As a nursing home abuse lawyer who routinely handles cases of nursing home abuse and neglect against facilities located in Venice, Sarasota, Englewood, North Port, Port Charlotte, Punta Gorda and surrounding Florida communities, I am always most appalled and angered when the nursing home’s failure to provide care results in a significant and often fatal bed sore. Why? — Because bed sores are almost always preventable with proper care.
What is a bed sore? Simply put, a bed sore is an area of skin breakdown that results from too much pressure being applied to the area for too long a period of time without relief. Redness is followed by a blistered area that opens up in much the same way a sore can develop on your heel when breaking in a new pair of shoes. In fact, the heel of the foot is one of the most common areas where bed sores develop in the nursing home population.
Bed sores, also known medically as “pressure sores” or “decubitus ulcers,” predictably result from inadequate care in nursing homes and assisted living facilities. Their prevention begins with the obvious: relief from constant pressure over vulnerable areas of the body, including the heels, elbows, hips, back and buttocks. The resident who cannot adjust his or her body weight relies almost exclusively on the nursing home staff to assist in turning and repositioning themselves. Therefore, the elderly patients who are most at risk for skin breakdown are those who have suffered a stroke and are left with some paralysis, recovering from a major surgery such as a hip transplant or surgical repair, admitted for rehabilitative care for a debilitating illness such as pneumonia, or who suffer from dementia or Alzheimer’s disease and may simply not be aware of the need to turn themselves in order to off-load pressure points.
Pressure may result in skin breakdown in as little as two hours. As a result, nursing home staff should devise and implement a plan of care that includes turning and repositioning a resident at risk for the development of pressure sores at a minimum of once every two hours. The “care plan” should also include other measures designed to reduce skin breakdown, such as pressure relieving devices in the form of seat cushions, special mattresses and heel protectors.
Pressure relief, however, plays only one part in the resident’s overall care when it comes to the prevention and healing of bed sores. Nursing home staff members frequently fail to provide assistance to those residents who require help going to the bathroom. It is not uncommon for a busy aid to instruct the resident to relieve himself in his clothing and advise that the resulting mess will be dealt with when aid can “get around to it.” Other times, residents push their call buttons to summon toileting assistance and no one ever responds. Without question, these practices constitute abuse and neglect under Florida and federal law and qualify as a serious violation of the resident’s rights. More importantly, the resulting heat and moisture from waste and chemicals in the waste itself furthers the process of skin breakdown and introduces fecal and urinary bacteria, such as enterococcus and pseudomonas, directly to the wound site, thereby enabling infection. An infected pressure sore is more likely to deepen, tunnel and worsen with time, causing serious harm to the resident and jeopardizing their life.
All nursing homes in Florida receiving Medicare payments must comply with federal requirements and guidelines designed to promote patient safety and well-being. These guidelines implement very specific requirements with regard to the prevention and healing of pressure sores. Specifically, those federal guidelines require that:
Based on the comprehensive Assessment of a resident, the facility must ensure that –
(1) A resident who enters the facility without pressure sores does not develop pressure sores unless the individual’s clinical condition demonstrates that they were unavoidable; and
(2) A resident having pressure sores receives necessary treatment and services to promote healing, prevent infection, and prevent new sores from developing.
A pressure sore can only be said to be “unavoidable” if all reasonable interventions and precautions were taken, and despite these best efforts, skin breakdown occurred. In our forensic review of nursing home charts, rarely do we find that the nursing home and its staff did everything it could have done to avoid the development of skin breakdown.
The nursing home industry knows that allowing, and even encouraging, a resident to lie in their own waste promotes skin breakdown, infection and serious ramifications to the resident’s health, yet the industry accepts and tolerates these practices as the less costly alternative to hiring and training sufficient numbers of qualified staff to meet their residents’ needs. It is a matter of making profit the priority over patient lives. Nursing Home residents develop bed sores as a result of neglect and abuse.
If you or a loved one has suffered from harmful abuse or neglect in a Florida nursing home, call me, James Keim – Attorney at Law – for a free, confidential consultation at (941) 485-7600. Cases are handled on a contingency fee and cost basis. We recover our fees and costs, only if we are successful in handling the case against the nursing home, at the time a settlement or verdict is achieved. In other words, we collect no fees or costs unless you win your case. Call Venice nursing home abuse lawyer, James Keim today.
