Nursing Home Pressure Sores Lawyers in Texas
Pressure Sores and Decubitus Ulcers
Pressure sores, also known as bedsores or decubitus ulcers, are a serious problem among nursing home residents. People with the highest risk of bedsores are those who spend most of their time in bed or in a chair, or those who have medical conditions that limit their ability to change positions. Most pressure sores are preventable when nursing home caregivers take the time to properly reposition residents and implement other precautionary measures.
Without proper care, bedsores can progress rapidly, creating the risk of sepsis or severe infections. If your elderly loved one has developed pressure sores in an Texas nursing home, it may be a sign of neglect and negligence on the part of the facility and its staff.
What Causes Pressure Sores/ Decubitus Ulcers in Nursing Homes?
As stated by the Mayo Clinic, there are three primary contributing factors to bedsores. Those factors are:
- Pressure: Constant pressure on a part of the body, as with sitting or lying in bed, lessens blood flow to the tissues. Blood flow is essential to deliver oxygen and nutrients, and without it, the skin and tissues become damaged and may die. In nursing home residents with limited mobility, this type of pressure occurs in areas that lie over bone and lack padding with muscle or fat. These areas include the shoulder blades, elbows, spine, hips, and tailbone.
- Friction: When the skin rubs against bedding or clothing, friction occurs. This makes the skin more susceptible to injury, particularly when it is moist. For this reason, it is crucial for nursing home caregivers to ensure that residents with limited mobility are kept dry.
- Shear: A shear is a strain in structure produced by pressure when layers are laterally shifted in relation to each other. If a bed is elevated at the head, the body tends to slide down the bed. When this happens, the skin over a bone may stay in place, creating pulling in opposite directions.
Bedsores: Stages 1 through 4
Pressure sores are classified as to severity in the following stages.
This is the mildest stage for bedsores, when they affect only the upper layer of skin. Symptoms may include burning, itching, and pain. The sore may feel different than the surrounding skin – softer, firmer, warmer, or cooler. You may notice a red or discolored area on the skin that does not get lighter when you press on it, or even 10 to 30 minutes afterwards. This indicates that less blood flow is reaching the area. Stage 1 pressure sores may resolve in as little as two or three days with proper treatment.
In this stage, the bedsore extends deeper below the surface of the skin. The area is swollen, warm, and/or red. The skin is broken, leaving an open wound, and has the appearance of a pus-filled blister. The sore is painful and may ooze clear fluid or pus. When properly treated, Stage 2 pressures sores should improve within three days to three weeks.
Stage 3 pressure sores have gone all the way through the skin layers into the fatty tissue underneath. At this stage, the bedsore has the appearance of a crater and may have an unpleasant odor. Signs of infection may be present, including red edges, odor, heat, pus, and/or drainage. If tissue in or around the sore has died, it will be black. It may take one to four months for a properly treated Stage 3 bedsore to heal.
Stage 4 bedsores are the most serious, and may affect muscles and ligaments. These sores are large and deep, with skin that has turned black and shows signs of infection, such as red edges, heat, odor, pus, and drainage. Muscles, tendons, and bone may be visible through the sore. Stage 4 pressure sores are a medical emergency and may require surgery. Recovery can take anywhere from three months to years.
What Are the Risk Factors for Pressure Sores?
Older people in nursing homes with health conditions and limited mobility have a higher risk of developing pressure sores. Risk factors for this condition include:
- Immobility or limited mobility
- Lack of sensory perception (as with neurological disorders and spinal cord injuries)
- Poor hydration and nutrition
- Medical conditions affecting blood flow (such as diabetes and vascular disease)
What Are the Most Common Locations for Pressure Sores?
For nursing home residents confined to a wheelchair, pressure sores are common in the following sites:
- Shoulder blades
- Backs of arms
- Backs of legs
Residents who are bedridden are more likely to develop bedsores in the following areas:
- Back or sides of the head
- Shoulder blades
- Lower back
- The skin behind the knees
What Are the Complications Associated with Bedsores?
Serious or life-threating complications can develop with pressure sores, which means that proper prevention and care in nursing homes is essential. Complications of decubitus ulcers include:
- Cellulitis: This is an infection of the skin and surrounding soft tissues. Cellulitis symptoms include warmth, redness, and swelling.
- Bone and joint infections: Infection caused by pressure sores can burrow into the bones and joints. Joint infections, technically known as septic arthritis, can damage tissue and cartilage. Bone infections (osteomyelitis) can cause reduced function of the limbs and joints.
- Sepsis: This is an extreme response of the body to an infection. When microorganisms enter the body through a pressure sore, it can trigger a chain reaction with life-threatening consequences. Without proper and rapid treatment, sepsis can lead to tissue damage, organ failure, and death.
- Cancer: Long-term pressure sores that don’t heal can develop into a type of skin cancer – squamous cell carcinoma.
What Responsibility Do Nursing Homes Have for Pressure Sores in Residents?
Under federal regulations, nursing homes have extensive obligations to prevent and treat pressure sores in residents. When they fail to provide the basic care necessary to prevent bedsores, nursing homes may be liable for resulting injuries. Pursuant to federal regulations, if a resident enters a nursing home without pressure sores, he or she should not develop them unless it is clinically unavoidable. Nursing home staff are required to do everything possible to prevent bedsores. Once a decubitus ulcer has developed, nursing homes must provide proper care to avoid infection and to promote healing.
Are Nursing Homes Liable for Pressure Sores and Complications in Residents?
If nursing homes are negligent in preventing and treating bedsores, they may be held liable for the resulting injuries. Types of negligence in preventing pressure sores that may lead to a claim for compensation include:
- Failure to regularly reposition a resident with mobility issues (to avoid leaving one part of the body bearing the resident’s weight for long periods)
- Failure to provide adequate toileting and changes of clothing and bedding for incontinent residents
- Failure to provide sufficient fluids and nutrition (as dehydration and malnutrition make the skin more vulnerable to injury)
When a pressure sore has already developed, nursing home staff should change the dressings regularly, apply wound treatments, use pressure-reducing devices, and administer nutritional supplements. Bedsores can progress and become infected, leading to serious or life-threatening complications. Failure to properly treat them may be grounds for a claim for damages based on negligence.