Bedsores, also called pressure ulcers or pressure sores, develop when immobile people remain in the same positions for too long without being turned and repositioned. These painful wounds progress from redness to open sores exposing muscle and bone, creating infection risks and excruciating suffering. Proper nursing care prevents bedsore development through regular repositioning, skin inspections, and pressure-relieving equipment. When nursing home residents develop bedsores, this almost always indicates facility neglect because the medical community considers these wounds largely preventable with appropriate care protocols.
Our friends at Disparti Law Group explain to families that seeing pressure ulcers on their loved ones represents visible proof of inadequate care. A medical malpractice lawyer experienced with these cases knows that bedsores create strong liability evidence because medical standards clearly establish prevention protocols, and facility failures to implement basic turning schedules demonstrate the kind of systematic neglect that causes preventable suffering.
How Bedsores Develop
Pressure ulcers form when body weight presses skin and tissue against surfaces like beds or wheelchairs for extended periods. This pressure restricts blood flow to affected areas, starving tissue of oxygen and nutrients.
Without regular repositioning to relieve pressure, tissue damage progresses through predictable stages. Initial redness advances to blistering, then to open wounds, and finally to deep craters exposing bone and tendon.
The most vulnerable areas include heels, tailbone, hips, and shoulder blades where bones sit close to skin with minimal padding. Residents who cannot move themselves depend entirely on staff to reposition them frequently enough to prevent pressure damage.
According to the Agency for Healthcare Research and Quality, pressure ulcers affect significant percentages of hospitalized and long-term care patients, with most cases being preventable through proper care.
The Four Stages Of Pressure Ulcers
Stage 1 involves intact skin with non-blanchable redness. The area appears red and doesn’t temporarily turn white when pressed. This represents early tissue damage that will progress without intervention.
Stage 2 shows partial-thickness skin loss with exposed dermis. The wound appears as a shallow open ulcer or blister. Skin integrity is compromised but damage remains superficial.
Stage 3 demonstrates full-thickness tissue loss. Fat becomes visible and the wound appears crater-like. Bone and tendon aren’t visible yet but damage extends deep into tissue.
Stage 4 represents full-thickness tissue loss with exposed bone, tendon, or muscle. These severe wounds often involve tunneling, undermining, and life-threatening infection risks.
Why Bedsores Indicate Neglect
Bedsore development almost always demonstrates facility neglect because prevention protocols are well-established and effective. Proper care includes repositioning immobile residents every two hours, conducting regular skin inspections to identify early pressure damage, using pressure-relieving mattresses and cushions, and maintaining proper nutrition and hydration supporting skin health.
Facilities that allow bedsores to develop failed to implement or follow basic care standards. Stage 3 and 4 pressure ulcers represent particularly egregious neglect because they take days or weeks to develop, providing ample time for proper care to prevent progression.
A resident developing multiple bedsores or pressure ulcers advancing to severe stages while in facility care demonstrates systematic neglect affecting basic turning and repositioning protocols.
Facility Defenses And Why They Fail
Nursing homes sometimes claim that certain residents are so ill or frail that bedsores are unavoidable despite proper care. This defense rarely succeeds because medical evidence shows that appropriate prevention measures work even for very sick residents.
Facilities might argue that residents refused repositioning or that medical conditions made turning impossible. Documentation showing repeated refusals or medical contraindications to movement is required, and facilities still bear duties to implement alternative prevention strategies.
The defense that residents arrived with existing bedsores from previous facilities or hospitals requires proving the ulcers pre-existed admission. New bedsores or existing ones that worsen during facility stays demonstrate inadequate care regardless of entry condition.
Documentation In Medical Records
Nursing home medical records should contain regular skin assessments documenting any pressure areas or early redness. Absence of these assessments suggests facilities weren’t monitoring for bedsore development.
Care plans must address bedsore prevention for at-risk residents. Documented turning schedules showing staff repositioned residents every two hours demonstrate attempts at proper care.
When bedsores develop despite documented prevention efforts, questions arise about whether staff actually followed documented schedules or whether records were falsified to create appearance of proper care that didn’t occur.
The Role Of Understaffing
Bedsore development often results from inadequate staffing. When too few nursing assistants care for too many residents, regular repositioning becomes impossible despite facility policies requiring it.
Facilities cannot use understaffing to avoid liability. Corporate decisions to maintain inadequate staff levels create conditions causing predictable neglect. Both facility operators and parent corporations face liability for understaffing that leads to bedsores.
Treatment Failures Compound Neglect
Once bedsores develop, facilities must provide aggressive treatment preventing progression and promoting healing. Treatment includes more frequent repositioning to relieve pressure on affected areas, wound care with appropriate dressings, nutritional support for tissue healing, and infection monitoring and treatment.
Facilities that allow existing bedsores to worsen through inadequate treatment compound the original neglect that caused initial development. Stage 1 pressure ulcers advancing to Stage 4 while residents remain in facility care demonstrate both failure to prevent and failure to treat.
Pain And Suffering From Bedsores
Severe pressure ulcers cause excruciating pain. Exposed nerve endings in deep wounds create constant agony that pain medication cannot fully relieve. Residents suffer tremendously from neglect that allowed preventable wounds to develop and progress.
The psychological impact includes humiliation from wound odor, depression from constant pain, and fear of additional neglect. Quality of life deteriorates dramatically when bedsores develop.
Infection And Life-Threatening Complications
Bedsores create entry points for bacteria causing infections. Osteomyelitis, a bone infection, develops when pressure ulcers expose bone to bacteria. This serious condition requires extended antibiotic treatment and sometimes surgery.
Sepsis from infected pressure ulcers can be fatal. Bacteria spreading from wounds into bloodstreams causes systemic infection that kills vulnerable elderly residents.
When residents die from sepsis originating from neglect-caused bedsores, wrongful death claims hold facilities accountable for preventable deaths resulting from failures to provide basic care.
Medical Costs Of Treating Bedsores
Treatment for severe pressure ulcers involves substantial medical expenses including wound care supplies, antibiotics, surgical debridement removing dead tissue, and sometimes skin grafts for wound closure.
Extended hospitalizations for bedsore treatment and complications create medical bills far exceeding what proper prevention would have cost. Facilities that neglect prevention create enormous treatment costs that they should bear responsibility for.
Proving Causation
Establishing that facility neglect caused bedsores requires medical opinions linking wound development to inadequate repositioning and care. Medical professionals review records showing when bedsores were first documented, how quickly they progressed, and whether facility care met prevention and treatment standards.
Photographs documenting bedsore severity provide powerful evidence of neglect’s physical manifestations. Progression photos showing worsening over time demonstrate ongoing care failures.
Regulatory Violations
Federal nursing home regulations specifically address pressure ulcer prevention. Facilities receiving Medicare or Medicaid funding must meet standards requiring systematic prevention protocols.
State health department inspection reports often cite facilities for pressure ulcer deficiencies. These regulatory findings support legal claims by providing independent verification that facility care fell below required standards.
Damages In Bedsore Cases
Compensable damages include medical expenses for treating pressure ulcers and complications, pain and suffering from wound pain and progression, decreased quality of life and loss of dignity, and wrongful death damages when infections prove fatal.
Severe bedsore cases involving multiple Stage 3 or 4 ulcers, infections, or death justify substantial damages reflecting the serious harm caused by neglect.
If your immobile loved one developed bedsores while in nursing home care, understand that these wounds represent strong evidence of facility neglect because proper care protocols prevent pressure ulcer development in the vast majority of cases. The existence of Stage 2, 3, or 4 bedsores demonstrates failures to implement basic turning schedules and skin monitoring that constitute fundamental care deficiencies. Don’t accept facility excuses that bedsores were unavoidable when medical evidence overwhelmingly shows that appropriate repositioning, skin care, and prevention measures work to protect vulnerable residents from the preventable suffering that pressure ulcers cause.
