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Bedsores often indicate neglect in nursing home patients

Nursing home patients face a high risk of being diagnosed with decubitus ulcers, otherwise known as bedsores. But patients don't have to be bedridden to develop bedsores. Patients who sit for long hours in the same position in a chair can also suffer from this very painful condition.

This is a condition that can almost always be prevented with good patient management techniques. Yet, analysts with the Medicare Patient Safety Monitoring System (MPSMS) determined that nationwide, the rate of pressure sores acquired in medical facilities was 4.5 percent. However, New York exceeded that rate and has the highest incidence of all 50 states at 5.2 percent.

Untreated, they can kill

Thousands of hospital and nursing home patients succumb to complications of decubitus ulcers each year. According to the National Pressure Ulcer Advisory Panel (NPUAP) decubitus ulcers are "localized injur[ies] to the skin and/or underlying tissue, usually over a bony prominence, as a result of pressure, or pressure in combination with shear."

New York has taken steps to penalize health care facilities that have lost patients due to bedsores. They include both New York University Langone Medical Center and Beth Israel Medical Center.

Who is at risk?

Sedentary patients of all ages are vulnerable. Those at highest risk include senior citizens and those with already compromised, thinning skin. They develop quickly on bony areas with few muscles or fat deposits, e.g., hips, heels, tail bones and shoulders.

Patients with low mobility and those who are comatose or otherwise unresponsive and who need assistance to shift their weight run into trouble when the blood flow gets blocked to the aforementioned areas.

Their skin breaks down and the tissue necrotizes. This can happen incredibly fast — over a single nursing shift, in some cases. This is why it's so vital that nurses and aides initially and regularly thereafter visually and manually assess and evaluate the residents' skin conditions during each daily shift.

Patients who are incontinent are at enhanced risk of skin infections in the genitourinary areas, so care must be taken to ensure that patients are changed and cleaned thoroughly after urination and bowel movements.

If neglect is a factor

While a single, well-treated bedsore may not be a reliable indicator of nursing home neglect, it could be part of an overall pattern of substandard care for your loved one. Monitoring the situation closely can help alert you to whether it is time to take legal action to protect a vulnerable patient from neglect and/or abuse.

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