Nursing home cases typically involve abuse or neglect. Abuse cases involve injurious harm to long-term residents by caregivers or fellow patients. Neglect cases typically arise out of the failure to monitor and treat medical conditions, failure to institute proper fall precautions, elopement (i.e., when patients with dementia wander), and failure to maintain skin integrity. We have seen numerous cases of poor skin care resulting in pressure ulcers and, sometimes, death.
Pressure ulcers occur in patients who are immobile or have restricted mobility. Contributing factors include malnutrition, failure to change incontinent patients regularly and failure to turn immobile patients. Inflamed skin tissue breaks down, and a sore develops. These may be referred to as decubiti, decubitus ulcers, pressure sores or bed sores. Sometimes they are minor skin disturbances that do not progress if treated. However, in extreme cases, we have seen pressure sores that have advanced to the point where muscle and bone are visible. The exposed flesh can easily become infected, leading rapidly to sepsis, septic shock, organ failure and death.
According to the Bedsore Institute (www.bedsoreinstitute.com):
“Most bedsores, or pressure ulcers, occur when someone is admitted to a hospital or nursing home. They affect roughly 1-5 in every 100 people admitted to a hospital. However, bed sores can also develop in someone at home, or in a nursing or residential home.
Bedsores are more likely to develop if you:
- Are seriously ill, including patients of an intensive care unit.
- Are not very mobile (for example, you may be confined to a wheel chair or bed). Particularly if you are not able to change your position without help from someone else.
- You are unable to move or feel your legs, and sometimes your arms.
- Are incontinent – this causes damp skin which is more easily damaged.
- Have recently had a broken hip or undergone hip surgery.”
Under Ohio law, when caregivers fail to follow accepted standards of nursing home care, and as a result, a patient develops severe pressure ulcers, a claim for nursing home neglect may lie. Any investigation into such a case would require that the nursing home’s records be scoured to see if the patient was properly nourished and hydrated, whether a plan of care was prepared to prevent or treat bed sores, whether proper wound care was administered, and whether the patient was regularly changed and turned.