One of the more frequent injuries we seen in our nursing home neglect clients, are pressure ulcers. While they are also clinically referred to as decubitus ulcers, plainly put, these are bedsores. They are injuries to the skin and underlying tissue, which result from prolonged pressure being placed on an isolated area on the skin. Bedsores and pressure sores/pressure ulcers most often develop on skin and underlying tissue that lies over bony areas of the body, such as the coccyx (tailbone), the buttocks, the hips, the outside surface of the knees, and the ankles.
These injuries to the body can be excruciatingly painful. Worse, because they are open wounds to the skin, they are incredibly convenient portal for infection – most often bacterial, but viral, also. Not only are they painful and dehumanizing, they are literally open doorways to sepsis and septic blood infections. Most of the reasons for this high danger, is due to the fact that most nursing homes and rehabilitation and hospitals are filled with bacteria and viruses. Why? These facilities are filled with sick people – and the sanitation conditions in these places are far, far from anything approaching “ideal”.
Nursing home patients and others who are at the highest risk level of developing bedsores and pressure ulcers are people with any condition that limits their own ability to change body positions – even something so simple as shifting oneself in a bed or chair. Obviously, patients at the highest risk of developing pressure sores are those who live most of their life in a bed or chair.
Bedsores don’t need a lot of time to appear – they can develop quickly. While many of these types of sores can eventually heal with treatment, some never heal entirely. Prevention is key – without prevention in the form of frequent re-positioning of the patient – pressure sores and decubitus ulcers will form – and as I said above, once this happens, the patient will not only suffer intense pain and what, as a Massachusetts nursing home neglect attorney, I consider to be dehumanizing experience – but these open wounds then provide gateways to septic infections.
The early symptoms & warning signs for pressure ulcers are fairly easy to spot:
- Atypical changes in skin color and/or texture
- Localized Redness or swelling
- Skin areas that become tender or painful to the touch
- Any pus-like draining
Bedsores and pressure ulcers start for one reason: The patient is put in a bed or chair, and left in the same position for hours, every day. The body’s weight bears down on areas of the skin that lie immediately above bony areas of the person’s frame – such as the buttocks, hips, shoulders, ankles and knees – and the skin and underlying tissues are worn down – worn thin – until the underlying tissues open up, and become exposed. Period. That’s what causes them. So, if prevention in the form of re-positioning patients is the key to avoiding this painful and debilitating outcome, why does it happen? Answer: Because most nursing homes and rehabilitation facilities are under-staffed, and the staff they do have are low-skilled, low-paid people, whose work is draining. Ownership and management of many of these facilities make their money and profits by hiring low-skilled, low-paid workers. They don’t want to hire enough staffers to care for each patient adequately. They don’t want to pay the staff appropriately, so that they would be (hopefully) more caring and attentive to patients.
Most nursing home facilities these days are owned by massive, out-of-state corporations. Don’t be fooled by the signage on the facility: Even if it has the same name on it that it’s had for years & years, it’s still probably owned by an out-of-state corporations: That’s just one diversion tactic they use: When they buy up a locally-owned facility that may have had a decent name and reputation, they keep that branding and signage, so that hopefully few will know who is really running the place, now. whose goal is singular: Make money, at all costs – even patient care and safety. Their concerns are three-fold: 1) Market themselves to as many patients and families as possible; 2) Make as much money as possible; and 3) Hire smiling “patient relations” types – usually women – to run interference with families who complain that their loved ones aren’t being cared for. In our practice, we know how to get past these smokescreens – exposing substandard nursing home patient care – and we’re proud of that. I’ll discuss more of what categories pressure ulcers or pressure sores fall in, and their dangers, in Part Two of this post, in a few days.