Bedsores

What nursing homes and other long-term care facilities do not want you to know is that bedsores are easily preventable. Pressure ulcers are easier to prevent than they are to treat. We firmly believe that no elderly person in a nursing home or long-term care facility should have to suffer with the pain and discomfort of bedsores. One of the easiest steps that nursing homes and long-term care facilities can employ to prevent bedsores is to simply have residents change positions frequently and consistently, inspect elderly resident’s skin daily, ensure that residents are obtaining proper nutrition, and provide pressure reducing beds, wheelchairs, and cushions.

Bedsores Are Preventable and Unacceptable

According to the Mayo Clinic, residents of nursing homes have a higher risk of developing bedsores than patients who are hospitalized or cared for at home.

Bedsores are also known as “decubitus ulcers,” “pressure injuries,” and “pressure ulcers.” They are a localized area of dead tissue that develops when soft tissue is compressed for a prolonged period of time between an external surface, such as a bed, chair, or other parts of the body, and a bony portion of the body. The most common areas of the body where bedsores develop are on or around the elbows, the hip bone, ankles, knees, and the lower back and tailbone areas.

Key Facts About Bedsores

According to a recent study by the Centers for Disease Control and Prevention of the US Department of Health and Human Services –

  • In 2004, approximately 11% of residents in US nursing homes had pressure ulcers, with the most common being Stage 2. This means that more than 1 in 10 nursing home residents in the United States had a pressure sore.
  • Residents of nursing homes for one year or less were more likely to have pressure ulcers than those with longer stays.
  • Nursing home residents 64 years of age and under were more likely to have pressure sores than older residents.
  • “Pressure ulcers are serious and common medical conditions in U.S. nursing homes, and remain an important health problem.” NCHS Data Brief, No. 14, Feb. 2009, Centers for Disease Control and Prevention.

Code of Federal Regulation (CFR) 483.25(c) – is a federal regulation created by the Department of Health and Human Services and other agencies to set standards for long-term care facilities such as nursing homes. This regulation was enacted to prevent nursing home residents from developing pressure ulcers and to ensure that residents with pressure sores are properly treated. According to Centers for Medicare and Medicaid Services (CMS) guideline F314:

  • A nursing home facility is required to ensure that any resident who enters the facility without pressure sores not develop any pressure sores unless the individual resident’s clinical condition demonstrates that the pressure sores were unavoidable; and
  • Any nursing home resident that has or develops a pressure sore must receive the necessary treatment and services to promote healing, prevent infection and prevent new sores from developing. TAG F314, CFR 483.25(c).

Pressure Sore Classification

Bedsores and decubitus ulcers are typically classified by stage – Stage 1 is the least severe and Stage 4 is the most severe.

  • Stage 1 Pressure Sore a Stage 1 bedsore is the least severe decubitus ulcer, and it is defined as a pressure sore that exhibits a persistent redness of skin.
  • Stage 2 Pressure Sore a Stage 2 bedsore is characterized by a loss of partial thickness of the skin and there may be a visible shallow crater in the skin. Many times, this stage of pressure ulcer appears as a blister, shallow crater, and abrasion on the skin.
  • Stage 3 Pressure Sore a bedsore is classified as a Stage 3 when the wound exhibits a loss of full thickness of the skin and a deep crater is visible. A pressure ulcer in this stage contains damaged or necrotic subcutaneous skin that may extend down, but not through the underlying facia.
  • Stage 4 Pressure Sore Stage 4 is the most sever form of bedsore. This stage of decubitus ulcer is characterized by a loss of full thickness of the skin exposing muscle and even bone of the patient. A Stage 4 pressure ulcer will exhibit extensive tissue necrosis and damage, and may require surgery.

Bedsores are Painful

The medical literature (and patients themselves) report that pressure sores, regardless of the age or health of the patient, are painful. Bedsores are dead tissue – in most cases, to be treated properly, this necrotic tissue must be removed. This process is known as “debridement” and it is often long and painful. So, not only are the pressure ulcers themselves painful, but many times the treatment is itself painful.

Bedsores May Lead to Other Life-threatening Injuries

Pressure ulcers may also lead to other life threatening injuries. Some of the complications that can develop from untreated or improperly treated pressure sores are:

  • Sepsis – Sepsis is an infection that occurs when bacteria enters the bloodstream through broken skin. This condition progresses rapidly and can lead to organ failure and death.
  • Gas Gangrene (myonecrosis)- Pressure ulcers may lead to a rare and severe form of gangrene, known as myonecrosis. This condition typically develops suddenly and it often spreads to other areas of the body rapidly.
  • Cellulitis – Cellulitis is an acute skin infection that targets the skin’s connective tissue. The condition causes severe redness, swelling, and pain, and the condition can lead to life-threatening infections of the body such as sepsis and meningitis.
  • Bone and joint infections – Pressure sores can lead to penetrating infections of the bones, including osteomyelitis and infectious or septic arthritis, which is an infection of the joints.
  • Cancer – Untreated bedsores may even lead to the development of a type of squamous cell carcinoma known as Marjolin’s Ulcer.

Let us fight for you.

If your elderly loved one is suffering from bedsores due to the inattention or inadequate care of a nursing home, long-term care facility, or a home health institution– DO NOT WAIT – call us for a free consultation. The time to act is now!