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Bed Sores Are a Common Sign of Nursing Home Neglect

March 8, 2012

grandmother.jpgAs more and more Californians reach their Golden Years, many face the horror of dealing with neglect in their long term care facilities such as nursing homes. According to the U.S. Bureau of the Census, the growth of the elderly (age 60 and over) in California is expected to be twice as fast as the total population and the oldest group (age 85 and over) is projected to increase faster than that. This means increasing numbers of the elderly will end up being placed in nursing homes.

While many long term care facilities provide excellent care, others subject their patients to some form of neglect or elder abuse. Some of the most common signs of neglect or elder abuse are dehydration, loss of appetite, pressure (bed) sores, bruises, broken bones and markings from restraints, among other things. The California Welfare & Institutions Code, Section 15610.57, addresses "neglect" in part by saying that it is the negligent failure to exercise the degree of care a reasonable person would have exercised had they had the care and custody of an elderly person. This would include the failure to protect that person from dehydration, bed sores, falls, other injuries caused by safety or health hazards and any type of injury that does not fit the explanation provided by the staff.

Under California law, many are charged with the duty to report indications of elder abuse to the Adult Protective Service Agency (APS) in every county, including doctors and other medical professionals, employees of nursing homes and others who care for the elderly. Unfortunately, this law is not apt to be followed by the nursing home staff or physicians whose neglect might have led to the injuries. For example, bed sores are caused by pressure against the skin that reduces the blood supply causing ulcers and ultimately death of the tissue. These usually are found on the back area, the tailbone, shoulders, hips, elbows and heels but are preventable by providing padding with pillows or foam support pads, frequent changing of the patient's position, sheepskin and powdered sheets. Likewise, falls and other preventable injuries are often covered up by writing an incident report and doctoring records. Since elders in nursing homes are essentially isolated from the outside world and often have reduced mental capacity, they are easily manipulated to believe what they are told. Therefore, it is of utmost importance for family members, relatives, visitors and others to make note of any warning signs of neglect or abuse of their friends or loved ones in nursing homes.

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Nursing Home Neglect Continues to Result in Life Threatening Bedsores

October 12, 2011

Contrary to what the nursing home industry wants us to believe, bedsores can be prevented. A bedsore, also commonly referred to as a pressure ulcer or decubitus ulcer, is basically an injury to the underlying tissues of the skin. They most often occur when an individual remains in the same position for an extended period of time, creating prolonged pressure that affects the necessary blood flow and nutrients to the skin.

Residents in nursing homes are often at most risk because many of them have medical conditions that limit their ability to move. The necessary pressure to create a bedsore can result from sitting or lying for a prolonged period of time. People in wheelchairs often suffer from bedsores on the tailbone, spine, and the back of their arms or legs. For those that are bedbound, they often occur on the heels, hips, ankles, shoulders or their head.

The number one key to prevention (and treatment) is relieving pressure. This can be accomplished most effectively by repositioning a person regularly, particularly once a bedsore has developed. A second strategy is to ensure the appropriate support surfaces are utilized. There are all types of special mattresses and cushions that are designed to relieve pressure.

Once you recognize a bedsore, you should contact your doctor immediately. Bedsores can often resolve with appropriate detection and treatment. Aside from relieving the pressure, your doctor will access the severity of the bedsore and likely consider removing any damaged tissue and/or cleaning and dressing the wound. It is also critical that a patient maintain nutrition and hydration to promote health skin tissues.

If you or a loved one reside in a nursing home, detection of the skin should be a routine part of care. Unfortunately, all too often we see patients that suffer from bedsores due to neglect or lack of an appropriate care plan. The following are just a few of the precautions and safety measures that should be taken to prevent the formation of bedsores.

• Periodic reassessment of the patient's risk;
• Appropriate bathing routine;
• Constant nutrition hydration;
• Repositioning to relieve pressure; and
• Use of appropriate support surfaces.

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