Bedsores: What You Need to Know & How They Can Suggest Neglect

Sadly, elder abuse is on the rise in Washington State and around the country. The NCEA estimates that roughly 10% of all elderly have been abused. One of the tell-tale signs that neglect is happening is the appearance of bedsores.

Let’s look at what causes bedsores and why they can be a sign of negligence.

What are bedsores and how do they happen? 

Bedsores, also known as pressure injuries or pressure sores, are skin injuries that happened due to prolonged pressure. Most often, these injuries happen at bony areas of the body such as hips, ankles, knees, and shoulders. When an external pressure source contacts one of these susceptible body parts for an extended time, damage to the skin and underlying tissues can occur.

For instance, imagine an immobile hospital patient who is left lying on their side without being adjusted or rotated. Over time, the external pressure of the bed and the internal pressure from the hip bone begins to harm the skin and a bedsore can form. If left untreated, a bedsore can progress to a serious condition that can lead to infection and even death.

It’s important to understand that bedsores are preventable. However, once they’ve formed, they can be difficult to treat.

Pressure injury symptoms and stages 

Pressure injuries are diagnosed based on how deep the wound has progressed.

Stage 1: At this mildest level, the injury impacts the outer layer of skin only. With proper care, stage 1 pressure injuries can heal quickly in days with minimal pain.

Stage 2: A stage 2 pressure injury has progressed to the deeper layer of skin and appears like an open wound. It may be pus-filled and can be painful. Treatment requires dressing the wound and keeping it clean. A stage 2 injury may heal within a few weeks of proper care.

Stage 3: If a pressure injury has advanced to stage 3, it means that it has gone through the layers of skin and reached fat. The wound may appear like a crater and show signs of infection such as drainage or have red or black edges. A stage 3 wound needs a doctor’s care. Antibiotics and surgical treatment may be necessary at this stage to avoid serious infection. Healing time may take several months.

Stage 4: In this serious stage, the wound has moved past the skin and fat layers and reached muscle or even bone. The sore may be large and black in color. A wound of this magnitude needs immediate medical attention. At this stage, the wound may take months, or even years, to heal.

There are a couple other classifications of pressure injuries you should know about. When you can’t see the bottom of the store, the pressure injury is unstageable. A doctor should clean and assess unstageable pressure injuries. A Suspected Deep Tissue Injury (SDTI) occurs when the outside of the skin appears to be a Stage 1 or 2, but underneath the skin may be a Stage 3 or 4.

Who is at risk for developing bedsores?

Some people are more at risk for developing bedsores. These include:

• Immobile patients. Patients who are unable to move themselves (such as those who are paralyzed or in a coma) rely on others for proper rotation.
• Elderly. John Hopkins reports that as many as 1 in 10 nursing home residents have experienced a bedsore.
• Wheelchair users. It’s important that people who use wheelchairs frequently shift their positions or have someone help them do so.
• People with lower weights. Lower and underweight individuals can be more prone to pressure injuries.

As you might have gathered from the list above, some of our most vulnerable populations are susceptible to these troubling injuries.

Preventing bedsores 

Fortunately, there are steps that can be taken to avoid bedsores.

• Rotation. Make sure to rotate immobile persons at a minimum of every two hours.
• Regular inspection. Keep an eye on sites that are particularly at risk for sores. These bony prominences include hips, buttocks, shoulders, knees, ankles, and shoulders.
• Skin care. Dry skin increases friction and the chances for sores to develop. Keep the skin moisturized.
• Nutrition. Proper nutrition and hydration can help prevent injuries.

Finally, remember that a stage 1 pressure injury can be treated with minimal pain in a matter of days whereas a stage 4 injury can take years. At the first sign of a sore, take swift measures to treat the wound.

The connection between bedsores and abuse 

We started this post saying that bedsores are often associated with negligence, particularly at nursing homes. So, what’s the connection?

When a patient has a bedsore, it’s an indication that they haven’t been rotated properly. And, in the unfortunate event that the bedsore is at a later stage, it means that someone has failed to provide adequate medical care. Stage 3 and 4 bedsores are referred to as “never events;” in other words, they should never happen.

Pressure injuries not only cause a great deal of pain for victims they can also be difficult to treat. Later stage injuries may require surgery or other aggressive treatments and if ignored, can lead to infection and even death. In our practice as personal injury attorneys, we have spoken with many clients over the years who have had loved ones experience bedsores due to neglect.

If someone you know has developed a pressure injury, there’s a good chance that their basic needs are being neglected. Also, it can be a sign that other important care is being missed. To learn more, read our post about elder abuse on the rise. Make sure you know how to see and report elder abuse.

When is involving a personal injury lawyer warranted? 

It’s always OK to reach out to a personal injury lawyer. Our lawyers offer free case evaluations, so there’s no risk to let us know what happened. If we feel you have grounds to pursue a claim, we’ll let you know.

To schedule an appointment with one of our nursing home abuse lawyers, please call us.