What are the Risk Factors for Bedsores in Nursing Facilities?

Bedsores are a painful and preventable condition suffered by patients in nursing homes, hospitals, and while receiving home health care. Also known as pressure ulcers, pressure sores, or decubitus ulcers, they can develop quickly if not properly monitored, leading to debilitating and potentially fatal complications. A recent report estimated 60,000 annual fatalities are related to pressure ulcer complications. Approximately 11 percent of nursing facility residents and up to 29 percent of hospital patients develop bedsores. Such high numbers often point to negligence or inadequate staffing, and severe cases may result in malpractice claims by patients and family members. With proper staffing and patient care, risk factors for developing bedsores can be assessed, observed, and prevented.

What Are Bedsores?

Bedsores are the result of consistent, unrelieved pressure on one particular part of the body. Bony prominences are most susceptible, such as elbows, hips, heels, shoulder, or coccyx (tailbone). When a nursing home resident is bedridden or wheelchair bound, movement is limited. This inhibits a healthy blood flow while causing constant compression on these sites. Eventually, the skin begins to breakdown.

This degeneration is medically categorized by four stages. The mildest presents with redness of the affected area that becomes warm to the touch. By the time the skin and surrounding tissues deteriorate, muscles, tendons, fascia, and bone may become exposed. Bacterial infections are likely by this stage.

Risk Factors

In nursing facilities, many of the risk factors for pressure sores may also be potential indications of health care neglect. Immobility is, again, the most common cause. However other factors contribute to a body’s susceptibility to bedsores:

• Skin – Elderly skin requires more attention as it becomes less elastic, much thinner, and increasingly dry. If the nursing staff does not assist with proper hygiene, skin may become compromised.
• Malnutrition and dehydration – Foods containing a healthy amount of vitamins, minerals, and calories are necessary to maintain elderly health. In addition, improper amounts of water intake can result in a domino effect of health concerns that may contribute to the breakdown of skin. If a nursing facility does not offer or monitor proper nutrition, they may be deemed negligent.
• Weight loss – If proper nutrition and an exercise routine are not maintained, loss of muscle mass and fat may exacerbate the onset of pressure ulcers. The lack of tissue density between the bone and the bed or chair surface enhances the skin’s deterioration.
• Incontinence – Moistness from urinary incontinence can compromise fragile elderly skin if not monitored and cleaned properly. Bowel incontinence can introduce bacteria from feces to an irritated area, potentially causing life-threatening, systemic infections.

Legal Recourse

Though nursing facilities should promote environments of compassion and advocacy for the elderly, this is not always the case. Government studies report that a minimum of 30 percent of US elder care homes perform some degree of malpractice. In the same study, approximately 5,000 of the resident fatalities listed malnutrition, dehydration, or pressure ulcers as the primary cause of death. The US Department of Health and Human Services proposes a federal standard of a two hour daily minimum, per patient, for nurse’s aide care. However, 54 percent of nursing homes fall below this standard.

If you suspect a friend or loved one has developed bedsores as a result of negligence, the following steps may help your case:

• Photograph lesions, documenting the date.
• If possible, obtain documentation regarding specific staff involved.
• Obtain documentation of previous negligence claims against the facility.
• Request a written explanation of the hygiene and health care routine for your loved one.
• If possible, obtain a list of any previous warnings or violations against the facility.

Berkowitz and Hanna LLC – Serving Fairfield and New Haven Counties

Dealing with nursing care neglect of a loved can be emotionally overwhelming. Understanding your legal rights is vital. At Berkowitz and Hanna LLC, our experienced malpractice attorneys will fight to protect the rights of your loved one. Our compassionate, knowledgeable legal team will examine every detail of your case and determine the best way to move forward.  If you or a loved one has been the victim of nursing home, hospital, or home health care neglect, contact Berkowitz and Hanna LLC for a free consultation.