Pressures sores, also known as “bed sores” and “decubitus ulcers,” are a risk for anyone confined to bed for long periods of time with limited mobility. They can become a dangerous problem in nursing homes, especially in residents already frail from age and other diseases. Pressure sores can kill as they can provide the conduit for deep systemic infection. Certain residents are at highest risk for development of pressures sores, especially those who are incontinent, (urine or feces can break down skin), residents who cannot reposition themselves, and residents with neurological or sensory damage who have diminished capacity to feel pain or discomfort.
Prevention of pressure sores is the best treatment and is part of every nursing home’s fundamental obligation – to properly monitor residents and protect health to the extent feasible and to maintain patient dignity. A resident prone to pressure sores must be monitored so that they can be repositioned frequently, vulnerable areas kept clean, nutrition maintained, and small sores promptly addressed. Pressure sores are staged similar to burns, category 1 being the most superficial and category 4 being large and deep. Category 1 sores may develop even in excellent nursing homes. There is never an excuse, however, for pressure sores to develop to the point of serious harm or death. An advanced pressure sore is strong evidence of nursing home neglect.