Pressure sores can have devastating health consequences for anyone, especially the elderly in skilled nursing facilities or residential care facilities for the elderly. Pressure sores are also known as bed sores, decubitus ulcers, and pressure ulcers. They are caused by prolonged pressure on certain areas of the body. If the pressure is not relieved, bed sores will develop. These wounds allow infection to enter the body, which can cause even more harm. Pressure sores develop when the cells in a particular area die. They die because the pressure placed on the particular area does not allow oxygen to reach the cells.
The Four Stages of Bed Sores
Bed sores are classified into stages from least severe to the most severe- Stage I, Stage II, Stage III, and Stage IV. The stages are based upon the appearance of the wound, as well as its depth and width. Certain pressure sores are “unstageable” because the nurse or other health care provider measuring the wounds cannot accurately assess the sore. This can occur when the wound is infected or when necrotic (dead) tissue obscures the health care provider’s view of the wound.
A terrific resource used by most professional health care providers is the National Pressure Ulcer Advisory Panel (found at npuap.org).
The NPUAP defines the stages of bed sores as follows:
Stage I – intact skin with non-blanchable redness of a localized area usually over a bony prominence. Stage 1 bedsores are not open wounds.
Stage II – partial thickness loss of dermis presenting as a shallow open ulcer with a red pink wound bed, without slough (dead tissue). Stage 2 bedsores are open wounds that present as shallow craters in the skin.
Stage III – full thickness tissue loss. With stage 3 bedsores, subcutaneous fat may be visible, but not bone, tendon or muscle.
Stage IV – the most severe. With stage 4 bedsores, there is full thickness tissue loss with exposed bone, tendon, or muscle. This causes damage to the deeper tissues and joints.
What Causes Bed Sores?
Prolonged, unrelieved pressure is the most common cause of a bed sore. The areas of the body most susceptible to bed sores are bony prominences like heels, the lower back, rear end, and the back of the head. When you sit in chair and you shift your weight because you’re uncomfortable, you are relieving pressure.
The elderly, who are often bed-ridden and unable to move, many times cannot shift their weight on their own. They require someone to assist them with pressure relief. Pressure sores can also occur when someone is allowed to sit in a wheelchair or chair for long periods of time. A common rule of thumb is that a person must be turned and repositioned every two hours. Otherwise tissue death can occur and bed sores will develop.
Poor nutrition is another risk factor. The skin requires protein, vitamins, and minerals to survive and remain healthy. Too little of these nutrients and the skin will become weak and susceptible to wounds.
Incontinence and moisture are also risk factors. Moist skin can break down more easily. Once an open wound develops, the person is at a much higher risk of infection. This is because human waste can contaminate the wound with bacteria and other harmful materials. An open wound must be kept clean and dry to heal.
Friction & Shearing
Friction can cause pressure sores. This is caused when an elderly person is dragged across a surface like a bed. Friction combined with moist skin can be dangerous in the elderly.
Shearing is another risk factor. This occurs when two surfaces move in the opposite direction. As an example, when a hospital bed is elevated, a person can slide down the bed. As the tail bone moves down, the skin over the tail bone may remain in place. This can cause damage to tissue and blood vessels supplying the skin.
For More Information, Call Attorney Travis Siegel
Pressure sores are avoidable with proper care and attention. To learn how you can help prevent this painful condition, read Pressure Sores: The Basics (Part 2). If your loved one has already developed bed sores, you may be able to hold negligent caregivers accountable. Contact Long Beach elder abuse attorney Travis Siegel today to discuss your legal options in a free consultation. Our law firm is equipped to fight for the proper care and compensation of your loved one.