Bedsores, or pressure ulcers, are lesions that impact the integrity
of the skin – a medical issue commonly caused by skin breakdown
due to a lack of proper care. Bedsores can be caused by many
care-related factors. Some of these are unrelieved pressure,
friction, shearing forces, temperature, age, incontinence and
improper nourishment, hydration and/or medication. Just a few
hours sitting in a wheelchair without proper padding can cause a
pressure ulcer. Although easily prevented and completely treatable
if found early, bedsores are a serious medical condition. They are
very painful, and can be fatal to an older person, even if the patient
is under medical care.
An elder care facility breaches its duty of care owed to a resident if
it fails to prevent and treat bedsores by not following generally
accepted medical practices regarding skin care. For example, an
elder care facility can be liable for damages if it fails to regularly
rotate a bed-ridden resident, or if it fails to utilize a pressure
relieving mattress to prevent the increase in size or depth of an
already known existing bedsore. Improperly treated bedsores can
lead to severe medical complications, including infection and/or
death. If someone you love has suffered unnecessarily from a
serious bedsore while under the care of a negligent nursing staff,
contact an elder care attorney.
A recent report showed that nearly half of all California nursing
homes failed to meet federal standards in the prevention of
bedsores (also called "pressure ulcers" or "decubitus ulcers"). So
serious is the problem, that Medicare soon will no longer pay for
the care of a bedsore if it is acquired after admission to a nursing
The initial development of a bedsore can occur in only a few hours
if the blood supply to the skin is restricted or cut off. Initially, the
skin begins to die and becomes reddened and painful, and
eventually turns a purplish color. Without treatment, a small
bedsore can quickly expand, exposing the individual to severe pain
Residents and patients of nursing facilities and hospitals are at
high risk for developing bedsores, and they typically develop in
bony areas of the body under pressure from lying in bed or sitting
in a wheelchair for an extended period of time. The degree and
severity of a bedsore is classified by stages, usually graded by the
degree of tissue damage.
Any development of a bedsore inside a nursing home or
residential care facility should be thoroughly investigated.
Stages of Bedsores
Stage I: A reddened area on the skin that, when pressed, can not
be blanched (does not turn white). This indicates that a pressure
ulcer is starting to develop. If the reddened skin does not return to
normal color 30 minutes after relieving the pressure, then the sore
is likely a Stage I.
Stage II: The skin breaks down and blisters begin to form, but the
damage is limited to the dermis. It can also look like a scrape or a
crater in the skin.
Stage III: Now the full thickness of the skin breaks down, and the
ulcer may extend into subcutaneous tissue, but not yet to the
muscle. Nonviable tissue may be present, which is frequently black
in color. This dead tissue, called eschar, must be removed before
healing can occur.
Stage IV: The bedsore has become so deep it causes damage to
the muscle and bone, and sometimes tendons and joints.
Bedsores, particularly Stage III and IV, should never occur
inside a nursing a facility, and are frequently the result of
neglect, including malnutrition, dehydration, or a simple
failure to examine the resident.