Bedsores, or decubitus ulcers, are common in nursing home neglect cases; however, bedsores are not always the product of neglect. Some residents are going to have bedsore issues event if the best care is provided. To be an effective nursing home neglect lawyer, it is absolutely necessary to know the difference.
Bedsores are most common among bedbound residents as they result from pressure points (mostly bony prominences) that are in contact with a mattress or bedding material that causes irritation and breakdown of the skin. Bedsores most commonly occur on the very lower back/upper buttocks, also known as the sacrum, as well as the heels and feet. If not properly attended to, the bedsores turn into decubitus ulcers that can quickly spiral out of control, leading to severe pain, amputation, infection and death.
As Jacksonville nursing home abuse attorneys, we have seen bedsores the size of a salad plate and open to the bone with dead black skin surrounding the gaping wound. Sadly, we have also seen numerous deaths caused by infection from these wounds.
A nursing home must provide special bedsore preventative measures to all bedbound residents.
First, all residents’ nutrition must be closely monitored. It is necessary that a resident’s diet contain enough protein for the body to be able to maintain healthy, vibrant tissues. Protein is measured in both albumin and pre-albumin levels, which are standard when a basic metabolic profile blood test is performed. This is a test that is neither costly nor time consuming.
Second, a resident’s body position should be changed frequently taking the pressure off of bony prominences. The frequent re-positioning of a resident must be written into the resident’s chart for the nursing home to demonstrate that this protocol was followed.
Next, an “air loss mattress” should be used. An air loss mattress reduces pressure on bony prominances by changing the areas of the body in contact with the mattress due to the mattress’ change in shape and rigidity as the air slowly leaks out of the air mattress. The use of such a mattress should also be reflected in the chart.
In addition, in order to reduce pressure on the feet, nursing home residents commonly require that their feet be placed in special boots designed to prevent pressure from the mattress, sheets and blankets on the areas that are most prominent.
If a bedsore does develop, additional protocols must be put in place. First, the resident should be given a protein supplement to assist the body in creating new cells to replace the wounded skin. Further, the wound should be measured both in size and depth and cleaned and dressed frequently.
It is imperative that the nurses chart each step along the way to demonstrate that the nursing home was: aware of the bedsore; keeping track of any improvement or progression in the wound; cleaning the wound frequently; keeping the resident’s doctor informed; and changing the dressing on the wound. When reviewing a potential nursing home case, our Jacksonville nursing home abuse attorneys methodically review the entire chart to determine whether these protocols were met.
There are residents for whom bedsores are an unavoidable problem. If a nursing home takes all of the steps above and keeps the resident’s doctor informed and involved, some people will still suffer from bedsores. However, our Jacksonville nursing home neglect lawyers often find that the protocols were not charted, the doctor was not informed and the resident’s bedsore progressed to a deadly stage four at which time the resident was sent to the hospital with a life-threatening infection.
Unavoidable ulcers are a special concern for residents who suffer from kidney failure. This is because persons with kidney disease cannot tolerate a high protein diet. Sometimes, nursing homes are caught in a “catch 22” if they don’t increase the resident’s protein levels, the bedsore will not heal: but, if they increase protein, the resident’s kidneys will fail. Again, if a nursing home finds itself in this position, the competing concerns should be reflected in the chart. Otherwise, it simply appears that the nursing home failed to respond to the problem.
If you or a loved one has suffered from a bedsore while residing in a nursing home in the greater Jacksonville area, please contact us for a consultation. If we are suspicious of neglect, at our own expense, we will obtain and review the records. If we still have concerns, we will then have the matter reviewed by an expert registered nurse. If, ultimately, we do not accept the case, you owe us nothing for the work and expense we incurred.