Bedsores

There is no reason for a properly cared for nursing home resident who is properly cared for to suffer the neglect and abuse of developing bedsores. Bedsores are painful and a hideous example of negligent care.

Bedsores are sometimes called “pressure sores” or “decubitus ulcers.” These sores are caused by poor nutrition combined with patients being permitted left to lie in beds unattended for long periods of time without being repositioned. In an ulcer’s early stages, the skin will appear red and turn white – like a sunburn – when touched. If left untreated, decubitus ulcers can form cavernous holes in the skin, leaving muscles, tendons, and bones exposed. These bedsores often result in unbearable pain and suffering and often lead to deadly infections.

Bedsores are classified in by stages. A Stage 1 bedsore appears as a painful red inflammation on the skin. By Stage 4, a bedsore has eaten through the skin, tissue and and muscle to expose bone.

Bedsores are very common in nursing homes largely due to nursing homes failing to employ sufficient staff to care for the residents. By no means are bedsores acceptable in today’s nursing home environment. The presence of a bedsore means something’s that something wrong and needs to be addressed. Thankfully, bedsores can be prevented by regular care. Care includes changing a person's position regularly and making sure that nursing home residents have adequate nutrition.

Causes of Bedsores in Nursing Homes

Bedsores result when nursing home residents lie remain motionless in the same position for long periods of time. Prolonged pressure slowly wears away the skin and muscle tissue, causing bedsore wounds to receive inadequate nutrients from the blood. This pressure results in the death of tissue. The bony areas of the body, like the lower back, elbows, knees and hips, are the sharper areas of the body that put the most pressure on skin, tissue and bone.

Because bedsore wounds and tissues are locatedusually develop in places on the body that make have repeated contact with the nursing home bed, there is a strong likelihood that the ulcerous wound will not heal if the patient is not properly treated. Tell your health care provider immediately if you notice a bedsore change color or the bedsore produces a foul odor. Both are strong indicators of infection.

The Four Stages of Bedsores

The effects of bedsoreBedsore injuries fall into four major categories or stages. Since the bedsore tissue damages increases at each stage, the classification of bedsores does not decrease during recovery. This means that a Stage 3 bedsore never heals to a Stage 1 or Stage 2 bedsore. Medically speaking, a Stage 3 that is healing is called a “Stage 3 bedsore in recovery.”

Here are the four stages, each defined by the National Pressure Ulcer Advisory Council (NPUAP):

• Stage 1 Bedsore: Changes in skin temperature (warmth or coolness), tissue consistency (firm or boggy feel), and/or sensation (pain, itching). The ulcer appears as a defined area of persistent redness in lightly pigmented skin. In darker skin tones, the ulcer may appear with persistent red, blue, or purple hues.

• Stage 2 Bedsore: Partial thickness skin loss involving epidermis, dermis, or both. The ulcer is superficial and presents clinically as an abrasion, blister, or shallow crater.

• Stage 3 Bedsore: Full thickness skin loss involving damage to, or necrosis of, subcutaneous tissue that may extend down to, but not through, underlying fascia. The ulcer presents clinically as a deep crater with or without undermining of adjacent tissue.

• Stage 4 Bedsore: Full thickness skin loss with extensive destruction, tissue necrosis, or damage to muscle, bone, or supporting structures (e.g., tendon, joint, capsule). Undermining and sinus tracts also may be associated with Stage IV pressure ulcers.

Weight Loss

For various reasons,Whether it’s whether due to today’s medications or simply a decrease in how we taste thingstaste as we get much older, age can affect appetite. Nursing homes that are negligent often do not have the staff or dedication needed to make sure their residents get necessary nutrition and hydration. Without proper nutrition, the body begins to eat itself in a serious medical condition called “cachexia,” or “Wasting Syndrome.” This condition includes loss of weight, muscle atrophy, fatigue, weakness, and significant loss of appetite in someone who is not actively trying to lose weight. As a loved one suffers, other diseases accompany malnutrition.

One of the least obvious warning signs of nursing home abuse - - and often waved off by staff as “just part of getting old” - - is sudden or severe weight loss. Your loved one’s weight loss can be the result of a number of factors, including dehydration, life-threatening illness and poor quality of food.

Undocumented weight loss, especially if other abuse and neglect warning signs are present, should raise strong suspicions about the quality of care your loved one is receiving.

What are the dangers of dehydration, weight loss, and the loss of senses for nursing home patients?

Our bodies are composed primarily of water. Water is vital to proper organ functioning regardless of your age. When the human body starts losing more water than it takes in, dehydration occurs. Dehydration results in exhaustion throughout the body as well as a decrease in blood pressure. This reduces the blood’s ability to deliver important nutrients to the body.

Elderly patients eat less. When the elderly don’t eat a regular, balanced diet, their bodies begin to draw nutrients stored in body tissues. At first, the body will burn fat deposits for its energy. However, when fat reserves fall low, the body begins to “cannibalize” or “eat” its own muscles, even including those that beat the heart. As the malnourished body degenerates, the chance of infection and illness increase. Bed sores are almost impossible to heal when combined with malnourishment. When you are thirsty or hungry, you simply get up and grab something to eat or drink. But Unfortunately, a bedridden loved one in a nursing home doesn’t does not have that option. Your loved one relies on a nurse or caregiver – often handling many patients – to help them.

As bodies age, so do the senses. The deadening of the senses of taste and smell requires special attention by nursing home staff to make sure that incapacitated residents are receiving and finishing their meals. If food is unappetizing the result can be similar, as can a reaction to medication. Doctor-prescribed prescription drugs can diminish appetite. It should be no surprise that simply not eating can also weaken appetite in a vicious circle of starvation.

No matter what the cause, a loved one under nursing home care should not be denied the attention and concern necessary to make sure meals are edible, healthy, and eaten. If someone you care about is not eating, it’s it is time for you to tell the nursing home that you are concerned and to have the home tell you what they intend to do about it.

Bruises

If you see bruises on a loved one’s body, your family should demand answers. There is no excuse for remaining silent. Bruises are not part of good nursing home care.

Bruises are pools of blood from broken capillaries right under the skin. They heal slowly in people with poor circulation. Bruises will occur when an unsupervised resident is allowed to fall or is struck by a member of the nursing home staff. Any bruise or cut requires immediate medical attention as well as an evaluation to determine its cause. To make matters worse, sometimes a bruise may be a telltale sign of sexual abuse. Bruises should never be ignored. Older people bruise more easily, but every bruise should be evaluated.

Bruises: where and why nursing home residents bruise

Bruises can occur for a number of reasons. Because bruising is much more common in the elderly – and can increase with an improper diet, malnutrition and dehydration – bruises are a good barometer of other forms of nursing home neglect and abuse.

Inattentive or abusive staff can cause a number of problems. These including include bruises on hips and arms from falls, as well as bruises from the use of bed rail restraints or physical abuse. Bruising along the wrists can indicate the use of cuffs or other questionable uses of force and/or physical restraints. Bruising can also occur when a nursing home resident is struck by a member of the nursing home staff or attacked by another patient in an unsupervised situation.

Residents are often quiet about abuse

Nursing home residents often won’t can not and will not report abuse. They might beare often targets of physical abuse because they are physically or emotionally weaker than their abuser. The memory of older residents can’t always be trusted. Think of it this way: Tthere is often abuse because the resident’s dementia disables their ability to remember being hurt; as a victim, they can’t remember the incident.