Bedsores: Are They a Sign of Neglect?

Residents of a nursing home are usually admitted due to their need for care beyond that which can be provided at home. When a resident enters a nursing home they are promised proper care and treatment. Often times, this requires staff to clean, change and move the resident regularly. However, this does not always occur. When a person is not changed regularly both the moisture and the acid from their urine and feces can cause skin breakdown causing a condition commonly referred to as bedsores. Additionally, if a resident is not regularly repositioned, the areas of their bodies bearing their weight may also suffer from skin breakdown. These areas can include the elbows, heels, back and tailbone. You may also hear bedsores referred to as pressure ulcers, decubitus ulcers and pressure sores. If a resident has a bedsore, it may be the result of neglect.

Bedsores are preventable. In fact, it is easier to prevent a bedsore than it is to treat a bedsore. Nevertheless, bedsores are becoming commonplace in many nursing homes. Bedsores are extremely painful and should be addressed immediately. These sores can lead to sepsis and death if they are ignored or improperly treated. The first sign of skin breakdown is the appearance of reddened skin. This is easy to spot on areas such as the elbows and knees. However, families may not be present while a resident is being changed or bathed and may therefore be unaware of an area of reddened skin on their tailbone or hip. Often, family members are unaware that their loved one is suffering with a bedsore because he/she is unable to communicate either their pain or the location of the sore to their families. If your loved one is unable to communicate, you may need to be extra vigilant in checking their skin for any signs of breakdown.

If a resident does unfortunately have a bedsore, medical personnel may tell you the severity by stage. Bedsores range from Stage 1 to Stage 4, with Stage 4 being the worse. According to the National Pressure Ulcer Advisory Panel, bedsore stages are described as:

· Stage 1: Intact skin with non-blanchable (redness that does not subside when the pressure is relieved) of a localized area usually over a bony prominence.

· Stage 2: Partial thickness loss of dermis presenting a shallow open ulcer with a red pink wound bed, without slough.

· Stage 3: Full thickness tissue loss. Subcutaneous fat may be visible but bone, tendon or muscle are not exposed.

· Stage 4: Full thickness tissue loss with exposed bone, tendon or muscle.

See: http://www.npuap.org/pr2.htm

Regardless of the stage, bedsores require prompt and appropriate treatment. If you see an area of reddened skin, request that the nursing home provide the resident with preventative devices such as a special air filled mattress and/or cushions that can be placed to alleviate the pressure on that particular area. Also, make sure that resident is receiving medical care to ensure that the area does not continue to worsen. These measures may help but ultimately the nursing home must take appropriate steps to ensure that the cause of the reddened skin is remedied. Nursing homes owe it to their residents to provide the care necessary to prevent these sores.