Pressure Sores in Nursing Homes
We rely on a nursing home to look after our elders and loved ones who need help with their daily living. While we hope our caregivers have the best interests of their patients at heart, the result is not always so aligned. Limited staff, subquality equipment, lack of proper training, and other factors can lead to serious injuries or death at a nursing home. A prevalent injury is the pressure sore, a condition that can cause the patient significant pain and suffering. When nursing homes are at fault for a patient’s development of a pressure sore, legal relief can compensate for the injury. Here, we explain what pressure sores are and provide common examples for how nursing homes can be responsible for them.
What Are Pressure Sores?
Pressure sores happen when limited blood flow prevents the skin from getting the oxygen and nutrients it needs. Extended periods of being immobilized along with frequent pressure on the skin limit the supply of blood to a particular area, resulting in the pressure ulcer.
Damaged skin from a pressure sore can also happen from the friction (i.e., shear) that can occur when the body constantly rubs against a surface. The skin is already weak from the continuous pressure and even the slightest amount of friction can cause the skin to tear. For example, the skin rubbing against clothes, or sliding down a bedsheet can lead to the development of a pressure sore.
What Makes Nursing Home Patients Susceptible to Pressure Sores?
In addition to having medical conditions that immobilize them, nursing home residents may also experience other challenges or conditions that increase their risk for developing pressure sores. They include:
- Poor sensory awareness and a diminished mental state: Patients with neurological deficits hardly notice the body’s pain sensors and other signs of discomfort from the pressure sores forming. This means patients have a hard time advocating for themselves and rely more heavily on staff to identify the beginning of a pressure sore.
- Incontinence: Patients who lack control over bodily functions may require the use of urine pads or adult diapers. This can keep the skin wet for long periods of time unless nursing staff is diligent in replacing pads and changing diapers. The wet skin adds to the chances for the shear or friction that rips the skin.
- Other factors that limit blood flow to skin: Diabetes and other vascular diseases can cause poor blood circulation from immobilization, allowing a pressure sore to develop faster than usual.
Identifying the Beginning of a Pressure Ulcer
Pressure ulcers can have different symptoms, depending on where the sore is located or how severe it is.. At their best, the damage to the skin and tissue will only vary in color and texture. However, pressure ulcers in advanced stages can be a lot more painful and include damage to the muscle and bone beneath the skin. Things to look for when identifying a pressure ulcer can include:
- The area being tender to touch
- Noticeable swelling
- Pus or purulent drainage
- The skin having a different temperature than other parts of the body (i.e., either much hotter or colder)
Pressure Sores Have Four Different Stages
Stage One of a Pressure Sore
In the earliest stage of a pressure sore, there will be a noticeable difference in the color of the skin that is usually a purple, red, or ashen color. The nursing home patient may experience pain along with significant changes in the temperature of the area compared to other parts of the body.
Stage Two of a Pressure Sore
A stage two pressure sore occurs when the top layer of skin is gone (usually due to the constant rubbing against clothes or other objects). The result is an open wound that is shallow and has a pink or red coloring from the now revealed underlying skin.
Stage Three of a Pressure Sore
The depth of the pressure sore will increase from stage two to stage three. The skin will have died at this stage and will likely be yellow in color.
Stage Four of a Pressure Sore
This is the worst stage of a pressure sore, in which the wound will continue to grow as the surrounding skin dies. This can lead to a loss of other tissues such as the tendon or muscle. The nursing home patient’s bones may be visible in extreme cases.
The Cause and Effect of Nursing Home Negligence and Pressure Sores
Caregiver facilities are responsible for the well-being of their patients. They are bound to a standard duty of care in which they must act reasonably given the circumstances. For a variety of reasons, some nursing homes fail to live up to this standard, which causes patients to unnecessarily develop pressure sores and related damages from their pain and suffering. Oftentimes, these causes all stem from the reality that many nursing homes operate as a for-profit institution. This can create an inherent conflict where the needs of the patients compete with the nursing home’s profit margin. Let’s discuss some of the more common ways that nursing homes are negligent toward their patients, leading to the development of bedsores.
The Nursing Home Has Substandard Protocols and Operations
Much of limiting pressure sore exposure for nursing home patients is about routine prevention methods and vigilance for stage one of a pressure sore. A facility’s caregivers should be doing the following at a minimum to prevent and treat bedsores:
- Repositioning the body
- Keeping the body as dry as possible
- Checking for warning signs
- Getting advanced help from a doctor when necessary
If the nursing home’s systems are faulty, then this may be a source for negligence. Whether protocols are negligent will depend on accepted practices, among other factors.
The Caregiver Facility Employs Abusive Nursing Home Staff
It’s possible that an individual or group within a nursing home are acting in way that transcends mere negligence and rises to the level of intentionally abusive. The nursing home facility is responsible for its employees and their actions while on the job. This may include vicarious liability for negligently hiring a caregiver with a history of abuse or allegations.
The Nursing Home Lacks the Proper Equipment to Provide Reasonable Care
Another source for negligence in nursing homes can be found in the equipment they use (or don’t use). Lacking or poor-quality equipment such as old or faulty beds or wheelchairs can contribute to pressure sores, as they do not provide enough cushion or support to alleviate pressure on the body. Medical equipment exists that can greatly minimize the risk of pressure sores from forming or worsening. However, a facility may fail to incorporate the equipment into its program due to cost. Depending on the situation, this may create a case of negligence.
The Facility Has Limited Nursing Staff to Provide Patients the Necessary Support
Depending on the size of the nursing home, it may not have enough nurses or other caregivers staffed to provide the adequate support. Pressure sores do not take long to develop, especially for a patient who cannot move because of physical limitations to a bed or a chair. If a facility does not have enough caregivers to provide basic levels of monitoring and prevention methods, the odds of a pressure sore forming can significantly increase. The last few years have made staffing a real issue as nursing workforce lost about 15% of its size from people resigning or leaving the field.
Poorly Trained Staff at the Nursing Home
Perhaps worse than not having enough caregivers is having caregivers who are ineffective in managing pressure sores because of poor or inadequate training. Nursing homes are responsible for ensuring their staff has the requisite skills and knowledge to prevent, identify, and treat pressure sores. If caregiver turnover is high at a facility, the staff may not have the proper training to meet the standard of care the nursing home must provide.
Speak with a Pressure Sore Lawyer Today
Bedsore.Law is a niche litigation firm that only handles cases of nursing home neglect that cause injuries like pressure sores. We approach our practice with an eye toward kindness and compassion for the situation of our clients and their families. We work hard to provide thorough and effective legal services because we understand the critical nature of our work in creating a better nursing home system for our elders and loved ones.