Bedsores: A Telltale Sign of Nursing Home Abuse

What are bedsores?

One of the telltale signs of nursing home abuse or neglect is the presence of bedsores. Also known as pressure injuries, pressure sores, pressure ulcers, or decubitus ulcers, bedsores occur when blood supply to the skin is cut off and the skin begins to die. These injuries to the skin and underlying tissue occur when prolonged pressure is applied to the same area of the skin, such as when a person is confined to bed for a long time and is not moved.

What causes bedsores?

Clinically, bedsores are caused by three factors: pressure, friction, and shear.  In almost every case involving bedsores, the patient’s injury is preventable and related to poor quality of care.  When a person’s mobility is limited and the body isn’t moved enough, constant pressure can cut off blood supply to areas of the skin, particularly those around the bones, such as the spine, tailbone, elbows, knees, heels, shoulder blades, and hips. When skin rubs against clothing or bedding, this creates friction. A little friction is normal and our bodies are designed to withstand such friction—but too much friction can damage our bodies, particularly the skin. If the skin is moist, it is even more vulnerable, which is why it’s important to keep skin dry. “Shear” occurs when two different surfaces move in different directions. As a person slides down in bed, for example, their tailbone moves down but their skin might stay in the same place and “pull,” potentially causing a pressure sore.

Who is at risk for bedsores?

According to the medical journal Wound Management and Prevention, “pressure ulcers occur in up to 23% of patients in long-term and rehabilitation facilities.” Bedsores are most common in individuals who are immobile, unable to feel pain in a certain area, in a wheelchair, or in a cast. If someone is diabetic, has circulation problems, or is not getting enough nutrients from their diet, then they are even more vulnerable to bedsores.

What are the symptoms of bedsores?

A bedsore often begins as a tender, red, warm area of the skin, and symptoms become more severe over time. There are four stages of the severity of bedsores, as outlined below:

Stage 1 Affected area is red and warm to the touch; may burn, hurt, or itch; in individuals with darker skin, the area may be tinted blue or purple
Stage 2 Affected area is likely an open sore, scrape, or blister; the surrounding skin may be discolored; individual complains of significant pain
Stage 3 Damage has occurred under the surface of the skin, creating a “crater-like” appearance.
Stage 4 Severe damage to the area; large wound; muscles, tendons, bones, and joints may be affected; high risk of infection

Other warning signs of bedsores include unusual changes in the color or texture of the skin, swelling, drainage, areas of the skin being warmer or cooler than usual, and tenderness.

How can bedsores be treated?

Upon recognizing a bedsore, the most important thing to do is to immediately relieve the pressure from the affected area. After this, the wound can be treated. It can be cleaned using a gentle cleanser and covered with the appropriate choice of bandage. If the wound has progressed, there might be dead skin that must be removed through a process known as debridement. Pain-relieving drugs can provide relief. Negative pressure therapy, also known as vacuum-assisted therapy, might be employed to clean a wound using a suction mechanism.

In severe cases, surgery might be required to apply a skin graft or cushion the wound with muscle taken from a different area. If bedsores are left untreated, serious complications can ensue. These include cellulitis, bone infections, joint infections, sepsis, and even cancer. The journal Wound Management and Prevention states, “It is estimated that up to 60 000 Americans die each year as a direct result of pressure ulcer-related complications.” To prevent these severe wounds and scary complications, make sure to take preventative measures.

How can bedsores be prevented?

Bedsores are prevented by shifting body position, properly caring for the skin, eating right, and monitoring the body for bedsores. If a person uses a wheelchair, they should shift their weight every fifteen minutes, and reposition themselves every hour. If a person is confined to bed, they should get help repositioning themselves every two hours. Choose cushions will relieve pressure. Every day, the skin should be checked for signs of pressure sores, including redness, which is the first sign of skin breakdown. Individuals should be sure to drink lots of fluids and eat nutritious foods, because without the proper nutrients, it is harder for the body to heal and leaves one more vulnerable to bedsores.

What should I do if I or a loved one has a bedsore?

Apart from treating bedsore medically, it is important to recognize that you can only get bedsores from neglect. While no one wants to think they are a victim, if your loved one has bedsores—or even a single bedsore—that means that they have been the victim of neglect by caretakers. The fact that only 1 in 24 cases of elder abuse are reported tells us that elderly people often hesitate to speak out when they are in pain or cannot speak up because of their fragile condition. Don’t let your loved one suffer in silence. Contact the an attorney for a free consultation by calling (877) 238-4175 or emailing