A bedsore is a type of skin injury that results from pressure (they are also referred to as pressure sores). Many residents in nursing homes are at risk of suffering from bedsores due to the fact they are chair or bed bound.
The pressure on certain parts of the body that results from sitting in a chair or laying in bed is what puts some nursing home patients at risk for suffering from bedsores. They are preventable with appropriate assessment and implementation of prevention plans
Causes of Bedsores in Nursing Home
There are two primary forces that combine to cause bedsores in the nursing home setting and otherwise.
- Pressure on the skin that cuts off blood supply to the skin; and
- Shearing forces that tear and harm the blood vessels.
The pressure that disrupts the blood supply to the skin occurs most frequently over bony areas of the body.
The disruption of blood flow to the area of skin deprives the cells oxygen and nutrition they need to survive and eventually the cells die.
This causes edema, inflammation and finally the formation of the bedsore itself.
Alternatively, if a patient in a nursing home is pulled across a bed or part of their body subjected to similar friction, the shearing may cause damage to the blood vessels underneath the skin.
Like pressure, this damage deprives the skin cells around the area where the shearing occurred of blood and nutrients.
Bedsore Stages – Classification
Once a bedsore has been caused, it progresses through a series of stages that have been developed to identify how far along the injury has progressed.
Stage I – at this stage the sore usually consists of an inflamed red area that is ordinarily over a bony provenance.
State II – the bedsore appears as a red/pink wound with a partial loss of skin thickness. It may also appear as an open/ruptured blister.
Stage III – the bedsore likely shows a full thickness tissue loss. Fat below the skin may be observed visible but no bone, tendon or muscle is exposed.
Stage IV – the bedsore will show full thickness tissue loss and exposed bone, tendon or muscle will be observable. The depth and category will vary by anatomical location. Stage IV bedsores can extend into muscle and/or supporting structures.
Bedsore Risk Factors
Below is a list of risk factors that nursing home and skilled nursing facilities should identify in their patients to ensure they are properly cared for and the risk of developing bedsores reduced or eliminated.
Persons that have the following problems or meet the criteria below are at heightened risk for developing bedsores.
- Bed Bound and Chair Bound Patients
- Patients that have Poor Nutrition and Dehydration
- Patients with Blood Flow Problems or Vascular Disease
- Patients with Incontinence Problems
The specific treatment plan will start with the specific patient being treated, including their medical and dietary history, and the stage and location of the bedsore being treated.
Minor bedsores can heal within a month or two, or less. Serious bed sores may require much more time and the treatment may include surgery.
Generally, the stages and types of treatment are as follows:
- Eliminate the pressure that is causing the sore. This may involve moving the patient or using devices to transfer the pressure away from the sore location.
- Sanitize the bedsore by cleaning the area. The severity of the sore typically dictates what type of cleaning is appropriate.
- Eliminate any dead tissue: the bedsore cannot heal well if there remains dead or infected tissue.
- Apply dressings to protect the sore area and assist with healing. The nature and extent, and type of the dressing will depend on the severity of the wound.
- A healthcare professional should provide antibiotics or antibiotic cream to assist with any infection that may have arisen.
The bottom line is bedsores are preventable, even in a nursing home or skilled nursing facility. If you or a loved have suffered from bedsores, it is likely the result of nursing home neglect or abuse.
Prevention ordinarily involves the following:
Identifying what patients are susceptible to developing bedsores
Designing and implementing a prevention plan that appropriately assesses and then implements actions that can be taken to eliminate bedsores in the patient population at a given facility.
Consider this – the Center for Medicare and Medicaid Services has classified bedsores as preventable illness. If a patient sustains a bedsore in the care of a certain facility, Medicare will no longer reimburse that facility for the patient’s care.
If you or a loved one have been the victims of elder abuse in a nursing home or skilled nursing facility, contact us for a free and confidential case evaluation.