People with advanced age and physical or cognitive impairments are at a greater risk of developing pressure ulcers, also known as decubitus ulcers, pressure sores or bedsores, if they are denied the necessary and appropriate preventative measures. Pressure sores occur when constant pressure against the skin reduces blood supply to certain areas of the body, often on elbows, heels, hips, ankles, shoulders, back, or back of the head, and the affected skin tissue dies. They may also occur anywhere skin is damaged by excessive friction, shear, and/or moisture. Once a pressure ulcer is developed, it can take from weeks to months or sometimes years to heal.
Pressure ulcers are categorized by their level of severity, from stage I to stage IV:
Stage I: The reddened skin does not turn white when pressed.
Stage II: The reddened skin blisters or forms an open sore.
Stage III: The skin breakdown looks like a crater because of damaged tissue below the skin.
Stage IV: The skin breakdown is so deep that the muscle, tendon, and/or bone are exposed.
Pressure ulcers are common in nursing homes or Skilled Nursing Facilities, especially among residents who are bedridden or unable to move certain parts of their body without help and those who have blood circulation, incontinence or cognitive issues. Apart from frailty of the residents, higher incidences of pressure ulcers are attributable to the inability of nursing home to provide an adequate level of preventive care due to understaffing. (For more information on prevention of pressure ulcers, please visit our Pressure Ulcer Prevention page.) Incidence rates in long-term care settings vary widely within and between sites of care, from 2.2% to 23.9%, but generally, a 2004 National Nursing Home Survey estimated that 159,000 (11%) of U.S. nursing home residents had a pressure ulcer, with stage II the most common type. (A particular U.S. nursing home’s published incidence and prevalence rates of pressure ulcers can be checked at Nursing Home Compare.)
Each nursing home is obligated to take steps, including but not limited to close monitoring, repositioning, application of dressing, or provision of special bedding, to either avoid pressure ulcers in susceptible residents or to prevent an existing ulcer from getting worse. Nursing homes should provide an adequate number of qualified and properly trained staff so that they can detect early signs of pressure ulcers and follow up with treatment protocols. (For more information on treatment of pressure ulcers, please visit our Pressure Ulcer Treatment page.) If proper care is not provided to accurately assess and treat pressure ulcers, they can lead to infection, serious pain, and even death.
Pressure ulcers are preventable and thus their development or aggravation is often a sign of elder neglect in nursing homes. If your loved one has suffered a pressure sore while in the custody of a nursing home, or a skilled nursing facility, please Contact Us immediately. We will do a comprehensive assessment, in consultation with our experts, to determine the cause of the pressure sore and advise you on your legal rights and options. We find the occurrence of preventable pressure sores reprehensible, and we will pursue your matter vigorously to a just resolution, including taking your case to trial.