Bed Sores: An Almost Completely Avoidable Deadly Nursing Home Complication

Elderly woman lies in bed

Bedsores are the completely unnecessary yet shockingly common problem that plagues Texas nursing homes. Studies have shown that at any given time, eight to 10 percent of residents at a nursing home have one or more bed sores

In truth, that percentage should be almost zero. Even in cases where a patient is bedridden or has limited mobility, there are still numerous strategies that healthcare staff can use to reduce the chances of developing bed sores. 

Bedsores are almost always a sign that a nursing home is negligent. In fact, in the healthcare community, serious bed sores are known as “never events”: injuries that should never happen when a patient is properly cared for, period. Bedsores aren’t simple skin wounds—they are a risk factor for numerous complications, some of which are fatal.

What Are Bed Sores? 

Before we can talk about the complications and risks of bedsores, we have to define what they are. Bed sores, also known as pressure sores, pressure ulcers, or decubitus ulcers, are injuries that usually happen when a senior is left in one position for too long. 

This may occur if they use a wheelchair, if they’re bedridden, or if they need help getting out of bed and no staff is available to help them. Pressure sores don’t take long to develop: they can happen in as little as two hours, according to Johns Hopkins University.

When a senior stays in one position, the pressure from their body weight prevents blood from reaching the skin, damaging it and the surrounding tissue. This is why bed sores usually happen in bony areas that make contact with a bed or chair, like the shoulder blades, elbows, heels, tailbone, and the back of the head. 

Bed sores progress in four stages:

  1. Stage 1: The skin is still intact, but damage has been done to the underlying tissue. It will usually appear as a patch of darkened or discolored skin. The area may also be painful.
  2. Stage 2: The dermis (the outermost layer of skin) has worn down, and the epidermis (the second layer of skin) is now exposed. The epidermis will likely appear pink or red, and there may be a blister or slight indentation where the damage has been done.
  3. Stage 3: The skin on the affected area has broken open completely, leaving an open wound through which fat and dead tissue can be seen. Once an open wound is created, the chance of infection increases significantly.
  4. Stage 4: The open wound has grown larger, exposing muscle, tendons, or bone. The surrounding skin and tissue have suffered extensive damage. 

If a senior can move, either with or without assistance, there should be minimal risk of developing pressure ulcers if they are being cared for properly. In cases where a patient is completely immobile or uses a wheelchair to get around, stage 1 and 2 bedsores can happen, even at nursing homes with high-quality care. It becomes negligence when staff fails to recognize and treat these early pressure sores quickly. There is never any reason why an elderly person in a long-term care facility should develop a stage 3 or 4 bedsore. 

In addition to the pressure of sitting in one position for too long, other factors that increase the risk of pressure sores such as:

  • Shearing: Shearing occurs when a patient’s skin moves in one direction (or remains stationary) while their bones move in the opposite direction. This can happen when a senior is moved too quickly from their bed to their wheelchair, for example.
  • Friction: Over a certain age, friction from scratchy bedsheets, ill-fitting clothing or shoes, or too many layers of blankets isn’t just annoying—it’s a health risk. Any repeated rubbing of the skin can lead to bed sores. 
  • Moisture: Dry, irritated skin is more susceptible to injury. On the other hand, too much moisture can also increase friction and skin irritation. In this case, pressure ulcers may be a result of leaving sweat or urine on the body for an extended period of time. 
  • Dehydration and malnutrition: Skin cannot stay healthy without proper nutrients. Seniors who are not given healthy meals or enough water are at risk of developing pressure ulcers. 
  • Reduced blood flow: If your loved one has diabetes, peripheral artery disease, or another condition that reduces blood flow, they are at a significantly higher risk of developing pressure sores. 
  • Lack of sensation: Someone with decreased skin sensation due to diabetes, arthritis, sciatica, or another medical condition may not be able to tell when something is wrong with their skin. These seniors must be monitored carefully for pressure sores. 

Every long-term care facility should have a plan in place to prevent and reduce bed sores, both in number and severity. Even if your loved one has medical complications that increase their risk of developing pressure sores, these risk factors should be addressed and mitigated.

Complications from Pressure Sores Can Be Deadly

An untreated bed sore is not just a skin wound—it’s potentially deadly. Stage 3 and 4 bed sores can allow dangerous bacteria into the body and create serious infections like sepsis. In some cases, this infection prevents oxygen from reaching organs, sending patients into septic shock that must be treated immediately.

Too often, treatable pressure sores are allowed to progress, leading to unnecessary death. Even in cases where the patient recovers from a serious bed sore, the risk of recurrence and death is increased significantly. 

With one of the highest nursing home populations in the country, wrongful death due to untreated pressure ulcers is shockingly common in Texas. Investigations by the TX Department of Aging have uncovered egregious negligence and abuse at nursing homes in Corpus Christi, Houston, and virtually every other major Texas city. 

In one case that made headlines, a family sued Senior Living, LLC when their mother died from pressure ulcer complications at a nursing home a few hours north of San Antonio. Nursing home neglect can happen anywhere, even at medical facilities with good reputations. 

Bedsore Early Warning Signs—Catch Pressure Sores Early

Nursing home staff should be watching residents for signs of bed sores, but if you’re not confident that the staff is performing their duties, you can check your loved one for signs of stage 1 and 2 pressure sores. Look for:

  • Discolored patches of skin (may appear red or brown on people with light skin, blue or purple on people with dark skin) 
  • Skin with an unusual texture (e.g., too soft or too firm)
  • Skin that feels cool or warm to the touch for no obvious reason
  • Skin that doesn’t lighten when pressed 
  • Itching, tingling, or pain 
  • Blisters or draining pus
  • Skin with a cratered appearance
  • Open wounds 

You’ll most likely see these warning signs on high-risk bed sore areas, like the tailbone, spine, hips, heels, elbows, shoulder blades, and back of the head. If you don’t see visible signs of bed sores, but your loved one is complaining of skin irritation or pain, keep a record of their complaints and let staff know that you’re watching the situation closely.

If your parent, grandparent, or family member has gotten serious bed sores while living in a nursing home or long-term care facility, you may be able to take legal action. Bed sores are a sign of negligence, and they’re usually just the tip of the iceberg. 

By filing a lawsuit, you can help put a stop to nursing home negligence, and you may be entitled to a financial reward for your efforts. If you believe you have a Texas nursing home negligence case, contact our office today to learn your options.

Related Posts
  • Holding Nursing Homes Accountable: Legal Remedies for Bedsores Caused by Negligence Read More
  • Texas' Worst Nursing Homes Read More
  • 7 Signs of Nursing Home Abuse and Neglect Read More