Nursing Home Negligence: How to Treat Pressure Ulcers
Nursing Home Negligence: How to Treat Pressure Ulcers Pressure ulcers, or decubitus ulcers, are also known as bedsores. When the weight of a person’s body is focused on one part of that person’s skin for extended periods of time, the continuous pressure causes the skin to become damaged. A pressure ulcer might start out as a red spot, but it can progress and become a deep open sore quickly if the affected area does not receive proper care and treatment. Bedsores are common on people who spend a lot of time in bed or sitting in a chair for hours on end, day after day. Lack of blood flow around bony areas of the body, such as the tailbone and hips, is the most common cause of bedsores. However, pressure ulcers may also present because of friction burns from sliding across bedding, areas of skin that fold over and rub against other skin such as when a person slides down off of a high surface, or excessive exposure to moisture, including sweat, urine, and feces. If excessive moisture causes bedsores, this is a sign of neglect because nursing staff should not allow a patient to lay in sweat, urine, or feces for any amount of time. Cooling pads are available for patients who have issues with staying cool. If you suspect negligence, contact a nursing home abuse attorney that will fight for your loved one's rights.
The Stages of Bedsores According to Johns Hopkins Medicine, a bedsore goes through four stages as it grows. The first stage is minor and usually presents as a rash or a patch of red or darker skin. The area may feel warm to the touch and may hurt, itch, or burn. If the sore is allowed to progress, it becomes very difficult to heal. If a bedsore is deep enough, it can require surgery to start the healing process. If you catch a bedsore at an early stage, you may be able to prevent it from getting worse. The first stage of a bedsore will also alert you to look for more sores and to take preventative measures to keep other sores from forming. When a bedsore reaches the second stage, the area might look like a blister or a scrape. The bedsore becomes more painful at this stage. You may notice discoloration around the edge of the pressure ulcer. In the third stage, the pressure ulcer looks like a crater because the damage is below the surface of the skin. In the fourth stage, the bedsore progresses to a large wound that can go as deep as the bones. If it does, tendons, muscles, joints, and bones can be affected. While any open wound can become infected, a pressure ulcer at the fourth stage is more likely to become infected than at any other stage, especially if caregivers are not tending to the sores. Staff should clean the wounds and change dressings frequently, especially if the sore is still weeping, to help prevent any infection from setting in.
Treating Pressure Ulcers Once you notice a pressure ulcer, you should seek medical attention for your loved one as soon as possible. If your loved one is in a nursing home, bring the sores to the attention of the nursing staff immediately. In some cases, bedsores cannot be helped, but in most, they develop due to neglect. Staff should monitor patients who are not able to move on their own and turn those patients every two hours. The treatment of a pressure ulcer depends on how advanced the sore is, and may include:
A doctor should also make sure the patient is getting the proper nutrition. If malnutrition exacerbates a bedsore, that could be a sign of elder abuse. If the bedsore is advanced enough, it might require debridement, which is removing dead tissue, infected tissue, and/or damaged tissue. If the bedsore is deep and very advanced, a doctor may order surgery to transplant healthy skin to the area. The doctor may also order antibiotics and negative pressure wound therapy to help with healing and to clear up any infection.
- Putting the patient on a schedule to turn the patient every two hours to remove pressure from the affected area.
- Cleaning the wound.
- Covering the wound with special dressings and/or medicated gauze.
Continuing Care for Bedsores If your loved one is being treated for bedsores, keep in contact with your loved one’s doctors, even if your loved one is in a nursing home. Even if the nursing staff at the nursing home is top-notch, always check the bedsores yourself and insist on daily updates. Stay in touch with your loved one’s doctor. It is extremely important to prevent bedsores from becoming infected if they are not already infected. Look for signs of infection, including redness around the lesion, a foul smell coming from the open wound or yellow or green puss around or in the pressure ulcer. Notify the nursing staff and your loved one’s doctor as soon as you notice any signs of infection.
Preventing Pressure Ulcer Caregivers can prevent or at least head off bedsores by inspecting the patient every day and by turning the patient at least every two hours. If the patient is sitting in a chair or wheelchair, they should be repositioned every 15 to 20 minutes. Adding soft padding to beds and wheelchairs can help to prevent pressure ulcers, but caregivers should still check patients. If bedsores do appear, make sure the patient is getting the proper nutrition. Without the correct vitamins and minerals, even a bedsore in its first stage will not heal properly, or sometimes will not heal at all. Look for signs such as dirty rooms, missing and dirty clothing, significant weight loss not related to an illness, poor hygiene, bruises, broken bones, and bedsores. These and other signs of improper care show that the nursing home might be negligent in the care of your loved one. If you see signs of negligence, including pressure ulcers, consulting with a nursing home abuse attorney can help you determine if you can pursue a legal case against the facility.