How Common Are Bedsores In Nursing Homes?

Pressure ulcers, often called bedsores, are a serious and often, dangerous marker of mortality in older adults. These injuries often occur in tandem with acute illnesses or other end-of-life conditions and are closely associated with neglect, abuse, and poor care.

Bedsores in nursing homes are often a warning sign that indicates something is not right in the facility. If you notice bedsores on your loved ones, you must take immediate action. Speak to the nursing facility’s management about your concerns and consider contacting a bedsore lawyer to file a nursing home abuse lawsuit.

What Is A Bedsore?

Bedsores are a kind of injury caused by the pressure of one’s body weight focused on an area for a prolonged period. In other words, when someone stays in one place for a long time, their body weight restricts the amount of blood flow and circulation in the area being pressed down, causing repeated chafing that ultimately leads to the breakdown of skin and tissues to form ulcers.

Pressure injuries can develop in anyone, at any time. However, they are most common among older adults residing in nursing homes or long-term care facilities. Individuals confined to wheelchairs or bed rest are particularly prone to bedsores, as are people with circulatory issues, diabetes, former or current smoking habits, malnutrition, or fragile skin. Common pressure ulcer locations include the buttocks, spine, knees, sides of ankles, elbows, and any other spot subject to chafing. You may also spot pressure sores on the toes, backs of ears, or raw patches on the scalp.

Stages Of Bedsores In Older Adults

Pressure ulcers are classified into several stages based on their severity:

• Stage 1: A developing bedsore often appears like a sensitive or raw patch of skin, similar to a bruise with some discoloration. Early signs of bedsores include itchy areas of skin, red spots that don’t “blanch” or whiten when pressed, or a shiny appearance on darker skin.
• Stage 2: At this stage, the bedsore’s “bruise” typically opens into a blistered patch of skin or an abrasion. The edges may be discolored, and are likely to be painful to the touch.
• Stage 3: A stage 3 bedsore has a deep, crater-like appearance that may be painful and numb to the touch. The edges may be red, purple, or black. It may also develop a foul smell.
• Stage 4: A stage 4 pressure ulcer causes damage to the surrounding joints, bone, and tissue. It may lead to life-threatening complications such as sepsis or a bone infection (osteomyelitis). The bedsore itself may look blackened or dead, or may be covered in a creamy yellow or white pus-like substance.

What Causes Bedsores In Nursing Homes?

The primary cause of bedsores is continued pressure on one area from lack of movement, usually due to confinement to a bed or wheelchair. Contributing factors like reduced mobility, incontinence, malnutrition, loss of feeling in limbs and dehydration make bedsores more common for nursing home residents. Bedsores can develop rapidly when nursing facility staff are overburdened or inattentive.

In addition, medical conditions like cancer, cerebral palsy, dementia, diabetes, heart/kidney failure, or spinal injuries put certain residents at heightened risk for developing bedsores in nursing homes.

How Long Do Bedsores Take to Heal?

To diagnose a bedsore, a doctor first examines the wound to assess its appearance and pain level. They will also inquire about the patient’s medical history (such as preexisting conditions) and undertake a biopsy to check for infection. Depending on the stage, bedsores may take a few weeks to months to heal entirely. Some may require antibiotic treatment or surgical intervention.

How To Prevent Bedsores

The Braden scale assessment is a test used to determine risk factors for pressure ulcers in adult patients. Elements like a patient’s responsiveness, mobility, and nutrition are weighed against additional concerns like how much moisture they are often exposed to and their ability to reposition themselves without help. Patients who receive a lower Braden scale score are at higher risk for developing bedsores – and therefore, nursing home staff should take additional preventative measures in their care.

Nursing interventions for pressure ulcers include regular repositioning, skin hygiene, and skin checks. The staff should also provide proper nutritional support to all patients so as to mitigate the risk of developing bedsores. They must also monitor hydration, set up pressure-relieving devices in beds and wheelchairs, and ensure that residents do not rub or chafe existing sore spots.

Bedsore Rates In Nursing Homes Versus Other Care Settings

Studies show that residents of nursing homes are particularly at risk for bedsores when compared to other care settings. Compared to older adults admitted into hospitals from other care situations, patients admitted from a nursing home were more than five times more likely to have a preexisting pressure ulcer.

One reason for higher rates of pressure ulcers in nursing home settings is that reduced mobility often drives older Americans into nursing care, whereas residents who remain at home may still be able to adjust themselves or lead more active lives. Close family members may be more likely to engage in activities with older relatives when they remain at home, which may increase their mobility. Additionally, many nursing homes remain relatively low-technology environments. This means nurses lack the level of technology that an acute care environment, like a hospital, has for detecting early-stage bedsores. Nursing home neglect and abuse, sadly, also answers the “why” in factors leading to higher rates of bedsores in nursing care residents.

Pressure Ulcers In Nursing Homes: Statistics

According to a study of nursing home residents, the presence of a pressure ulcer upon admission, developing a bedsore, or having a bedsore that refuses to heal are all associated with a two to threefold increased risk of death in the first six weeks after admission. Approximately two-thirds patients who develop bedsores necessitating hospitalization pass away, with roughly 56% succumbing to death within the first six weeks of the onset of the condition.

Pressure ulcers prevention and management starts with understanding the risk. Consider the following statistics:

• Stage 2 pressure ulcers are the most commonly reported bedsores across US nursing homes, according to the Centers for Disease Control (CDC). They make up about 50% of reported bedsores, while Stages 1, 3, and 4 make up the remaining percentage.
• More than 1 in 10 nursing home residents in the United States have had a pressure ulcer.
• Bedsores do not necessarily correlate to higher weights in nursing home residents. In fact, one in five nursing home residents with recent weight loss were found to have bedsores.
• Other risk factors for bedsore incidence in nursing homes include recent episodes of incontinence, taking more than 8 medications, and lower mobility.
• Pressure ulcers are most commonly found in newer residents of nursing homes. Studies estimate that residents in their first year of living at nursing homes are more at risk for bedsores than longer-term residents.
• Pressure ulcers are slightly more common in men (13%) than in women (10%).
• Black residents of nursing homes tend to report more severe cases of pressure ulcers than white residents. This may be due to inherent bias, as training materials to spot bedsores earlier on are more commonly depicted on lighter skin.

Studies from Switzerland indicate that bedsores are largely preventable, and that higher occurrences of bedsores can be considered a red flag for poor care. However, it is difficult to get an accurate picture of bedsore rates in the United States. One reason for this is the self-reporting system for nursing homes. Studies are based either on incidence rates (number of nursing home residents who develop a bedsore while under care) or prevalence rates (number of residents who have a bedsore at some point in time). Only incidence rates can be considered reliable indicators of care, since prevalence rates may reflect previously existing conditions in nursing home residents.

Why Are Bedsores So Common in NYC Nursing Homes?

New York City is a hotspot for bedsores. A 2019 exposé from the City University of New York (CUNY) highlights that nine out of the ten nursing homes in the state reporting the highest incidences of bedsores are located in New York City. Nationally, these ten New York nursing homes are among the worst in the nation for high bedsore rates, ranking in the top 2%.

High staff turnover is in part to blame, leading to a shortage of skilled nurses. In New York, Health Commissioner James McDonald issued an alert for an acute labor shortage in nursing homes statewide from April 2022 onwards. Approximately 75% of nursing homes in New York have been unable to meet minimum staffing requirements set by state law, causing around 400 nursing homes to request waivers of fines due to ongoing trained staff shortages.

New York also has the highest number of beds per nursing home facility in the United States. While the average number of certified nursing home beds per facility in the US is 107, New York has approximately 186 beds per facility, which can lead to overcrowding or short-staffing in nursing homes.

A large part of the blame, however, lies in nursing home ownership. Many nursing facility owners move money from their facilities through corporate arrangements, paying themselves handsomely while residents are left in deplorable conditions. New York nursing homes are required to spend at least 70% of their revenue on direct resident care. However, the law is criticized for being weakly enforced and has been recently challenged in court.

What To Do If You Suspect a Bedsore

If you suspect a bedsore, you should first wash and dry the area. Use mild or warm water (never hot) and moisturize the area. Take care to avoid chafing and try to adjust the bedsore patient regularly (every 10 to 15 minutes in a wheelchair and every two hours in bed). For developing bedsores, prop the area up on a pillow or foam cushion. Consult with a doctor for a saline rinse, as well as a special dressing that may promote healing for a bedsore. Ensure that the patient stays hydrated and that they are consuming enough Vitamin C and zinc to be able to heal.

If you spot a bedsore on your loved one in a nursing home, make sure to bring it up to the nurse and doctor immediately. You can help take all of the above steps but you should carefully assess if they are in a safe and healthy environment. Be mindful of any signs of neglect or abuse that might have contributed to the bedsore.

How Much Is a Bedsore Lawsuit Worth?

A bedsore attorney can help evaluate the total value of your lawsuit and work hard to increase your chances of recovering the maximum possible compensation.

At Dalli & Marino, we have won our clients over $1,300,000 in bedsore lawsuit settlements. We stand up for our clients and their families when nursing home neglect leads to unnecessary pain, suffering, and tragedy. No one should have to suffer the abusive and degrading circumstances that often precede the formation of an advanced-stage bedsore. When your family members are not being treated correctly, we fight for your rights to recover compensation and penalize corporate nursing homes that use their patients only for profit. Our bedsore attorneys are available for a consultation to determine how much your case might be worth.

How Common Are Bedsores in Nursing Homes: FAQs

Looking for answers? Contact a doctor for medical questions about how to treat bedsores, and an experienced elder abuse attorney with Dalli & Marino for any questions you might have about filing a bedsores lawsuit.

Are Pressure Ulcers and Bedsores the Same Thing?

Yes, a pressure ulcer is another term for a bedsore. They may also be referred to as pressure sores. All these are terms for a kind of tissue injury caused by pressure, lack of movement, and chafing on one area of the body.

What Do Bedsores Look Like?

At first, bedsores may appear reddened on light skin or as blue/purplish patches on dark skin. The area may feel sensitive or sore to the touch. It can also feel warm or itchy at the start. As bedsores worsen, they may look more like a blister or a crater in the skin. They may seem spongey or infected. At advanced stages, bedsores typically look blackened and have a bad smell.

Are Bedsores a Sign of Neglect?

On their own, bedsores may not always signal neglect or negligence. However, neglect is a major risk factor for developing pressure ulcers. In many cases involving nursing homes, bedsores are a clear indication of nursing home abuse or neglect. If you suspect this may be the case, contact a nursing home attorney as soon as possible.

Bedsores Are an Indication Of Which Type Of Abuse?

Bedsores are often associated with elder abuse. Patients who are incontinent or immobile are among the most vulnerable populations for bedsores, and require skilled and professional care.

Can Bedsores Kill You?

In the United States, approximately 60,000 people die annually from bedsore-related complications. Bedsores, when left untreated, can lead to sepsis, cellulitis, and potentially life-threatening complications. Even in the early stages, bedsores are a serious concern and should always be evaluated by a doctor to prevent further damage, infection, or death.

Can Bedsores Be Cured?

Doctors typically determine the likelihood of a bedsore healing by looking into factors such as the stage, depth, presence of infection, and other conditions. Bedsore treatment often involves applying a specialized pressure ulcer wound dressing, keeping the area clean and dry, and applying an ointment for bedsores. In severe cases, surgery may be required.

Have Concerns About Bedsores? Contact an Experienced Attorney at Dalli & Marino For Help

The elder abuse attorneys at Dalli & Marino help people who have been stripped off of their personal safety and agency. We are committed to the cause of helping nursing home abuse clients get the justice and compensation they deserve.

Many nursing home abuse cases are revealed through one resident or family speaking up through an attorney and shining a light on the pattern of abuse that allowed bedsores to develop. A bedsores lawsuit can potentially win you damages that protect your family and penalize nursing homes that neglect and mistreat their residents.

If you have concerns about bedsores on yourself or a loved one, contact Dalli & Marino today for help.