Guide to Bedsores in Nursing Homes

Also known as pressure sores, pressure injuries, or pressure ulcers, and decubitus ulcers, bedsores are injuries in skin tissue caused by pressure over a period of time.

These injuries mainly occur in people who are sedentary for any number of reasons, especially those confined to a bed or wheelchair who cannot move unassisted. Nursing home residents are at great risk for bedsores due to understaffing and the vast amount of their wards being elderly and immobile.

Recent and accurate statistics on bedsores in nursing homes are not readily available because mostly only severe cases are reported. Study data from the National Library of Medicine (NLM) shows that nursing homes self-reported only 59.7% of hospitalized patients who had bedsores between stages 2-4.

This data was collected only from nursing home residents who were hospitalized and received Medicare at that time.

How Pressure Ulcers Occur

Bedsores are usually caused by caregiver neglect or abuse and several factors can cause these injuries. The quick explanation is that they are caused by the interruption of blood flow to the skin. And that interruption can be due to:

• Constant pressure on the skin from lying or sitting in the same position for too long, destroying skin tissue
• Moist skin rubbing against clothing or bedding, creating friction and damaging the skin
• Two surfaces moving in the opposite direction, known as shear, such as a resident sliding down on an elevated bed

These injuries usually present themselves on areas of the body that don’t have much fat or muscle, such as the tailbone, shoulder blades, or the backs of arms and legs.

Severity of Bedsores

Much like any other injury, pressure injuries have stages of severity and are ranked from stage 1 as the least severe to stage 4 as most serious. Here is a quick rundown of the four stages:

• Stage 1: Some redness on the skin that heals within a few days
• Stage 2: Blistering or abrasions that usually heal within six weeks
• Stage 3: Visible loss of tissue that may take over six months to fully heal
• Stage 4: Damage occurs to the bone, muscles, and joints, often leading to amputation and sometimes deadly infection

Any stage of these injuries can quickly become a dangerous situation for an elderly nursing home resident and should be taken care of as quickly as possible to prevent more severe health issues.

What Can Be Done?

Nursing home residents suffering from bedsores can usually heal over time, provided medical intervention occurs quickly. The treatments for pressure ulcers that are available are such things as:

• Relieving the pressure
• Removing dead tissue
• Keeping the wounds clean
• Using medication such as antibiotics

Finding and caring for bedsores by stages 1 or 2 is important to the overall health of the individual. The longer it goes untreated, the higher the risk for severe health issues and even death in some cases.

How Bedsores Can Be Prevented

Understanding bedsore prevention is the key to ensuring your immobile loved one remains healthy in their nursing home. The easiest way to reduce the risk of bedsores occurring is by:

• Making sure your loved one is moved or repositioned every few hours
• Checking your loved one’s skin regularly
• Making sure severely immobile residents participate in physical therapy

These are just a few precautions we can take to prevent our loved ones from developing what can often be a life-threatening injury. Visiting your loved one in their nursing home as frequently as you can is always an important preventative measure as you will be more likely to notice any health changes.

Who is Most at Risk for a Bedsore?

Decubitus ulcers usually develop more frequently in nursing home residents who are in wheelchairs or are bedridden. When an individual is immobile and relies on others to assist them in daily tasks, such as changing their position in a chair or on a bed, it raises the chances that bedsores may occur.

Long-term care facilities are notoriously understaffed and the caregivers who work at these facilities care for many patients at a time. It’s an unfortunate reality that not all patients are treated equally, especially those who have more extensive needs, such as being unable to move or care for themselves.

These residents are more likely to be looked over and ignored, either on purpose or accidentally, which often leads to injuries such as bedsores.

If your loved one is largely immobile and residing in an assisted care facility, it’s important to maintain awareness of their health. They often can’t speak up for themselves, or if they do, they may be ignored.

We are their biggest advocates when it comes to their health and well-being. If you see any signs or are concerned about your loved one’s health, speak up and make sure your loved one is being properly cared for. In some cases, making a report of nursing home abuse may be necessary.