When we place our loved ones in a nursing home or long-term care facility, we hope the caregivers and staff treats them with the dignity and respect they deserve, yet abuse and neglect are common problems in nursing homes. Signs of elder abuse and neglect in nursing homes are sometimes subtle, but one of the most obvious signs of nursing home neglect is the presence of bedsores. Bedsores, or pressure ulcers are painful and dangerous, sometimes leading to infection, sepsis, and death when left untreated.
If you have an elderly family member in a nursing home, it’s important to watch for signs of nursing home abuse, including bed sores. Bedsores begin as reddened areas on the surface of the skin. If left untreated, they advance all the way down to the bone. Recognizing the stage of bedsores in a nursing home resident can help family members understand whether or not the patient is receiving appropriate treatment. If your loved one is facing neglect, contact a Louisville nursing home abuse attorney at Gray & White, PLLC to get justice.
Recognizing a Stage One Bedsore
Bedsores result from unrelieved pressure on one area of the body, particularly in areas over bony perturbances like the tailbone. They result when patients are unable to regularly shift and change their position, making them common in bedridden patients or those confined to wheelchairs. The unrelieved pressure causes a sore which opens up and becomes inflamed. An individual with a stage one bedsore may show the following symptoms:
- The skin appears red and irritated (on those with dark skin tones, the sore may first appear as a darkened or purpled area)
- The patient feels discomfort or mild pain
- The temperature of the area feels warmer than the surrounding flesh
Prompt treatment of stage one bedsores requires relieving the pressure, washing with mild soap and water, and keeping the area dry. If left untreated, the sores advance to stage two.
Stage Two Bedsores
In stage two bedsores, the injured skin wears away and then breaks open, forming an ulcer. Symptoms of stage two bedsores include the following:
- An open, oozing sore resembling a burst blister or a crater
- Redness and inflammation surrounding the sore
- Severe pain
The open sores in stage two bedsores leave the individual at risk of infection. Treating stage two blisters requires repositioning for pressure relief, gentle cleansing with saline, and debriding or removing dead skin tissue so healing can begin. Healing may take several weeks or longer in elderly individuals.
Stage Three Bedsores
In stage three, the open wound deepens through all layers of the skin, sometimes revealing the fat layer below. Symptoms may include:
- A deep, open sore with necrosis (tissue death)
- Redness in the surrounding area
- Areas of blackened dead skin
- Oozing pus or fluid
- Fever
Treatment may require extensive debridement and/or surgery and sterile dressing as well as repositioning for pressure relief in the area throughout the healing process. Most patients also receive antibiotic treatments to heal infection and prevent sepsis.
Stage Four Bedsores
In stage four bedsores, tissue death occurs all the way through the fatty layer to the muscle and bone. Stage four bedsores exhibit the symptoms below:
- A deep crater that may also be large in circumference
- Exposed bone
- Blackened, ragged edges
- Hot skin
- Fever
- Swelling
- Drainage and pus
- Foul odor
- Excruciating pain
Stage four bedsores require extensive debriding in surgery. Frequent sterile dressing changes and complete relief from pressure in the area are crucial for healing. The individual also requires antibiotics to reduce infection and prevent sepsis.
Bedsores and Sepsis in Nursing Homes
Nursing home residents face a high risk of developing life-threatening sepsis. Sepsis occurs when a serious infection causes unregulated inflammation throughout the body, causing organ damage. Bed sores are a sadly common cause of sepsis and death in nursing home residents.