long-term effects, and the legal implications for nursing homes that fail to prevent them is crucial for families to protect their loved ones.
What Are Pressure Sores, and Why Are They Dangerous?
Pressure sores (also referred to as bed sores, pressure ulcers, or decubitus ulcers) are injuries to the skin and underlying tissue caused by prolonged pressure on specific areas of the body. They often develop in people who have limited mobility, such as nursing home residents who are confined to a bed or wheelchair for long periods of time.
These sores most commonly develop on bony areas of the body, but the specific area can depend on the position of the patient. These include:
| Patient Position | Location of Wound |
| Sitting in wheelchair | Shoulder blade, elbow, buttocks, lower back, and hips (sacrum and ischium), heel, and ball of foot |
| Sitting up in bed | Back (spinous process), buttocks, lower back, and hips (sacrum and ischial tuberosity), and heels |
| Laying flat on back in bed | Back of head, shoulder (scapula), elbows, buttocks, lower back, and hips (sacrum), and heels |
| Laying face down in bed | Cheeks and ears, shoulder (acromial process), breasts, genitals, knees (patella), and toes |
| Laying on side in bed | Side of head, ear, shoulder (acromial process), lower back and hip (ischium), thighs (greater trochanter), knee (medial and lateral condyles), and ankle (malleolus) |
If pressure sores are left untreated, they can quickly progress from mild redness or skin irritation (stage 1) to deep wounds that expose muscle or bone (stage 4). In severe cases, pressure sores can lead to life-threatening complications, such as:
- Infections: Open sores are highly vulnerable to bacteria, which can cause sepsis, a dangerous infection that spreads throughout the body.
- Tissue Death (Necrosis): If the sore is left untreated, the tissue around the wound may die, requiring surgical removal.
- Bone Infections (Osteomyelitis): Severe pressure sores can expose bone, leading to infections that are difficult to treat and may require long-term hospitalization.
Since nursing home residents are often frail or have underlying health issues, pressure sores can significantly worsen their overall health and quality of life. In some cases, these wounds can be fatal if not treated promptly and correctly.
How Neglect Leads to Pressure Sores
The development of pressure sores is often a sign of neglect. Nursing homes are responsible for providing proper care to prevent residents from developing these sores, but many fail to meet this obligation. Pressure sores usually form due to a combination of several factors, all of which are preventable with the right care and attention.
1. Lack of Movement and Repositioning
Residents who are immobile or have limited ability to move rely on nursing home staff to help them reposition regularly. If staff members neglect to reposition a resident who is bedridden or wheelchair-bound, pressure builds up in certain areas of the body, cutting off blood flow and leading to sores. Nursing homes should have protocols in place to reposition residents at least every two hours to prevent these sores from developing.
2. Inadequate Hygiene and Skin Care
Keeping a resident’s skin clean and dry is critical to preventing pressure sores. When nursing home staff fail to properly clean and care for residents’ skin, especially after episodes of incontinence, the moisture and bacteria can cause skin to break down more easily, leading to sores.
3. Poor Nutrition and Hydration
Proper nutrition and hydration are essential to maintaining healthy skin and tissue. Nursing home residents who are malnourished or dehydrated are at a higher risk of developing pressure sores because their bodies are less capable of repairing damaged skin and tissue. Nursing home staff must monitor residents’ diets and ensure they receive adequate nutrients to prevent these issues.
4. Understaffing and Poor Training
Many nursing homes are understaffed, which means caregivers are stretched thin and unable to provide the necessary attention to each resident. This lack of care often results in residents being neglected, increasing the likelihood of pressure sores. In addition, poorly trained staff may not recognize the early signs of pressure sores or know how to prevent them, further endangering residents.
Legal Responsibility of Nursing Home to Prevent Pressure Sores
Nursing homes have a legal and ethical obligation to provide proper care to prevent pressure sores. When a facility fails to meet this standard of care, they can be held legally responsible for the resulting harm.
1. Duty of Care
Nursing homes are required to provide an appropriate standard of care to ensure the safety and well-being of their residents. This includes taking preventive measures to reduce the risk of pressure sores, such as repositioning immobile residents, providing adequate nutrition and hydration, and maintaining proper hygiene.
2. Failure to Provide Adequate Care
If a nursing home neglects its duty of care by failing to prevent or treat pressure sores, the facility may be found liable for medical negligence. In cases where neglect leads to severe health issues or death, families can pursue legal action to seek compensation for medical expenses, pain and suffering, and other damages.
3. Proving Nursing Home Negligence
Proving negligence in a nursing home requires showing that the facility failed to meet the expected standard of care and that this failure directly caused harm to the resident. This may involve gathering evidence such as medical records, expert testimony, and witness statements to demonstrate that the nursing home neglected its responsibilities.
What Families Can Do if Pressure Sores Occur
If you suspect that your loved one is suffering from pressure sores due to nursing home neglect, it’s essential to act quickly. Here’s what you can do:
1. Document the Condition
Take photographs of the sores and keep a detailed record of your loved one’s health, including any signs of neglect. This documentation will be crucial if you decide to pursue legal action.
2. Seek Medical Treatment
Pressure sores require immediate medical attention. Ensure your loved one receives the proper care from a qualified healthcare professional. This may involve transferring them to a hospital or another facility that can provide the necessary treatment.
3. Report the Neglect
You can file a complaint with your state’s long-term care ombudsman or adult protective services if you believe the nursing home is responsible for the neglect. These agencies can investigate the situation and take action to hold the facility accountable.
4. Consult with a Lawyer
A nursing home neglect attorney can help you understand your legal rights and options. If pressure sores have caused significant harm, you may be able to file a lawsuit against the nursing home to seek compensation for medical bills, pain and suffering, and other damages.
Conclusion
Pressure sores are a clear and often preventable sign of nursing home neglect. Families who suspect their loved ones are suffering from these painful and dangerous wounds should act immediately to protect their well-being and hold the responsible facility accountable. By taking legal action, families can seek justice for their loved ones and help prevent future neglect from occurring in other nursing homes.
The Powless Law Firm is an Indiana law firm that represents victims and families state-wide in serious cases involving nursing home neglect, medical negligence, personal injury and wrongful death. If you have concerns about nursing home neglect or abuse, please contact us at 877-469-1292. Together we can make a difference.
REFERENCE
Park-Lee, E., & Caffrey, C. (2009, February). Pressure Ulcers Among Nursing Home Residents: United States, 2004. Centers for Disease Control and Prevention. https://www.cdc.gov/nchs/products/databriefs/db14.htm#nursing