Tips for Bedsore Prevention:

Change positions regularly, every 15 minutes if you are in a wheelchair and at least every two hours if you are in a bed. It also helps to avoid laying directly on your hip bones; try to lay at a 30 degree angle to reduce pressure to the hips. Avoid laying with a raised head of more than 30 degrees as this encourages the body to slip down and raises the risk of friction injuries. Try using a pressure reducing mattress if you must remain in a bed every day.

Inspect skin daily. Inspecting the skin is a great prevention tool to incorporate into your daily routine. Also keep skin clean and dry. If you have bandages also make sure they are changed daily. If you notice any skin damage, foul smell, infections, or tenderness you should receive medical attention immediately.

Pay close attention to nutrition. Malnutrition can lead to bedsores as well as other diseases and illnesses. It is essential to get enough calories, protein, fat, vitamins, and minerals in your diet. Consult a dietitian to help come up with an eating plan that appeals to your food preferences while supplying the necessary nutrients.

Try to exercise every day. Exercising increases blood flow throughout the body, as well as promotes a positive mood and socialization; all three are important while in a nursing home. You should consult with a physical therapist for an exercise program that is most beneficial to you.

 warning sign of nursing home neglect. You should consult a nursing home abuse lawyer if you suspect your loved one’s fall at a nursing home was a result of neglect

Signs of Elder Abuse and Neglect


Physical abuse can be as extreme as assault and battery or rape – or may consist of forced restraint, either by mechanical or chemical means (such as administration of psycho-pharmaceutical drugs not authorized by a doctor).

Emotional abuse may include insults, humiliation, threats, and attempts to frighten the resident; it can also be a crime of omission, as when the resident is ignored, disregarded, and/or isolated against his or her will.

Neglect can consist of withholding food, water, and/or medication as well as failure to change bedding or take care of hygiene needs.

Obvious signs to look for include:

•unusual bruising or bleeding

•open wounds, bed sores or cuts

•burns and abrasions

•sudden and unexplained change in weight

•soiling, poor hygiene, smell of urine or feces

•infections

•loss of hair

•torn, stained, or bloody clothing or bedding


Less obvious signs may consist of:

•listlessness or unresponsiveness

•infantile or other strange behaviors

•physical or emotional withdrawal

•disappearance of personal items

•sudden and unusual financial transactions


If you note any of these signs you may have questions on what to do. First you should begin by notifying the facility management. Please remember that just because your loved one is displaying possible signs of abuse doesn't mean someone directly abused them. It could be one of many signs of nursing home neglect.


More Red Flags


If you arrive at a facility to visit a resident during regular visiting hours and the staff refuses or delays access – or a staff member refuses to leave the room during your visit – these may be signs that they are hiding something. Again, it is important to begin by registering your concerns with the management, but if you are not satisfied, you have the legal rights to file a complaint to the appropriate agency. And of course you can always, and are urged to, contact a nursing home abuse lawyer.

Bed-Related Strangulation and Suffocation


As older people find themselves in bed for longer periods of time, the chances of an injury increase. Compounded by other issues such as malnutrition and dementia, the possibility that a resident will become trapped between hospital bed rails is increased. According to the federal government, 20 to 30 deaths occur in nursing homes each year because of strangulation or suffocation associated with bed rails or falling between a poorly sized mattress and the bed frame.

Bed Sores


In addition to the mechanical injuries associated with the bed and frame, a patient who spends extended periods of time in bed may also be subject to bed sores. Also known as pressure ulcers, stages of bedsores can range in severity from very mild to lethal. In its most mild form, a bedsore is a red irritation that is quickly relieved. In its most severe form, it can result in a wound that penetrates the skin and muscle and can, in extreme instances, introduce infection into the bone. This latter scenario is attributable to a lack of appropriate care and sure indicator of neglect. Bedsores have been the source of many fines and citations by the federal and state regulatory agencies (due to individuals who filed a complaint). A bedsore results from pressure that is unrelieved and persists for hours and even days, which means that appropriate attention is not being given to the resident.

Dehydration


A result of poor care or of dementia that prevents the individual from responding to normal bodily needs, dehydration can be lethal. It can be avoided by maintaining a rigid schedule and assuring that staff regularly addresses the dietary and hydration needs of the resident.

Wrongful Death: Nursing Home Abuse and Neglect

When people decide to place their loved one in a nursing home, they think that they will be placing him in good hands. The staff who work in a nursing home are supposed to be kind and compassionate. However, the sad reality is that nursing home abuse is very prevalent. In fact, a recent statistic revealed that over 30 percent of American nursing homes have received an abuse citation. There has also been evidence to suggest that over 90 percent of nursing home patients do not get the care that they need.

 

The signs of abuse may not always be obvious. That is why most people have no idea that their loved one is being mistreated. If nursing home abuse is left unreported, the patient can become seriously ill or injured.

In many cases, nursing home abuse has lead to death. For example, many nursing home patients have died because they were not fed properly, or because a bed sore became seriously infected. Others have succumbed because they did not get the medication that they needed. Some nursing home patients have even been beaten to death. Additionally, nursing home falls are extremely common and can be prevented with proper care. Many patients have died because of the head trauma that they sustained due to the fall.

Falls in Nursing Homes

The statistics are alarming:


•The largest single cause, at 36 percent, of potentially preventable hospital emergency room visits made by nursing home residents is injury due to a fall.

•The death, sometimes wrongful death, of approximately 1,800 nursing home residents each year can be attributed to fall-related injuries.

•A typical, 100-bed nursing home reports 100 to 200 falls per year -- more than one per patient -- and many falls aren't reported.

•Adults 65 and older are four times more likely to die of fall-related injuries if they live in a nursing homes than if they do not.

•Up to 75 percent of nursing home residents fall each year -- more than double the rate for seniors who don't live in nursing homes -- and the average is over 2.5 falls per person per year.

•Over a third of fall-related injuries happen to residents who can't walk.

•Although a relatively small number (2 to 6 percent) of falls result in fractures, 10 to 20 percent of nursing home falls do cause serious injuries, which can lead to loss of function and disability; the resulting fear of falling can also lead to further loss of function, social isolation, and depression.

It's true that nursing home residents are on average older and in poorer health than seniors who live in the community, so therefore may be more prone to fall. However, a well-run nursing home should be able to prevent most falls. Staff should be attentive to patients at risk of falling and ensure that they receive proper foot care and shoes and have (and know how to use) appropriate walking aids. They should eliminate environmental hazards, such as poor lighting, slippery floors, and incorrect bed height, which cause nearly 30 percent of nursing home falls.

Falls and Neglect

When these issues are neglected, falls can and do occur, and residents suffer. And, sadly, nursing home neglect is all too common. Researchers in Michigan recently published the results of a random sampling of family members of elderly nursing home residents. The results were disturbing: more than one in five reported residents were neglected in the previous year. Since family members are often unaware of incidents of neglect, the study's author predicted that the actual number of patients neglected was almost certainly higher than 20 percent. Although this particular study was limited to nursing home residents in Michigan, there is no reason to believe the situation is any different in the rest of the country.

The study did not specifically address falls caused by neglect or nursing home abuse; however, it did look at incidents of physical neglect in which nursing home staff failed or refused to meet various needs of residents, including personal safety. Disturbingly, the study found that the most vulnerable residents -- those with severe physical limitations or behavior problems caused by dementia and other illnesses -- were most at risk of being neglected.

Stages of Bedsores

 Bedsores are a vicious sign of patient neglect at medical establishments, including nursing homes. Medical facilities have been suggesting for years that bedsores are just part of the aging process or they coincide with certain medical conditions. This is not true and bed sores can be prevented when the patient is cared for properly.

 When patients, who are already suffering due to a disability or are elderly, develop bedsores, this is an extremely cruel complication for them to endure. These sores can cause them pain, disability and considerably increases the chance of patients acquiring dangerous complications including gangrene, osteomyelitis or sepsis, which can lead to wrongful death in a nursing home.

 The Four Stages of Bedsores

Hospitals and nursing homes use a scale to help determine and treat these bedsores. Bedsores are also known as decubitus ulcers and pressure sores or ulcers. By using this scale to categorize bedsores, according to their typical characteristics, some uniformity can be established. This assists medical facilities in the treatment of those suffering with bedsores.

Stage I

At first, a pressure sore will appear as an area of skin that is red and it could possibly itch. This area may also feel firm or warm and spongy to the touch. People with darker skin may have an area with a purple or blue hue, rather than the aforementioned red. It could also look ashen or flaky. Stage I bedsores will heal once the pressure has been relieved.

Stage II

Some skin loss has occurred at this point. This loss can be in the epidermis, which is the outer layer of skin or in the dermis, which is the deeper layer of skin, or in both of these layers. The wound has become a sore that resembles an abrasion or blister. The tissues surrounding it may have a purple or red discoloration. If this bedsore is treated promptly, these sores can generally heal rather quickly.

Stage III

Once the bedsore has reached this stage, all the layers of skin have been affected down to the muscle. This process has now damaged or destroyed these tissues. The wound that has been created is a deep wound resembling a crater.

Stage IV

This is the most advanced and serious stage. Damage has now been done to the bone, muscle and the joints and tendons, which are the supporting structures. Large amounts of skin have been destroyed and these wounds are very difficult to cure. At this stage, they can cause lethal infections.

On occasion, a bedsore will be categorized as ‘unstageable.’ These are generally extremely advanced wounds involving muscle, skin and bone.

Abuse in Nursing Homes

When a family member or loved one requires nursing home care, most people expect that they will be watched over by professionals and treated with kindness, respect and dignity. While many nursing care facilities do offer all of these things and more, unfortunately, there are cases in which a nursing home patient is subjected to neglect, poor medical care and even sexual nursing home abuse.

When these events occur, it is not always apparent to friends, family and loved ones, and in extreme cases, this kind of treatment can lead to physical, mental and emotional trauma which can ultimately be life threatening.

Although neglect and poor medical care can cause many problems for residents of nursing homes, sexual abuse is often the worst type of crime that can take place in such a setting. The problem with sexual abuse within a nursing home setting is that it takes on a variety of facets, and each one causes a victim to suffer in silence.

Often times, victims of sexual abuse in a nursing home are victimized because their condition makes it difficult to communicate with others. Additionally, victims of sexual abuse in a nursing home are intimidated by their abuser, or they are told that they will not receive food, medication or other necessities if they speak of the abuse. Finally, as with virtually all sexual abuse cases, victims are often ashamed of what is taking place and therefore, they don't tell anyone.

Unfortunately, many family members do not find out about the sexual abuse of their loved ones in a nursing home until it's too late. Often, this kind abuse goes undetected for weeks, months or even years, and in some cases, it is never reported.

In extreme cases, nursing home staff and authorities are aware of the abuse and yet they choose to ignore it. In these situations, staff members who are responsible for the abuse may simply be transferred to a different area of the home or to another facility. Unfortunately, these types of offenders generally go on to abuse others in their new surroundings, continuing the cycle of pain.

Dehydration and Malnutrition in Nursing Homes

If you are like many other people that have loved ones in nursing homes, then you know there is always a concern about the possibility of nursing home abuse. You likely want to make sure that someone is taking care of your loved one like they were their family. While you may think of the obvious forms of abuse such as physical or sexual abuse, there are others that you may not think about. Dehydration and malnutrition are the most common forms of abuse among nursing home residents. Between 1999 and 2002, approximately 14,000 residents died as a result of dehydration and malnutrition.

Dehydration

Dehydration is defined as an excessive loss of body fluid. This many times is a result of not enough fluids being available or offered to the residents in nursing homes. This is a large problem because many of the residents in the nursing home are not physically able to get their own drinks, and may not be able to properly voice their concerns should they feel symptoms of dehydration.

Dehydration Signs to Look For

- Thirst

- Loss of Appetite

- Dry Skin

- Skin Flushing (markedly red in the face)

- Dark Colored Urine

- Dry Mouth

- Fatigue or Weakness

- Chills

- Dizziness, Faintness or, Light-headedness

More serious symptoms include vomiting, difficulty breathing, and seizures--in which case emergency help is needed immediately.

Get the Help You Need

If food and drink are not offered to nursing home residents, they can become dehydrated and/or malnourished very quickly. If an elderly person becomes dehydrated or malnourished, it can lead to many health problems, such as an increased risk of bed sores. And without proper hydration and nourishment, their bodies can not fight off infections, which can lead to life-threatening illnesses. If you think your loved one in a nursing home is a victim of dehydration or malnourishment report the problem to staff immediately to get your loved one the immediate help they need.

What To Look For

In choosing a nursing home facility for your loved one there are several things you should look for when you are inspecting the place for the first time. Make sure to check all areas of the home that a patient would normally be allowed to go to. Then check the not so normal places such as elevators, or closets. Even an outdoor patio should be properly cleaned and free of hazards. Check the kitchen first, and if you are allowed to talk to some of the people that work there you can get an idea of how clean a kitchen is by looking at the cleanliness of the people who work there.

Poor hygiene in nursing homes should not be tolerated. However, it does exist and is all too commonly overlooked until what started out as simple neglect leads to more serious and deadly health issues. The elderly are often the victims of debilitating medical conditions when they arrive at a nursing home. Many suffer from severe mental and emotional disorders as well. They often cannot speak out in their own defense because most of the time they are not aware that they should be doing so. Or they may not know how to report problems. It is up to the rest of us to look after and take proper care of the people that took care of us.

Overmedicating, Wrong Medication, and Nursing Home Abuse

A seemingly inescapable fact of life is that as one ages, the chances of being prescribed drugs increase. Cancer, heart disease, and stroke, the three biggest killers of the elderly, require numerous medications; and high blood pressure, diabetes, Parkinson's disease, and Alzheimer's disease are also common reasons why older people are prescribed drugs. In fact, according to AARP, Americans 75 and older take on average more than 11 different drugs over the course of a year. A 2003 Families USA study reported that while seniors comprise 13 percent of US population, they account for almost 35 percent of all prescriptions filled. Ninety percent of Medicare beneficiaries use prescription drugs.

 Given these facts, one would hope that properly managing patient medication would be a high priority in nursing homes. In well-run facilities this is the case -- proper staffing and procedures ensure nurses have the time to verify each patient is receiving all and only the medications he or she has been prescribed. Unfortunately, however, giving patients the wrong medication and overmedicating patients are too-frequent forms of nursing home abuse in poorly managed and operated nursing homes.

Watch for Signs

If your loved one's health or behavior changes erratically, if he or she starts developing unusual physical symptoms, or if he or she grows more lethargic or confused, medication-related abuse may be at fault. If at all possible, visit the nursing home when medications are dispensed to see whether care is taken to ensure that the correct drugs and dosages are given to patients. Ask to see a log of the drugs given to your loved one. And if you do suspect that your loved one has been improperly medicated, ask a doctor to run tests. Furthermore, you should contact a nursing home abuse lawyer to discuss the problem and your legal rights.

Sepsis in Nursing Homes

Sepsis, an infection caused by bacteria entering through open wounds on the body, or through IV lines or catheters, continues to be a serious issue in nursing homes throughout the nation. If sepsis is not treated immediately, the results can be catastrophic. Unfortunately, there are far too many nursing homes with inadequate and/or overworked staff members, which results in nursing home residents contracting sepsis when it otherwise could have easily been prevented.

According to the consumer advocacy group, Nursing Home Complaint Center, sepsis is one of the most important warnings of nursing home abuse. Sepsis occurs when infections are left untreated which could have otherwise been treated quickly, and even prevented. In addition, patients with catheters and intravenous lines should be monitored closely at all times. If the aforementioned issues are not closely checked up on and treated immediately, the patient’s bed sores, open wounds, and other exposed areas become a literal breeding ground for bacteria, which ultimately leads to sepsis.

Once the patient has sepsis, an array of symptoms usually follow, ranging from rapid heartbeats, shaking, sweating, confusion, fever, chills, hyperventilation, discolored skin, and low urination. Since the elderly have a lower immune system, sepsis is extremely dangerous and can quickly lead to sepsis shock; an advanced stage of the infection that can lead to organ loss, extremely low blood pressure, and wrongful death.

Wound Care in Nursing Homes

A high number of residents in nursing homes in the United States suffer from wounds on an almost daily basis. According to the Centers for Disease and Control and Prevention’s National Center for Health Statistics, nursing home residents today tend be older than those over a decade ago, and also tend to have more preexisting conditions that could lead to wounds, such as diabetes.

Wounds in nursing homes consist of pressure ulcers, bed sores, lesions, cuts, or any other open injury on the skin and body. Without proper care, wounds can become infected at a much higher rate for senior citizens compared to an average healthy adult, leading to serious health issues such as additional illnesses and even death. The key to helping nursing home residents is to have a qualified medical staff on board who can properly identify each wound and treat it successfully.

Veterans and Nursing Home Abuse

While nursing home abuse is a truly disturbing thought, the rampant abuse of our elderly veterans in homes and retirement living communities is even more heinous. To think that those who have risked their lives for the defense of this country during their younger days are forced to come face-to-face with humiliating abuse in their elder years is more than troubling.

The fact is, this happens every day in America’s nursing homes, and the problem is no less significant in the homes for elderly veterans run by Veteran’s Affairs or other state agencies which should otherwise be committed to the protection and welfare of those who have served the armed forces of the United States.

The name for Veterans Administration (VA) homes have been changed, but the mission remains the same. Once termed “VA Nursing Home Care Units”, the newly redubbed “VA Community Living Centers” seek to provide compassionate care to veterans who meet certain requirements. The Veteran’s Administration describes those who meet the criteria as veterans with chronic stable conditions such as dementia, those requiring rehabilitation or short term specialized services such as respite or intravenous therapy, or those who need comfort and care at the end of life.

The goal of the homes operated by the VA is to “restore to maximum function, prevent further decline, maximize independence, or provide comfort when dying.”

This means that veterans being served by the VA in homes operated by the Administration are particularly vulnerable to abuse. The residents of such communities have declined physically or mentally to such a degree that those who perpetrate acts of abuse generally do so without fear of retribution or of even being discovered. This places our veterans in a difficult and often defenseless position.

Add to this the fact that most veterans applying for residency in such a VA home are likely to not be financially well-off—and therefore unable to switch to a new home at will—and the magnitude and seriousness of the problem of elderly veteran abuse comes into sharper focus.