Every year an estimated 2.5 million people in the United States get bedsores, and more than 60,000 die as a result. Of that number, 23% are in rehabilitation or long-term care facilities, and between 10% and 41% are patients in ICU in a hospital setting. Nursing homes are one type of long-term care facility where bedsores are very prevalent. One study found that patients with Medicare were the largest population with bedsores, at 3.5%, while Medicaid patients made up 0.8%. Patients with private insurance and self-pay patients were 0.6% and 0.4% respectively. It is a serious health problem and it isn’t going away.
What are Bedsores?
A bed sore, also known as a pressure sore, or decubitus ulcer, is an ulcer that develops on the skin of a person who stays in one position for a long time, such as when they are bedridden or in a wheelchair. They are caused by prolonged pressure on certain parts of the body, typically the tailbone, lower back, buttocks, and hips on people who lay down or stay seated without moving for long periods of time. Bedsores also tend to affect the foot area, including the heel an ankle in patients who experience continuous pressure in those areas – often due to being in a wheelchair for a long time or leaving footwear on for extended periods of time. They begin as a red, tender area on the skin, but if left untreated can become infected or progress to a point where they affect the muscle and bone.
Stages of Bedsores
There are four stages that medical professionals use to describe bedsores.
The skin is red but not broken. It does not blanch (lose color when pressed). It may be a different color (tan red) in a dark-skinned person. The temperature in the affected area is usually warmer. It usually feels either softer or firmer than the area around it.
The skin forms an ulcer, wears away, or breaks open. It is usually painful and tender. The sore spreads from the skin surface into deeper layers. It may have the appearance of a blister filled with clear fluid, an abrasion, or a shallow depression in the skin. The skin and flesh can be permanently damaged at this stage. It can also lead to death.
The sore or ulcer worsens, extending to the deeper tissues that are beneath the skin. It forms a small crater and fat may be visible. At this point bone, tendon, and muscle cannot be seen. The damage may be so severe that the patient feels little or no pain at this point.
The sore is very deep at this stage. It extends beneath the skin and deeper tissues, affecting the muscle and bone. The damage is extensive and irreparable. Joints, tendons, and deeper tissues may also be damaged. The damage is so extensive at this stage that the patient may feel minor pain or none at all. When pain is so persistent damage to nerve fibers can cause peripheral neuropathy. This leads to an inability to feel pain. Also, damage is so extensive at this stage that the patient is often in excruciating pain, even after the administration of powerful analgesic agents.
Complications of Bedsores
Significant complications can arise from bedsores. They can be disabling, disfiguring, and even life threatening. They include:=
- Joint and bone infection – The joint and bone can become infected. Septic arthritis, infection in the joints, can cause damage to the tissue and cartilage. Osteomyelitis, bone infection, can limit the function of limbs and joints.
- Cellulitis – The skin and soft tissues surrounding it can become infected. The affected area may be swollen, red, and warm to the touch. It can cause nerve damage, and if that occurs, the pain may be minimal.
- Cancer – Marjolin’s ulcers, a long term wound that does not heal, may develop into a squamous cell carcinoma.
- Bacterial infection – Open wounds are prone to various types of bacterial infection, including staph. It can cause the patient to lose a limb. The infection may then spread through the body and into the bloodstream and lead to death..
- Sepsis – It is rare, but bedsores can lead to sepsis which can be fatal.
Bedsores Often Imply Neglect
The presence of bedsores typically indicates neglect or improper care. A patient who is bedridden, confined to a wheelchair, or who is sedentary due to limited mobility needs to be moved frequently. Ideally, they should change positions every two hours or so. When bedsores develop, it usually means that the patient’s caregiver is not taking proper care of them, or being neglectful.
Bedsores can be a serious health problem, but they may also be an indication of neglect. If you have a loved one who has bedsores or had them and they developed in a medical setting or nursing home, you need an experienced lawyer. We can help. Contact the attorneys at The Law Offices of Ivan M. Diamond and get the assistance you need.