Are Pressure Sores Normal in Nursing Home Residents?

It happens too often - people visit their Mom or Dad in a nursing home and see a nasty, large, often smelly wound on their backside, buttocks or heels. Are those normal?

Medicare says no - they consider serious pressure ulcers to be a "never event" that should not happen. If your loved one has developed a bed sore or pressure wound in a nursing home, they might have a case.

Understanding Pressure Ulcers

Pressure ulcers, also known as bedsores or decubitus ulcers, are localized injuries to the skin and underlying tissue that occur due to prolonged pressure. They are a significant concern in nursing homes, where residents may have limited mobility. However, with proper care and preventive measures, pressure ulcers should not occur in these settings.

Key Factors Contributing to Pressure Ulcers

Pressure ulcers develop when there is sustained pressure on the skin, particularly over bony areas. Several factors contribute to their development:

• Immobility: Residents who are unable to change positions frequently are at a higher risk.

• Moisture: Excess moisture from sweat or incontinence can weaken the skin.

• Nutrition: Poor nutritional status can impair skin integrity.

• Age: Older adults have thinner skin and reduced blood flow, increasing vulnerability.

Preventive Strategies

Nursing homes typically implement some combination of the following strategies to prevent or minimize the potential for pressure sores or bed sores:

• Regular Position Changes: Residents should be repositioned at least every two hours to relieve pressure.

• Skin Assessment: Regular skin checks can identify early signs of pressure damage.

• Proper Nutrition: Ensuring residents receive adequate nutrition and hydration supports skin health.

• Use of Support Surfaces: Specialized mattresses and cushions can help distribute pressure more evenly.

• Education and Training: Staff should be trained on the importance of pressure ulcer prevention and proper care techniques.

So What Goes Wrong?

In our experience suing nursing homes for pressure sores, here is what we often see:

• Poor or nonexistent initial assessment: Many times an assessment of skin integrity is missed, rushed, or put off for too long, and once it's done the skin has broken down.

• Failure to follow the plan: A plan is only as good as its implementation. Was the resident actually turned and repositioned as needed? Were dressings changed regularly? Were the right surfaces actually provided for beds, chairs and wheelchairs? Were skin changes charted and nurses/physicians notified?

You or your loved one may have a case.

Pressure ulcers are largely preventable with the right strategies in place. Nursing homes should prioritize the implementation of comprehensive care plans that focus on prevention, education, and continuous assessment. Unfortunately, when nursing homes don't make skin care a priority, the residents suffer and sometimes die prematurely. If you think you might have a case, call Howard Zimmerle at 309-581-5336 or email him at howard@lawzim.com We accept cases throughout much of Illinois and Iowa.