Many people call us here at The Dickson Firm because their loved one has developed a bedsore. These are also called “pressure sores”, and “decubitus ulcers”.

They often ask us why their loved one developed a bedsore. In many, many cases, their loved one developed a bedsore because of neglect at the nursing home. One of the primary causes of bedsores is understaffing.

We talk to many families whose loved one was living at home independently. They suffer a fall and a fracture. They often go to the hospital where they need to have surgery. And then they are sent to a nursing home for rehabilitation. When they get to the nursing home, they are not able to move around independently as they were able to prior to their fall and prior to their fracture. They are dependent on the staff to help them move around. They need the help of the staff to reposition themselves in bed. They need the help of the staff to get out of bed. They need the help of the staff to go to the bathroom. They need the help of the staff to go to the dining room so they can eat. They are dependent on the staff.

If they cannot move around on their own, the staff is required to turn and reposition them every two (2) hours when they are in bed. They are required to reposition them in a chair every hour. And they are required to help them with their activities of daily living.

Sometimes these residents are incontinent. If that's the case, the staff must monitor them to make sure they're cleaned up properly. Feces is caustic on the skin. Moisture on the skin can lead to skin breakdown. If residents are not kept clean they can develop skin breakdown.

If someone you love has been neglected or abused in a nursing home, please call us at The Dickson Firm at 1-800 OHIO LAW as we would be happy to talk with you and help you in any way that we can.

Pressure sores are caused by unrelieved pressure. If the person is left sitting in the same position for an extended period of time, the blood is not able to circulate to the tissues. There is pressure between the person's body and the surface they are sitting on. We often seen bedsores on the coccyx area or the buttocks area where unrelieved pressure prevents circulation through the tissues.

Bedsores are evaluated in stages.

A Stage 1 bedsore is a reddened area. It is what is called "non blanchable". This means
that if you push your finger on it, it does not turn white and go back to red. This is an indication
of the beginning of damage to the tissue.

A Stage 2 bedsore is open. It's usually not very deep. But it's more severe than a Stage 1.

A Stage 3 bedsore is deeper.

A Stage 4 bedsore can go all the way down through the muscle to the bone. I have seen
many bedsores where bone is exposed. This is often the sign of severe neglect. Residents with
Stage 4 bedsores have often been left to lay or sit in the same position for hours at a time until
they have suffered horrible, horrible skin breakdown.

Some bedsores are unstageable because they have an eschar or scab over the top of them
so their depth cannot be determined.

Once a person begins to develop skin breakdown, it's imperative for the nursing home staff to keep pressure off the area where there is skin breakdown so the skin breakdown can heal. Therefore, rather than repositioning them in bed from their back to their side to their back to the other side, they must turn and reposition them side to side, keeping them off of their back and keeping pressure off of the area of skin breakdown.

Nutrition and hydration also play a serious role in the development of skin breakdown and also in the prevention of skin breakdown. People who are well nourished and well hydrated, are less likely to develop skin breakdown. Once they do develop skin breakdown, people who are well nourished and well hydrated are more able to heal their skin breakdown. People who are malnourished and dehydrated, are much more susceptible to develop skin breakdown. People who are malnourished and dehydrated have a very hard time healing their skin
breakdown.

In order for the nursing home to be able to turn and reposition their residents every two (2) hours and make sure they are properly fed and make sure they are properly hydrated, they have to have adequate staff. They have to have enough people to get around to all the residents and turn and reposition them every two (2) hours in addition to all of their other duties. If the nursing home is understaffed, the residents will definitely be neglected. If there aren't enough staff to turn and reposition all the residents, then the residents will not get turned and repositioned, and they will develop skin breakdown.

If someone you love is being admitted to a nursing home, and they are recently immobile due to a fracture or some other reason, you should have a detailed discussion with the nursing home staff, including the Director of Nursing, and find out what the plan is to prevent skin breakdown for your loved one. Are they on a turning schedule? Are they documenting how often they're turning and repositioning your loved one? Ask to see the records. Ask to see the turning and repositioning chart that shows each time your loved one was turned and repositioned. There's no reason whatsoever for a nursing home not to maintain documentation of every single time the person is turned and repositioned. Skin breakdown can absolutely be fatal. As a result, it is imperative that it be taken very seriously.

While there are some skin conditions that make skin breakdown unavoidable, if your loved one has not suffered skin breakdown in the past, then it is very likely that they should not be suffering skin breakdown despite the fact that they're recently immobile. A properly staffed nursing home should be able to keep your loved one from suffering skin breakdown.

If someone you love has been neglected or abused in a nursing home, please call us at The Dickson Firm at 1-800 OHIO LAW as we would be happy to talk with you and help you in any way that we can.