Articles Posted in Pressure Ulcers

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There has been a growing movement in favor of in-home or community-based care, in which a patient avoids the bureaucracy and potential neglect that can come with a nursing home stay, and instead receives more personalized and human care in the comfort of their own home. This can often be with the direct care of indirect support from loved ones.

Real World Examples

There was a recent case profiled in The Atlantic that combines the idea of care from one’s family member along with neglect and exploitation that has resulted in a long prison sentence. In California, an 85 year old woman had resided in a nursing home because she could not care for herself even on the most basic level. Eventually her daughter, who was homeless and lived in her car, convinced her to move into an apartment, which the daughter paid for by tapping into her mother’s social security money. The daughter moved in and assumed responsibility for her mother’s care.
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Pressures sores remain one of the single clearest signs of Chicago nursing home neglect. Far too often family members of seniors are horrified to discover that their loved ones developed serious open skin breakdowns on their body as a result of constant pressure on certain high-risk areas including the sacrum, lower back, heels, and several other locations.

Make no mistake: pressure sores are preventable. With proper caregiving, steps can be taken to ensure that the skin remains free of too much pressure, clean, and healthy. Yet, far too often–particularly at the worse performing facilities–caregivers do not provide nearly enough support to prevent the development of bed sores.

For one thing, the most vulnerable residents usually need to be repositioned in bed every two hours to ensure that no single area of the body has too much pressure from the mattress for an extended period of time. But many understaffed facilities do not abide by these re-positioning and turning requirements. In addition, many seniors do not receive adequate nutrition and hydration, which makes them more susceptible to skin breakdowns.

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Most nursing home neglect cases include a few familiar types of incidents: falls, failure to prevent bed sores, resident-on-resident violence, inadequate nutrition, and wandering. But these general issues are certainly not the only ways that long-term care facilities can fail to meet their legal duty to protect residents. Sometimes the mistakes are a bit more nuanced and connected to the more skilled medical care that these facilities provide.

However, at the end of the day, considering there are so many clear trends when it comes to neglect, family members worried about mistreatment should most familiarize themselves with the most common issues, particularly falls and pressure sores.

Pressure Sore Case

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Bed sores (also known as pressure sores or pressure ulcers) are considered one of the “warning signs” of nursing home abuse and, in particular, nursing home neglect. Nursing home abuse and neglect are becoming a major national issue in part because approximately 1.3 million people live in nursing homes in the U.S. as of 2010 (census data here). Furthermore, the CDC estimates that, currently, 1 in 10 people living in nursing homes has a bed sore. Studies also suggest that people living in nursing homes are more likely to have bedsores today than 10 years ago.

As has been noted previously on this blog, bed sores are serious injuries that can become life-threatening if not treated in a responsible and timely manner. Bed sores are categorized into four stages as they develop and become more dangerous (see a helpful WebMD Bed Sore summary here). Unfortunately, the first two stages may be hard to notice for an untrained eye because the injuries appear as raw, reddened skin (Stage 1) and then a blister (Stage 2). By the time the bed sores have become very noticeable by later Stage 2 or Stage 3, the damage to the body may extend all the way through the layers of the skin into the tissue below. To make matters worse, once someone has bed sores even the best care often requires slow treatment throughout which the patient suffers from pain and discomfort.

For those of us who know or have loved ones living in nursing homes, we expect excellent care from the staff and reasonable comfort for the residents. We certainly expect the staff to treat any injury, like a bed sore, as quickly and effectively as possible. However, the reason bed sores are considered a “warning sign” for nursing home abuse and neglect is not merely because of the sore itself but why it appeared in the first place. The occurrence of bed sores is much more likely in individuals who are dehydrated, malnourished, and left in a bed or wheelchair for very long periods of time without being cared for. The best treatment for bed sores is prevention- and preventative measures fall precisely within the standard of care we expect from nursing homes.

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Bed sores are one of the most well-known signs of inadequate nursing home care. When residents do not receive attentive aid over a period of time, these skin breakdowns may develop, causing serious injury, pain, and (in some cases) contributing to the death of a senior resident. Elder caregivers must be well-versed in these pressure ulcers, understanding how they develop and what needs to be done to make sure they are properly treated. If nursing home caregiver fail in this regard, then the civil law may allow the senior (or their family) to seek legal accountability.

Illinois Bed Sore Lawsuit

That is exactly what is happening in a new nursing home neglect lawsuit filed by our legal team at Levin & Perconti against the Applewood Rehabilitation Center in Matteson, Illinois. We are representing a family in the legal matter whose 81-year old senior relative passed away in January 2012 after a stay at the facility.

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Pressure sores (also known as pressure ulcers or bed sores) are far too common injuries that affect residents of nursing homes that do not receive proper care. Essentially, these injuries are breakdowns of the skin, which usually develop on “bony prominences” in the body–like the heel or lower back. Wherever pressure is placed on the skin from bones for prolonged periods of time, these sores can develop. Expectedly, immobile seniors who may spend significant times in bed are at heightened risk of having skin breakdowns as a result of laying without repositioning for so long.

Fortunately, steps can be taken by caregivers to avoid those injuries. Ensuring movement, repositioning, cleansing, and similar steps can make all the differences. Failures in this regard continue to occur, however. When pressure sores do develop, they can occur along a range of seriousness, usually referred to as the four “stages” of pressure ulcers.

A Stage 1 pressure sores is one where the skin itself has not been broken, but instead appears reddened and raw. The skin is often firmer than those around it. A Stage 2 pressure sore is where the skin itself breaks away leaving an open wound. It often looks like a blister on the skin that goes through several layers. Some fluid may be visible in a Stage 2 sore, and in some case there may be permanent skin death.

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Nursing home residents themselves are often not the ones who make claims of neglect or abuse. There are many reasons for this. For one thing, many of them have significant mental and physical vulnerabilities that make it difficult to understand their own condition or appreciate what quality of care they should expect. The nature of their relationship also makes it challenging for many to call our poor care. After all, if you count on certain people to help get by every day–from eating breakfast to going to the bathroom–it is difficult to make allegations about their them personally.

All of this makes it imperative for outsiders to step in and demand accountability when reasonable standards of care have not been met. In many cases this is family members. For example, we recently settled an Illinois nursing home neglect case where the family members of the residents were the ones to identify–on several occasions–that their loved one developed bed sores. The actual nursing home employees whose job it was to prevent the sores and provide proper treatment if detected, never proactively noticed the situation. Sadly, those sores ultimately led to complications which took the senior’s life.

Bed Sores Identified at Hospital

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It strikes in Chicago, the suburbs, and throughout Illinois: nursing home neglect. Sadly, most will not truly consider the problem until it happens to someone that they love. While many long-term care providers work hard to ensure proper treatment of residents at all times, there are far too many who do not. The result is a string of incidents where seniors are forced to spend their last days in pain, suffering, confusion, and sadness. It is never acceptable, and we need to work to minimize the number of elderly residents affected.

Each Chicago nursing home lawyer at our firm is proud to help families in the aftermath of these tragedies. Be demanding legal accountability, we are able to ensure families are compensated as much as possible for their loss and that negligent facilities have a reason to change their practices so that future problems are avoided.

Evergreen Health Care Center Pressure Sore Settlement

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Earlier this week we shared information on a new senior financial exploitation guide that provides helpful information to both identify possible senior financial abuse and tips to act on suspicions. You can download a copy of the brochure here.

The informational piece includes some worthwhile advice not only about preventing abuse but identifying what to do if you suspect mistreatment.

What If You Find a Problem?

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It is hard to say that there is a “typical” case of mistreatment in nursing homes, because accidents of all kinds occur quite frequently. However, if one were to pick a “standard” example of nursing home neglect, then it would likely be the development of pressure sores by vulnerable seniors-often contributing to death.

This is the case because no other injury develops as much in senior residents and is as directly associated with the care received (or not received) than pressure ulcers (also known as bed sores or pressure sores). In other words, problem with medication, for example, leads to injury for many residents, but not all of those problems are related to neglect or abuse. Pressure sores, on the other hand, generally do not develop at all unless the care received by the resident is substandard. Proper hydration, nutrition, re-positioning, bathing, and other facets of decent caregiving is usually enough to prevent these painful and damaging injuries from developing.

Unfortunately, it is often only when it is too late-and a resident is rushed to the hospital for a serious medical emergency-that the problem is uncovered. In many instances an ailing resident will have their sores noticed by medical caregivers. But by the time this happens the senior may already be on the downhill. It is not uncommon for residents to pass away shortly after their injuries of this nature are discovered.