The Dickson Firm represents nursing home residents and their families in cases against the owners and the operators of nursing homes throughout the State of Ohio.
One the biggest problems that we see in nursing homes in Ohio are residents who suffer bedsores.
These are also referred to as pressure sores or pressure ulcers or decubitus ulcers. Without adequate care, nursing home residents develop bedsores. If the resident does not receive proper care these bedsores get worse and they are often fatal.
Nursing home attorney Blake A. Dickson has represented hundreds of nursing home residents and their families in bedsore cases throughout the State of Ohio over the last twenty five (25) years.
What we typically see is an individual, living at home, independently who suffers a fall and often suffers a fracture. They are taken to the hospital. They often need surgery. And now they arrive at the nursing home and they are no longer able to turn and reposition themselves. One of the most common injuries that we see are fractured hips. People fall and break their hip and often need surgery to repair their hip. As they recover from hip surgery, they are not able to turn and reposition themselves. If a resident is not able to turn and reposition themselves, then it is absolutely incumbent upon the nursing home, the nurses and the aides at the nursing home, to make sure they turn and reposition the resident.
Bedsores are caused by unrelieved pressure. Bedsores usually form on bony prominences. We see a lot of bedsores in the coccyx area or the buttocks area. This is because there is pressure between the hard surface the person is sitting on and their coccyx or pelvis. This stops circulation to the tissue. If circulation is topped by pressure long enough the tissue dies.
A person who is not impaired, a person who is able to turn and reposition themselves, naturally relieves that pressure. They shift around in a chair. They roll back and forth in bed. They get up and they move around. But when you have a nursing home resident who is impaired because of a prior injury they need the staff to turn and reposition them.
If you or a loved one have developed a bedsore due to the negligence of nursing home staff, contact lawyer Blake Dickson at 1 (800) OHIO-LAW, 24 hours a day, 7 days a week.
When in bed a resident should be turned and repositioned every two hours. This includes all through the night. The staff should come in and turn and reposition the resident every two hours. When the resident is in a chair they should probably reposition them every hour. But more importantly, the resident should be monitored to determine if they are developing skin breakdown. As will be explained below, bedsores occur in stages. The first stage is stage one and it is simply a reddened area. The nursing home staff has a duty to monitor the resident to make sure they are not developing skin breakdown.
If a resident begins to develop skin breakdown, then the staff must make sure that they are relieving the pressure on that skin breakdown. Nursing homes have a duty to adequately assess each of their residents. Based on the comprehensive assessment they must then develop a care plan with measurable objectives and timetables. That care plan must address all of their needs specifically including the need to prevent skin breakdown. So if a resident cannot turn and reposition themselves, the staff must turn and reposition them. If they begin to develop a bedsore the staff must keep pressure off of that bedsore.
A resident who does not have any skin breakdown can be turned and repositioned in bed from their back to their left side to their back to their right side and so on. But a resident who does have skin breakdown, particularly in their buttocks area or their coccyx area, must be turned and repositioned side to side. The staff must keep pressure off of the area where the skin breakdown is.
Bedsores are evaluated in four stages.
We have seen many cases where, tragically, because of the severity of the bedsore, a person's bone is exposed.
Some bedsores are unstageable because they have eschar or a scab over them and so the depth cannot be determined.
The worse a bedsore gets the harder it is to heal. As a result the nursing home is obligated to first do everything in its power to present the bedsore. In fact there is a federal regulation that requires nursing homes to prevent skin breakdown unless, based on the person's clinical condition, the skin breakdown is medically unavoidable. Once the resident has skin breakdown, the nursing home must do everything in its power to heal the bedsore.
If your loved one develops a bedsore or pressure sore, is that evidence of abuse or neglect? Perhaps. If you have questions or concerns, we ask that you contact lawyer Blake Dickson at 1 (800) OHIO-LAW, 24 hours a day, 7 days a week.
Nutrition and hydration are very important. A well hydrated resident is much less likely to develop skin breakdown. A well nourished resident is much less likely to develop skin breakdown. Dehydration and malnourishment both put a resident at greater risk for skin breakdown. Likewise, hydration and nutrition are extremely important with respect to healing skin breakdown. A well nourished resident who is kept well hydrated has a much better chance of healing skin breakdown than a dehydrated resident who is malnourished.
In addition, the nurse home must keep the resident clean and dry. As indicated above, one of the most common areas of skin breakdown is the coccyx area or the buttocks area. Unfortunately, this is also close to where someone urinates and defecates. With a resident who is incontinent, the nursing home must work extremely hard to keep them clean and dry. They must clean them up promptly after an episode of incontinence. They must check on them frequently. Feces is caustic on the skin and can lead to skin breakdown.
The answer to this question is absolutely yes. The skin is our largest organ and it is designed to protect us. It is a protective barrier protecting us from things that can lead to infection. One of the most common areas of skin breakdown is in the coccyx or buttocks area. Once the skin is open it is very susceptible to infection from feces. Once a person has even the beginning of skin breakdown it is imperative that the staff relieve the pressure on that area of their body and keep that area of their body clean so they do not develop an infection. Infections are very often fatal. If the skin is open the staff must be very vigilant to keep the open area clean and dry. If the nursing home is understaffed it is virtually impossible to keep the incontinent residents clean and dry.
If bone is exposed the resident is susceptible to osteomyelitis. This is an infection that occurs when the resident’s bone is exposed to the air.
The signs and symptoms of infection can include a foul smell coming from the wound of discharge coming from wound. If the resident has an infection they may have a fever. These are all signs and symptoms of infection. The nursing home must monitor the resident to determine whether or not they have signs and symptoms of infection. When a person has an infection, time is of the essence. The longer the infection is untreated the worse it will get.
Tragically bedsores can absolutely be fatal. As a person develops a worse and worse bedsore, their bodies struggle to heal the wound. This saps their resources. Each person has a certain capacity. Often elderly people with multiple comorbidities have a reduced capacity. They have less reserves. As their body is taxed with the incredible task of trying to heal a bedsore this can often deplete their reserves. In addition, if a person suffers an infection, the infection can likewise deplete their reserves and cause them significant harm. We see many cases where the resident tragically dies because of an avoidable bedsore.
We have definitely seen many cases where skin breakdown is caused by neglect. The most common cause of skin breakdown is understaffing. If the nursing home is understaffed, they simply do not have enough employees to make sure that each and every one of their residents who cannot turn and reposition themselves are turned and repositioned on a regular basis. They do not have enough employees to keep their residents clean an dry. They do not have enough employees to help their residents with nutrition and hydration. The staff is unable to monitor the residents. The staff does not make sure that the resident does not become dehydrated.
We have represented families involving tragic cases of wrongful death where a person has literally died of dehydration. We have handled cases where the resident goes to the hospital severely malnourished because they were neglected at the nursing home. Inadequate staffing is one of the biggest things we face when it comes to cases involving bedsores.
There absolutely are. In Ohio the state legislature passed the Ohio Nursing Home Residents Bill of Rights. This is a specific set of laws designed to protect nursing home residents in a nursing home. Nursing home residents have the right to a safe environment. They have the right to adequate care. The nursing home is obligated to have an adequate number of properly trained nurses and aides to provide for the needs of their residents. If a resident's rights are violated, and that resident suffers harm, including wrongful death, the nursing home is liable for that harm including the death of that person.
In addition to the Ohio Nursing Home Residents Bill of Rights there are sections of the Ohio Administrative Code promulgated by the Ohio Department of Health which absolutely apply to the care of nursing home residents in a nursing home. Nursing homes are obligated to follow these sections.
Finally, there are sections of the Code of Federal Regulations which apply to all nursing homes in the country including all nursing homes in Ohio. Pursuant to the Code of Federal Regulations, if a resident enters a nursing home without skin breakdown, the nursing home must ensure that they do not develop skin breakdown unless the skin breakdown is unavoidable based on the resident's clinical condition. Likewise if a resident enters a nursing home with skin breakdown, they must heal that skin breakdown unless they cannot heal the skin breakdown because of the resident's clinical condition.
All of these laws are designed to protect nursing home residents in a nursing home. Tragically, nursing homes after ignore these laws or violate these laws leading to harm for their residents. At The Dickson Firm, we are very familiar with the laws and regulations that apply to the care of nursing home residents in a nursing home. We often pursue the owners and the operators of nursing homes for their violation of these laws.
The answer to this question is an emphatic yes. Tragically, most of the cases we handle are wrongful death cases. If a nursing home resident dies as the result of neglect in a nursing home, we are able to open an estate for that person with the probate court. We are then able to pursue to the nursing home in the name of the personal representative of the estate. The estate is then able to recover for the nursing home resident's pain and suffering and their loss of enjoyment of life as well as any medical bills they incurred for treatment that they needed as a result of the substandard care provided at the nursing home.
We are also able to make a recovery on behalf of the resident's next of kin. We are able to recover for their mental anguish or their emotional suffered as a result of the person's death as well as their loss of society meaning that they had a valuable relationship that was taken away from them and the nursing home must compensate them for that relationship.
In Ohio there is a time limit for any claim of personal injury or wrongful death. This time limit is known as the statute of limitations. The statute of limitations for a medical claim is one year from the date that the resident knew or should have known that they had received substandard care or one year from the date they stopped treating with the potential Defendant for the condition complained of, whichever date is later. In the nursing home context this means that the resident or the resident's family must file a Complaint in Court within one year from the date that the resident realized they were receiving substandard care or one year from the date they stopped treating for the condition complained of at the nursing home, whichever date is later.
This is usually the date the resident leaves the nursing home. It is possible that if a person is at a nursing home for a long period of time that they might stop treating for the condition complained of. So in other words a resident suffers a fall at the nursing home, they suffer a fracture, they have surgery for that fracture and eventually that fracture heals. If the resident were to stay at that nursing home past the point where that fracture healed and they were no longer receiving treatment for that fracture then that might be the time that the one year statute began to run. The one year statute might begin to run as of the last time they treated for that fracture.
If a resident is demented or otherwise mentally impaired than the one year period never begins to expire during their lifetime. It would probably begin to expire on the date of their death and you would have one year from the date of their death to bring a lawsuit.
According to the law in the State of Ohio you have two years from the date of a resident's death to bring the wrongful death claims. As explained above these are the claims for the next of kin, for their mental anguish or emotional suffering as the result of the resident's death and for their loss of society meaning compensation for the loss of their relationship with that resident because of that resident's death.
There have been a number of cases decided recently where defense counsel has tried to argue that the entire case must be brought within one year. That is not what the statute says. But there have been some bad court decisions that limit medical claims including the wrongful death portion of those claims to one year.
Our best advice to anyone who thinks that they may have a claim against a nursing home is to call us at The Dickson Firm as soon as possible at 1-800-OHIO LAW and discuss your claim with us so that we can make a proper determination of how much time you have to bring your claim. If you wait too long your claim will be permanent and forever time-barred. Tragically we get a number of calls from families about appropriate nursing home claims that are simply time-barred because the person waited too long to contact us.
We handle all of our cases on a contingent fee basis including the expenses advanced. This means that if you hire us, we will gather your loved one's medical records, we will analysis the records, we will analyze the case, and we will pursue your case on a contingent fee basis. If we do not make a recovery, you do not owe us anything whatsoever. You do not even have to reimburse us for the expenses that we advance on your behalf. If we do make a recovery then we are reimbursed for our expenses out of that recovery and we are also compensated for our time. Our fee is contingent on the recovery. If we do make a recovery our fee is a portion of that recovery.
We rarely handle a case where the nursing home admits to the family that the bedsore was caused by neglect. We rarely handle a case where the hospital tells the family that the bedsore was caused by neglect. The employees at the nursing home are trained to protect the nursing home. They rarely admit any fault. They rarely tell the family that the resident received substandard are.
We do have some cases where one of the people at the nursing home either contacts the family or even contacts us. We have handled cases where we have had an employee or a former employee who has been candid with us and communicated to us about the substandard care at the nursing home.
We are representing a family right now and the son of the resident received a phone call from an aid at the nursing home telling him to get his mother out of the nursing home. He promptly called the nursing home to insist they transfer her to the hospital. The director of nursing argued with him for an extended period of time and refused to send his mother to the hospital. Tragically, when he finally did convince the DON to send his mother to the hospital, she was severely dehydrated and she died shortly thereafter.
Therefore, if you have concerns about your loved one's care, we strongly recommend that you contact us here at The Dickson Firm at 1-800-OHIO LAW. We would be happy to discuss your concerns. If you have concerns that your loved one is not receiving proper care at the nursing home, we strongly recommend that you consider moving your loved one to a better nursing home. Tragically, many of the cases that we handle are wrongful death cases. In a lot of a cases, the person's death could have been avoided if the resident was moved sooner.
People often ask us what they should look for at a nursing home? What should they be concerned about?
With respect to skin breakdown, people rarely inspect the skin of their mother or father or grandmother or grandfather. This is understandable. If you are concerned your loved one is not receiving appropriate care then someone should inspect their skin. If you are uncomfortable doing it, perhaps someone else in your family can do it. Perhaps there is someone in your family who is a nurse, who feels more comfortable inspecting your loved one’s skin. If you or someone else feels comfortable you can visit your loved one when they are receiving a shower or otherwise being bathed and you can inspect their skin at that time.
Check your loved one's bedding. Is it clean? Do you see dried urine or feces on the bedding? Do you feel as if your loved one is being kept clean? Are their sheets changed regularly? Are they receiving regular showers and baths? Is their hair brushed and washed? Are their nails being maintained? Is their room clean? These are all things to check to determine if your loved one is being neglected.
We recommend that people visit their loved ones at all different times of the day. Visit the nursing home first ting in the morning. Visit the nursing home at meal time. Visit the nursing home late at night. As indicated above, proper nutrition and proper hydration are imperative to prevent skin breakdown. Visit your loved one during meal times. If they need assistance with eating are they receiving it? Is somebody with them helping them eat? Is the nursing home keeping them hydrated?
One of the most important things to ask yourself is can your loved one feed themselves and/or drink when they need to? We have tragically handled multiple cases where a resident cannot drink on their own and the staff did not make sure that they were receiving adequate fluids. These residents wound up profoundly dehydrated. Dehydration in and of itself can be fatal. So you should definitely monitor if your loved one is receiving adequate nutrition and hydration.
If you have questions or concerns about a loved one who is in a nursing home who develops a bedsore, you can speak with an experienced Ohio bedsore lawyer at The Dickson Firm, toll free, at 1 (800) OHIO-LAW (1-800-644-6529), 24 hours a day, 7 days a week.
