BEDSORES: A VERY REAL INJURY
One of the most publicized areas of nursing home neglect involves the development of Decubitus Ulcers, more commonly referred to as pressure sores, or bedsores. The association of nursing homes with bedsores is so common that one would think bedsores only occur in a nursing home setting. That is not the case. Bedsores frequently occur in hospitals, after a serious operation requiring hospital stay. While the operation and post-operative medical care may have been excellent, patients confined to bed and can quickly develop bedsores if the nursing staff fails to turn the patients with sufficient frequency from one side to the other.
This failure to turn allows the pressure from lying in place or sitting too long on a wheelchair to cut off circulation to what the Mayo Clinic refers to as vulnerable body areas, such as the buttocks, hips and heels. Without adequate blood flow, the affected tissue dies.
Once a bedsore has developed, it should be treated rapidly or it may well progress from a superficial stage (Stage 1 bedsore) characterized as an itchy or slightly painful area of red skin to a more serious condition in which the wound becomes an open sore. This Stage 2 bedsore looks like a blister or abrasion but is still susceptible to quick healing if the treatment is prompt.
In a well-staffed and efficient hospital, the early stage bedsores will be recognized and treated effectively. However, in the absence of early intervention, “early stage” bedsores may well worsen when the patient is discharged to his or her home or to a rehabilitation facility, or even back to a nursing home.
This allusion to rehabilitation facilities points to another locus within our health system where: 1) bedsores can either originate; or 2) pre-existing bedsores from the patient's hospital stay can worsen. Without proper treatment, relatively minor Stage 1 and Stage 2 bedsores can worsen into crater-like wounds below the skin (Stage 3) and even deteriorate further into Stage 4 bedsores. Stage 4 bedsores involve a large scale loss of skin along with the possibilities of muscle, bone, tendon or joint damage. These wounds are particularly difficult to treat and can lead to infection and even death.
Since bedsores ranging from the early stages to the more serious ones occur in hospitals and rehabilitation facilities, as well as in nursing homes, why – it could be asked – is so much of the glare of publicity, and so much of the litigation focused on bedsores arising from nursing home neglect?
One answer may be that a large share of the nursing home resident population is composed of elderly people who may have been moved to such facilities by well meaning family members simply because they are too old, too enfeebled, or too lacking in cognition to be cared for at home. In a nursing home setting, many of the residents are what Mark Twain might have called “Innocents Abroad.” They need a lot of skilled care and are too often no longer sufficiently mentally acute to demand help or to verbalize their discomfort and/or pain. What makes this problem even more serious is that the resident’s close family member(s) may not have the awareness of the painful consequences that can spring from neglect in a nursing home environment. Nor may family members have the opportunity to visit frequently enough due to a variety of reasons such as geographical separation, work obligations, and/or other family obligations (such as small children ) to be able to ask the right questions and demand the answers they are entitled to under various Nursing Home Bills of Rights enacted by most states, including Florida.
Let’s take a bedsore situation. A daughter, perhaps in her forties or fifties learns after a number of visits that her mother, in her seventies and in an early stage of dementia, has developed a bedsore. The daughter complains to nursing home management and demands steps be taken right away to cure the bedsore, perhaps requiring visits from a wound care specialist. Suppose that either the steps are not taken or, even if taken, are only successful after weeks or months of pain and suffering. The daughter may consider contacting a nursing home neglect and abuse attorney to discuss possible legal action.
In our initial blog on this topic we noted that the lawyer cannot erase the pain and suffering of the resident or assuage the family member’s emotional distress (and possible feelings of remorse). The lawyer can only seek monetary redress, but as inadequate as that may be, it is the only remedy our society can provide under the circumstances.
Moreover, this fact must be balanced with fact that such “litigation” remedial action is not usually swift. Knowing this, the nursing home company and/or its insurer frequently tend to put up prolonged battles before a jury verdict or a pre-trial settlement. Moreover, even if the bedsore-afflicted victim dies before the conclusion of the legal action against the negligent nursing home, the nursing home abuse case does not die with him/her, as it would in the case of, say an elderly plaintiff injured in a slip and fall accident. Here, the family members of the bedsore victim (now decedent) would, with the attorney’s guidance, set up an estate, which could be entitled to recover for the pain and suffering of the decedent and for the emotional distress of the family members.
We should add that sometimes the medical outcomes for bedsore victims are brighter. Most of the time the bedsores victim survives and the bedsores eventually heal due to proper medical treatment. The victim and the victim’s family member(s) acting through competent counsel may nevertheless still be monetarily compensated through settlement at or before mediation or by a jury verdict. Thus at least some satisfaction can be achieved through legal action.
It should also be noted that though this blog and the previous blog have at least touched on the rights of the family member(s) to complain and try to rectify a typical nursing home neglect situation without the help of an attorney, such an effort is not a pre-requisite to seeking redress through a lawyer’s demands and suit, if necessary. Even if family members have learned of the plight of the resident too late to bring a satisfactory end to the suffering entailed in, say, a Stage IV bedsore situation, they can still “fight for” the legal rights of the resident.
Lastly – for now- we have addressed the bedsore situation with the perspective of family members in mind. But some of you reading this blog may be current or former bedsore victims who are hardly ancient and are fully mentally capable of making your own decisions concerning possible legal action. Even if your bedsore(s) have entirely healed, if you suffered from them through neglect in any institutional setting, such as a hospital, rehabilitation center, assisted living facility, and/or nursing home, you might consider having a nursing home abuse and negligence attorney go over the facts of your case to determine if you have a cause of action before the appropriate statute of limitation runs out.
