Placing a loved one in a nursing home can be a difficult decision. Because of this, we do our best to ensure that our family members are well cared for medically, socially, and emotionally. When nursing homes betray the trust placed in them to provide an accepted standard of care, it can be devastating. Bedsores or, as they are also commonly known, “pressure sores,” can develop quickly and unexpectedly if the nursing home staff is not vigilant about risk factors and warning signs. If treated promptly, bedsores do not present a risk to a resident's health; however, if left untreated, they can deteriorate quickly and become life threatening.
Bedsore Risk Factors
Several risk factors contribute to the likelihood that a resident might develop bedsores or pressure sores. In patients with these conditions, it is especially important to be watchful of any developments that might signal the onset of bedsores. Risk factors include
- Immobility due to spinal injuries, paralysis, obesity, or poor health. Bedsores develop when areas of the body experience prolonged periods of pressure and friction, which is more likely when the patient cannot easily readjust themselves.
- Poor nutrition and hydration. Without the proper nutrition, the body cannot repair itself. The skin, in particular, becomes weaker and more susceptible to injury when there is a lack of proper diet.
- Decreased sensory perception. If the nursing home resident has some level of nerve disorder they may not be able to feel pain or numbness from developing bedsores or note when they need to change position.
- Chronic health conditions that affect proper blood circulation. Since pressure sores often develop when areas of the body are deprived of blood and therefore oxygen and nutrients, conditions such as diabetes, heart conditions, and kidney diseases can all increase the risk of bedsores.
- A history of bedsores. If patients have had bedsores in the past, they are more likely to develop them again.
- High moisture. If patients are often incontinent or if they are bathed with soap and water but not dried correctly, the extra moisture can make their skin more vulnerable to small tears, the beginning of a bedsore.
Professionals who work with residents in short or long-term care facilities should be trained to recognize these risk factors and pay special attention to those who display them.
Bedsore Warning Signs
If you are concerned that your loved one might be at risk for bedsores or may be suffering from them already, certain warning signs can signal the need for immediate attention.
Changes in Color
The most common early sign of a bedsore is a change in the skin's coloration. In lighter skin tones, the sore often appears reddened or bruised. In darker skin tones, the affected area may look blue, purple, or black. In addition, a blanch test can be performed. If you press your finger down on the suspected area, it should first turn white but then return to the original color quickly (within a few seconds) to demonstrate effective blood flow.
Changes in Texture or Sensation
While pain is an obvious warning sign of impending bedsores, sometimes patients cannot feel their onset. Changes in the appearance or feel of the skin that caretakers can observe include cracking, blistering, hardness or shininess. In addition, early bedsores often feel hot to the touch or, alternatively, cool, either from increased blood flow attempting to heal the area or a lack of blood flow.
It is important to remember that even though a wound or tear in the skin may appear small from the outside, damage to the tissue below the skin might be more extensive and severe. Since bedsores usually involve the slow death of tissue due to lack of blood flow, the skin may appear relatively normal while the underlying flesh is in need of immediate attention.
Bedsores can be treated with regular movement, specialized mattresses, dressing and packing the wound, cleaning, and disinfection with creams or oral medicines, and, in extreme cases, surgery. In almost all instances, if bedsores are caught before an additional complication arises, patients can make a full recovery with extended, attentive care. However, these wounds can develop quickly and even a couple of days in lapsed attention can cause serious long-term health issues, especially if a resident's vitality is already compromised by old age, weakness, or chronic conditions. If left untreated, complications may arise, such as
- Cellulitis, a skin and connective tissue infection characterized by pain, warmth, and swelling of the affected area. Cellulitis requires immediate treatment with antibiotics, or it might spread to surrounding areas such as the blood, bone, joint, or membranes surrounding the spine and become highly dangerous.
- Blood Poisoning or Septic Shock can occur when the sore's infection spreads to the bloodstream. The chance of this happening increases if the patient's immune system is already compromised. Blood poisoning must be treated very quickly or the patient's blood pressure may suddenly drop, causing them to enter septic shock, a potentially fatal condition in which the organs begin to fail.
- Necrotising Fasciitis or “flesh-eating bacteria,” is another kind of particularly aggressive infection commonly caused by Group A streptococci. This infection must be cut out or it will continue to spread throughout the body, causing massive tissue damage and death.
- Gas Gangrene, a fatal bacterial infection caused by the clostridium bacteria which thrives in moist environments with little oxygen, such as a wound.
- Marjolin's ulcers, a particular kind of cancer called squamous cell carcinoma which can develop from long-term wounds, scars, or chronic inflammation.
Representation for Nursing Home Abuse Victims in Baltimore
If you have noticed any of the signs listed on this page, it is imperative to inform the nursing home immediately so that your loved one can get treatment as soon as possible. If you feel that the nursing home is not properly concerned with the resident's condition and is failing to provide necessary medical attention, you might consider taking your loved one to a doctor who is not associated with the facility to give you their professional opinion and advise care. If someone you loved has suffered bedsores as the result of nursing home neglect, they may be entitled to compensation. For a free legal consultation, call trial attorneys Charles Gilman and Briggs Bedigian today at (800) 529-6162 or contact them online.