What is it: Bedsores, also known as pressure sores, decubitus ulcers, and pressure ulcers, are not the inevitable result of aging. While not all bedsores are preventable, most are preventable. In fact, the presence of in-house developed bedsores is universally considered one of the “quality indicators” used by long-term care providers to determine how they are doing in caring for their residents. According to the CDC, as many as 1 out of 10 residents in nursing homes currently suffer from bed sores.
Bedsores are the result of pressure over an extended period of time resulting in lack of blood flow and the life-giving oxygen carried by the blood. For this reason, health care providers are well aware of the rule of thumb that bed-bound or chair-bound residents must be turned and repositioned at least every two hours. For this reason, with the ease of prevention, true pressure sores are preventable, and should be prevented. True pressure ulcers most often develop on the body’s natural pressure points: heels, ankles, knees, hips, sacrum, shoulder blades, elbows and ears. Wounds that develop in the web spacing between the toe, for example, are not likely to be pressure related, and may be circulatory in origin as opposed to pressure.
However, pressure sores can develop anywhere on the body where there is unrelieved pressure, such as an ankle wrapped too tightly or where a catheter or oxygen tube runs under the body. In the sacral area, the genesis of a decubitus ulcer may well be a combination of pressure and excoriation (caused from laying in urine or feces for an extended period of time). Bedsores are typically staged I – IV, with a Stage I ulcer being described as a reddened non-blanchable area, to a Stage IV ulcer that is deep and has eroded into the underlying bone, tendons, and muscles. Wounds should be recognized before they advance beyond a Stage II wound, and appropriate treatment obtained. Most medium and larger communities now have specialized wound care centers, often associated with a hospital. These wound care centers are usually staffed by experts who document and photograph wounds, and sincerely do a good job in healing wounds. However, long-term care providers may not be quick to make referrals to a wound care center, unless prompted by concerned family members.
Stages of Bed Sores / Infections: Per the National Pressure Ulcer Advisory Panel, bedsores fall into four different stages:
- Stage 1 is the beginning stage of bedsore. The skin is still intact but will appear red on people with a fair complexion. People with a dark complexion may no notice skin color change at all, while others may notice a bluish color. The skin area around the bedsore will not blanch when touched and is typically painful and warm to the touch.
- Stage 2 is when the bedsore becomes an open wound and can consists of a crater-type appearance with the areas of fat around the infected exposed. The bedsore may appear pinkish in color with the appearance of a fluid-filled blister.
- Stage 3 bed sores are considered deep wounds and may appear to look like a crater, with or without yellow-colored dead tissue attached (known as slough). The damage goes beyond the infected areas and into healthy skin layers.
- Stage 4 is the final and most advanced stage of bedsore where the wound has become so damaged that bones, tendons, and muscles may be exposed. The bottom part of the pressure sore may show slough and dry, dead tissue.
Common Areas to Monitor for Bedsores: Depending on the body position of the elderly person, different areas of the body may be affected. Someone who is sitting will have a different location of bed sores than someone who is confined to a bed.
- Buttocks area or tailbone
- The back of the legs or arms
- Shoulder blades
- Both sides and back of head
- Outside of the ears
- Lower back and hips
- Knees, heels, ankles
Getting help: If you or your loved one has suffered from pressure sores because of the negligence of a nursing home, an experienced nursing home abuse attorney at Brooks, Leboeuf, Bennett, Foster & Gwartney, P.A. can help you. Our dedicated team of award-winning nursing home abuse lawyers have the knowledge and experience to help you.