Decubitus ulcers are preventable skin breakdown that look like sores on the skin. Decubitus ulcers (also known as bed sores or pressure sores) form when a patient is left in bed or in a wheelchair for long periods of time. If that patient is too weak to reposition themselves in bed, it is the job of the nurses to turn and reposition the patient. Failing to reposition the patient in bed results in decubitus ulcers. This is commonly referred to as patient neglect, and it is against the law for a patient to develop a preventable pressure sore. As pressure sore lawyers, we give voice to the voiceless victims of decubitus ulcers and assist them in pursuing a decubitus ulcer claim. This site was created to educate you on patients' rights in a nursing home or hospital and specifically, a patient's right to be free from pressure sores.
Why Do Decubitus Ulcers Occur?
Elderly patients develop thinner, less elastic skin as they age. Because of this, our elderly loved ones are more prone to the development of bedsores (decubitus ulcers). When an elderly patient is unable to turn and reposition themselves, they are dependent on staff to physically reposition them in bed. If there are unrelieved pressure areas in the patient's skin, the flow of blood gets interrupted. As a result, the skin in the effected area dies and a painful hole in the skin forms. This hole is known as a decubitus ulcer, but is also referred to as a bedsore or pressure sore. Pressure sores commonly develop on the patient's coccyx, buttocks, elbows, heels, sacrum, hips, shoulders and lower back.
Pressure Sores are Categorized by Staging (Stage 1 to Stage 4):
Stage I: Initially, a pressure sore appears as a persistent area of red skin that may itch or hurt. The stage 1 wound feels warm and spongy to the touch. In Caucasians, the Stage 1 sore is a red spot. In African-Americans, the mark may appear to be blue or purple, or look flaky. A Stage 1 decubitus ulcer has not yet broken the skin and can be easily cured through proper pressure relief.
Stage II: By the time a decubitus ulcer advances to Stage 2 there is a partial loss of skin in the epidermis (outer layer of the skin). A Stage II bedsore is open and looks like a small blister or abrasion. The skin tissue around the Stage 2 wound may be red or purple. If treated promptly, a stage 2 decubitus ulcer can be healed.
Stage III: A stage III pressure sore is an open crater like wound. The damage to the inner skin tissue will be visible. A stage III bedsore requires quick intervention from a trained wound care team in order to try to heal the stage 3 decubitus wound and prevent it from deteriorating into a Stage 4 pressure sore.
Stage IV: This is the deepest, most severe stage of decubitus ulcer. To be classified as a Stage 4 pressure sore, a large-scale loss of skin occurred. The stage 4 bed sore burrows so deep into the skin that it damages the muscle, bone, tendons, and/or joints. Stage IV pressure wounds are very dangerous and require extensive wound care. Stage 4 bedsores sometimes require surgery. A stage 4 decubitus ulcer can lead to bone infections (osteomyelitis), blood infections (sepsis), limb amputations and death. A Stage 4 bedsore often creates a visible hole down to the patient's bone. It is very difficult to heal a stage IV decubitus ulcer.
Unstageable: An unstageable pressure sore is a bedsore that does not fit the above staging categories. In an unstageable bedsore, the doctor or nurse cannot see the true depth of the decubitus ulcer, and therefore cannot grade it. Signs of an unstageable decubitus ulcer are wounds covered by slough (yellow, tan, gray, green or brown) and/or eschar (tan, brown or black) in the bottom of the decubitus wound. Sometimes, the slough and/or eschar needs to be removed in order to properly stage an unstageable pressure sore.
Decubitus Ulcers are Preventable
Statistics show that decubitus ulcers are easier to prevent than to heal. Federal and State laws require hospitals and nursing homes to prevent avoidable pressure sores in their patients. These laws also require that the hospital or nursing home must document the patient's skin status upon admission and keep record of the patient's skin status throughout his/her residency.
The most important task nursing homes and hospitals can do for at risk patients is turn and reposition the patient every two hours. Experts recommend changing a patient's position every thirty minutes that they are sitting in a wheelchair and every two hours while in bed at night. Turning and repositioning the patient is the best prevention measures against decubitus ulcer formation. If the staff fails to reposition a patient as required, this failure is considered nursing negligence. Hospital staff and nursing homes also employ cushions, called wedges or donut seats, which help circulate blood flow while the patient is sitting. At night, when the patient is asleep, the nursing home or hospital should utilize special pressure relieving mattresses and floating heel boots. Failure to implement a pressure sore preventative plan is negligence on behalf of the nursing home or hospital.
Proper nutrition is another great defense against skin breakdown like decubitus ulcers. Malnourished patients develop pressure wounds faster due to the deficiencies in their caloric intake. Specifically, protein-calorie malnutrition has a high correlation with bedsores so make sure your loved one is intaking enough protein. Similarly, dehydration (lack of water) can cause skin to fall apart in at risk elderly patients. It is important to provide extra care for incontinent nursing home residents, as they cannot control their bladder and will become dehydrated quickly. These incontinent patients are at a much higher risk for development of stage 4 decubitus ulcers. Moisture from dirty sheets, unchanged diapers, urine or draining wounds can also cause the development of pressure sores in at risk patients. Ultimately, it is the job of the nurses to ensure that the patient is properly nourished and clean of urine/feces.
Patients in Nursing Homes/Hospitals At Risk for Decubitus Ulcers:• Patients who are wheelchair bound or permanently in bed• Immobilized patients who cannot move on their own• Patients who are malnourished• Patients who are dehydrated• Patients who have dementia, stroke, alzheimer's disease or altered mental status• Patients who cannot turn and reposition on their own• Underweight patients• Patients with diabetes• Patients who have incontinence and cannot control their bladder
Hospitals and nursing homes are very aware of who is at risk of developing decubitus ulcer skin breakdown. If your loved one developed a pressure sore in a nursing home or hospital setting, do not let the abuse go unreported. Make sure to alert the head of the nursing staff, the nursing home administrator, the on-staff doctor and a wound care consultant. After doing that, contact a qualified bedsore lawyer for a free consultation on your potential decubitus ulcer case.
If you or a loved one developed a decubitus ulcer, call (561) 316-7207, email firstname.lastname@example.org, or fill out the free case evaluation form on the right to see if you have a valuable decubitus ulcer claim. A qualified nursing home abuse lawyer will promptly contact you and give you a free case evaluation.