Two problems that exist in nursing homes are the high rate of preventable bedsores and falls resulting in injury. In a two-part series, we will discuss both. Here, in part two, we examine the common issue of bedsores among occupants of nursing homes.
Americans are living much longer than our relatives, largely due to significant improvements and availability of healthcare services and investment in medical research. Studies show that the number of people 65 years and older rose from 8% in 1950 to 12% of the total population in 2000. What’s more, this figure will rise to 20% by 2050 and will likely continue to rise steadily thereafter.
Unfortunately, living longer can also mean declining health. For some, aging means decreased independence and long term care needs. Far too often, families are forced to make the difficult decision of how to provide the best care and treatment for their loved ones. One option is placing your loved one in a long-term care facility or nursing home. Many families choose this route so that professionals are caring for their loved ones at all times.
While there are many fine nursing home facilities in our region, unfortunately, some nursing homes have a high rate of incidents involving their patients. It is critical to research nursing homes carefully before making a decision for the care of your loved one.
An unfortunate consequence of poor treatment in nursing homes are bedsores. Bedsores, also called pressure ulcers and decubitus ulcers, are injuries to skin and underlying tissue resulting from prolonged pressure on the skin. Bedsores most often develop on skin that covers bony areas of the body, such as the heels, ankles and tailbone. People most at risk of bedsores are those with a medical condition that limits their ability to change positions or those who spend most of their time in a bed or chair.
Three primary contributing factors for bedsores are:
- Constant pressure on any part of your body can lessen the blood flow to tissues. Blood flow is essential to delivering oxygen and other nutrients to tissues. Without these essential nutrients, skin and nearby tissues are damaged and might eventually die.
For people with limited mobility, this kind of pressure tends to happen in areas that aren't well-padded with muscle or fat and that lie over a bone, such as the spine, tailbone, shoulder blades, hips, heels and elbows.
- Friction occurs when the skin rubs against clothing or bedding. It can make fragile skin more vulnerable to injury, especially if the skin is also moist due to incontinence.
- Shear occurs when two surfaces move in the opposite direction. For example, when a bed is elevated at the head, you can slide down in bed. As the tailbone moves down, the skin over the bone might stay in place — essentially pulling in the opposite direction.
Risk factors: People are at risk of developing pressure sores if they have difficulty moving and are unable to easily change position while seated or in bed. Risk factors include:
- This might be due to poor health, spinal cord injury, and other causes.
- Lack of sensory perception. Spinal cord injuries, neurological disorders, and other conditions can result in a loss of sensation. An inability to feel pain or discomfort can result in not being aware of warning signs and the need to change position.
- Poor nutrition and hydration. People need enough fluids, calories, protein, vitamins and minerals in their daily diet to maintain healthy skin and prevent the breakdown of tissues.
- Medical conditions affecting blood flow. Health problems that can affect blood flow, such as diabetes and vascular disease, increase the risk of tissue damage.
(Source: Mayo Clinic)
Depending on the study, anywhere from 3 to 28% of people in nursing homes may have bedsores. It is true that some of these sores may have developed prior to a transfer to the nursing home. Bedsores can develop quickly. Most sores heal with treatment, but some never heal completely. Nursing homes can take steps to help prevent bedsores and aid healing.
Unfortunately, bedsores are often left untreated or unnoticed in nursing homes. Other times, the nursing home assessments fail to address the patient’s risk for developing a bedsore and proper prevention is not initiated. Untreated, bedsores can result in very serious consequences.
Federal regulations are particularly strong in the areas of preventing, documenting, and treating bedsores. The website www.medicare.gov (click on "Compare Nursing Homes in Your Area") gives the ratings for every nursing home and tells gives the percentage of residents with bedsores and how that compares with the national average.
At the law firm of Theodoros & Rooth, we are especially concerned about the mistreatment of residents at nursing homes, whether it be bedsores or any other affliction caused by neglect on the part of the people who are supposed to be caring for our loved ones.
If you suspect that caregivers at a nursing home are guilty of mistreatment, we want to know about it immediately. Call us for a free consultation. We will listen to your concerns with understanding and compassion. If we suspect there is a case, we will represent you until justice is served. Proper care for the elderly or anyone not able to take care for themselves is a priority for the attorneys at Theodoros & Rooth. Our loved ones deserve nothing less.