What Causes Bed Sores?

According to the Agency for Healthcare Research and Quality, more than 2.5 million Americans will develop bed sores annually. This condition disproportionately impacts the elderly and those with limited mobility because it is caused by restricted blood flow. 

Read on to learn more about what causes pressure sores, risk factors, preventative measures, and how a nursing home injury lawyer can help you get justice if you develop pressure injuries while in care.

Nursing Home Law Center can provide legal representation when you are ready. 

What are Bed Sores (Pressure Ulcers)?

Bed sores, or pressure sores, occur when prolonged pressure is applied to the skin. This pressure reduces blood flow and damages the skin’s surface, underlying soft tissue, and, in severe cases, bones, joints, and muscles. Depending on the stage, pressure sores can present like bruises or festering wounds.

Pressure sores can disproportionately impact elderly patients at nursing homes, causing them pain, depression, anxiety, and other mental health issues. The wounds may also cause them to self-isolate, leading to a loss of enjoyment in life.

How They Develop

Patients who are bedbound or limited to wheelchairs are often seated in the same position for prolonged periods. This causes extended pressure on the skin, leading to pressure sores due to friction, shear forces, skin tears, and more. 

Examples that can lead to pressure sores include:

• Sitting in bed without moving
• Being left in a wheelchair
• Friction from oxygen masks
• Lying on the side for an extended time
• The sheets are too tight
• Too tight clothing
• Laying on uneven surfaces 

The longer the pressure is applied, the deeper the wound can get. In some cases, the affected limb may need to be amputated to stop the spread of infection. 

Where They’re Commonly Located

Bedsores can occur throughout the body but are most commonly present at bony locations with limited fat and muscle protection. This can include:

• Sacrum and coccyx 
• Heels
• Hips
• Elbows
• Head
• Ears
• Shoulders
• Knees

The bony points of your body can more easily rub against surfaces, causing pressure sores to develop. 

Risk Factors for Pressure Ulcers

Nursing homes will assess a patient’s risk factors for developing pressure sores. They include the following.

Immobility

Patients who have limited mobility or are entirely bedridden have an increased risk of developing a pressure sore. They cannot move their body without assistance, so they cannot reposition themselves. 

Instead, they rely on nursing home staff to adjust their positioning in the bed or chair. This should happen every 15 minutes; however, understaffed nursing homes can cause some patients to go without moving for extended periods. Immobility is among the most common reasons for developing pressure sores. 

Malnutrition and Dehydration

Nursing home patients may be malnourished or dehydrated, which can cause their skin to lose elasticity and become damaged. They may not eat enough calories or lack the necessary nutrients to help their body heal. Additionally, dehydration can slow down essential body functions. 

Both can weaken the skin’s surface, making it more vulnerable to developing pressure sores. A balanced diet and proper hydration can improve a patient’s skin health. 

Incontinence

Patients suffering from incontinence can face an increased risk of developing bedsores. Moisture from urine or feces can collect on the skin, making it easier to tear. These body functions can also cause infection, leading to advanced pressure sore stages. 

• Soiled adult diapers can cause friction when not changed frequently
• Soiled sheets can rub against the skin, leading to abrasions 
• Prolonged moisture on the skin surface can make it break down easier

Nursing home staff should clean the skin and change soiled linens to prevent infection and pressure sores.

Medical Conditions

Some medical conditions can increase a person’s likelihood of developing pressure injuries. These include:

• Diabetes: Some patients with diabetes have nerve damage, so they cannot feel discomfort. They may also have impaired wound healing. 
• Obesity: Patients who are overweight may place more pressure on the body while lying in bed.
• Underweight: Patients who are too thin may have more bony protrusions on their bodies that can cause friction and lead to a pressure sore. 
• Vascular conditions: Some vein conditions, including peripheral artery disease and chronic venous insufficiency, can impair a person’s ability to heal wounds.
• Dementia: Patients who suffer from dementia have less awareness of what’s going on around them. They may lose time and sit in the same position for too long.
• Cancer: Some treatments can reduce the skin’s strength and make it easier to develop bedsores. Left untreated, decubitus ulcers can also cause cancer. 

Any medical conditions that cause limited mobility can increase the risk of developing pressure sores. 

Age

Age can be another contributing factor to the development of pressure injuries. Elderly patients often face the following issues.

• Limited mobility: Elderly patients often cannot move without aids or support.
• Skin health: They often have more fragile skin, making them prone to developing a pressure sore.
• Health issues: Select conditions can increase the risk of pressure sores. 

Reduced blood flow and extended periods of immobility can cause pressure injuries in the elderly. 

Stages of Pressure Ulcers

There are four stages of pressure sores, ranging from a mild inconvenience to a severe health concern. 

• Stage 1: Stage one pressure injuries present like bruises. They may be patches of red, blue, or purple skin that do not blanch when applying pressure. They also do not fade when you relieve pressure. The skin is not broken in a stage one pressure sore, but it can be hot and itchy for patients.
• Stage 2: Stage two pressure sores have broken the skin. They may look like blisters or simple cuts penetrating the dermis and epidermis skin layers. The skin around the sores is often discolored due to dead tissue, and the wound will be swollen and weeping pus or moisture. 
• Stage 3: A stage three pressure sore is among the most serious. It has penetrated the subcutaneous tissue, causing crater-like wounds to develop. They are often red, swollen, filled with pus, and discolored. There may be black tissue present. This is dead skin.
• Stage 4: Stage four pressure injuries are the worst. The deep tissue pressure injury can extend to the bones, muscles, joints, ligaments, and tissues. The damage is extensive and painful and may require serious medical intervention. 

Sometimes, bed sores can be unstageable. This is due to black tissue (eschar) or slough (discolored tissue that can be yellow, gray, green, brown, or black). Medical professionals cannot see through the condition to properly diagnose the wound.

If this is the case, doctors will cleanse the pressure ulcer to remove any damaged tissue or dead skin obstructing their view. 

Proving Nursing Home Negligence in a Bed Sore Claim

Nursing home injury lawyers can help you prove negligence in your bed sore lawsuit. You will need to establish the following conditions. 

Duty of Care

You must demonstrate the nursing home had a duty of care to you to prevent pressure ulcers. If you were a patient, you had a reasonable expectation of care. 

Breach of Duty

Next, you must establish that the nursing home breached that duty by failing to provide appropriate care. This may include not moving a patient, resulting in decreased blood flow, lack of a wound healing plan, or failure to prevent pressure injuries. 

This breach caused harm, and this harm led you to suffer significant physical, emotional, and financial damages. When you prove these conditions were met, you can hold the nursing home liable for negligence. 

Signs of Neglect

Lawyers will look for the following conditions to help prove neglect. They include:

• Unsanitary conditions: Rooms may not be maintained, patients may use dirty linens, and common areas can be uncleaned. A lack of sanitation spreads infection.
• Inadequate staffing: Understaffed nursing homes cannot provide the care needed to vulnerable patients. 
• Unsafe living conditions: Lack of heat, fire hazards, faulty electrical systems, and other conditions can make patients unsafe.
• Patients left unattended: Patients left alone for long periods can indicate they are being neglected.

Increased reports of pressure sores, injuries, and deaths can also be signs of neglect in nursing homes. 

Preventing Pressure Sores

Nursing homes can easily prevent pressure sores if they adequately treat their patients. 

Repositioning

Prolonged pressure reduces blood flow. However, frequent repositioning can promote blood flow to the skin and relieve pressure on parts of the body with bon areas. It is recommended that patients be repositioned every 15 minutes to prevent pressure sores from developing. 

Skin Care

Proper skin care practices can prevent pressure sores, including:

• Keeping the skin dry: Wet skin can easily lead to broken skin with friction.
• Washing the skin: Wash and sanitize the skin regularly to prevent bacteria from developing. Remove any urine or feces promptly.
• Properly moisturizing: Dry skin can catch and lead to skin damage and severe sores. Apply moisturizer to maintain elasticity in the affected area and the surrounding skin. 

Failure to do so can cause pressure sores.

Support Surfaces

The ideal angle for a person to rest at is 30 degrees to prevent bedsores. Some specialized mattresses and cushions can help a patient maintain this position. It will redistribute the pressure on a person’s body, making it less likely to develop pressure sores.

Seeking Legal Help for Nursing Home Residents Suffering From Pressure Injuries

Lawyers can help victims of nursing home neglect get justice, including those who have developed pressure ulcers.

• Advocate: Lawyers will advocate for your rights, helping represent you throughout the legal process.
• Investigate: Lawyers gather evidence to build a solid case to help you recover compensation. 
• Negotiate: Lawyers negotiate with nursing homes and insurance companies to help you reach a fair settlement. If they can’t agree, they represent you in court.

Lawyers can help hold nursing homes accountable for their actions and prevent these conditions from occurring again. 

Compensation for Damages

Pressure sore victims can recover various types of compensation for their injuries, including: 

• Medical expenses: Doctor’s visits, surgery, hospitalization, physical therapy, medication, etc., can be recovered.
• Emotional distress: Many victims can face mental health issues, including depression and anxiety, as a result of their pressure sores.
• Pain and suffering: Bedsore victims can receive compensation for their pain and suffering. This can be on a per-diem basis or as a multiplier of the expenses they endured. 
• Punitive damages: Victims can also recover punitive damages if a nursing home is found guilty of gross negligence. These are intended to punish the nursing home and deter them from maintaining these conditions.

How much compensation you can recover depends on your case, and a nursing home lawyer can help you understand your legal options. 

Secure Expert Legal Representation! 

Pressure sores are preventable, but if they occur, it can be a good indication of nursing home neglect. If you or your loved one are a victim of pressure injuries, contact Nursing Home Law Center for a free consultation. 

Our team can explore the details of your case and recommend an appropriate legal course of action. Call us at (800) 926-7565 to get started. We are ready to help you get justice for your injuries when you are.

References: [1] American Health and Research