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Understanding Pressure Ulcers in Nursing Homes: Signs, Prevention, and Legal Options

By: Emily Ashe, Anapol Weiss Partner

Pressure ulcers, also known as bedsores or pressure injuries, are a significant concern in nursing homes, where residents may have limited mobility or be totally immobile. These painful wounds can develop when pressure is applied to an area of the skin for an extended period, often leading to tissue damage and can result in infection and death. As a concerned family member, it is crucial to be vigilant and proactive in preventing and addressing pressure ulcers while your loved one is in a nursing home.

What to Look For:

  1. Red, Discolored, or Purple Skin: Check for any changes in skin color, particularly in areas where bones are close to the skin, such as heels, elbows, hips, and the lower back or sacrum.
  2. Skin Texture Changes: Feel for areas of skin that are unusually warm, tender, or firm to the touch, as these could indicate the early stages of pressure ulcers.
  3. Open Wounds or Blisters: Keep an eye out for any signs of broken skin, sores, or blisters, especially in areas prone to pressure, friction, or moisture.
  4. Complaints of Pain or Discomfort: Pay attention to verbal cues from residents who may be experiencing discomfort or pain, as pressure ulcers can be quite painful. However, in non-verbal residents, signs such as moaning, wincing, or grimacing with movement may be an indicator of pain due to a pressure injury.

Where to Look:

1. Bony Prominences: Inspect areas where bones are close to the skin, such as the heels, elbows, hips, and tailbone.

2. Bedridden Areas: Check areas that are in constant contact with the bed, wheelchair, or other surfaces, including the back of the head, shoulders, and buttocks.

3. Medical Devices: Examine areas under medical devices, such as oxygen tubing or urinary catheters, where pressure and friction may occur.

4. Skin Folds: Don't forget to inspect skin folds, particularly in obese residents, where moisture and friction can contribute to pressure ulcer formation.

What to Do If You Identify Pressure Ulcers:

  1. Notify Staff Immediately: Inform the nursing home staff or medical professionals as soon as you identify a pressure ulcer, providing them with details of the location, size, and severity of the wound. Ensure that staff immediately addresses and documents the wound and ensure that the physician is updated.
  2. Seek Medical Attention: Ensure that the resident receives prompt medical evaluation and treatment for the pressure ulcer to prevent further complications and promote healing. This can include outside wound consultations wherein a specialized wound physician visits the facility, typically on a weekly basis to assess and treat the pressure ulcer.
  3. Document and Advocate: Keep detailed records of the pressure ulcer, including photographs if possible, and advocate for appropriate care and interventions to prevent recurrence.

Legal Options:

If you suspect that inadequate care has contributed to the development of pressure ulcers while your loved one was a resident at a nursing home, seeking legal guidance may be necessary. A qualified attorney can investigate the situation, review medical records, and determine if there are grounds for legal action to hold the facility accountable for any harm caused.

In conclusion, preventing and addressing pressure ulcers in nursing home residents requires diligence, observation, and prompt intervention. By knowing what signs to look for, where to look, and how to respond, caregivers and family members can play a vital role in protecting the well-being of their loved ones. Additionally, seeking legal assistance may be necessary to ensure accountability and justice in cases of suspected neglect or abuse.