Nursing Home Abuse and Neglect Blog

A jury in Santa Ana awarded the family of Mary Adams $2 million after the 104-year-old was neglected in a Laguna Hills nursing home. The jury awarded $1 million for the Villa Valencia Health Care's negligence, and another $1 million in punitive damages.

Juror Rory Paster, a 41-year-old engineering analyst who lives in Huntington Beach, said the jury wanted to "send a message that the company should do a better job of treating patients."

According to reports, Adams admitted herself into the nursing home after suffering a fractured leg. Shortly after admission, Adams developed pressure sores on her heels, which were ignored, and not adequately treated. As a result, she contracted sepsis, and died about two months after her admission.

Attorneys for the family alleged neglect and wrongful death, including allegations that the facility’s owner, Sunrise Senior Living, purposely understaffed the facility in an effort to increase profits.

Posted by Walton Barber | Permalink | Email This Post

Posted In: Bed Sores , Decubitus Ulcer , Nursing Home Abuse and Neglect , Orange County Nursing Home

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Studies show that almost 50% of California nursing homes do not meet federal standards in preventing pressure ulcers. The problems are so widespread that the treatment of these ulcers – also called bed sores - will no longer be covered by Medicare if the sore was acquired after admission into a nursing home.

Family members should be aware that a bed sore can develop in only a few hours if an area of the skin is subjected to enough pressure that cuts off blood flow to that area. The skin will initially appear red and will be painful, slowing appearing to have a purple color. This is the best time prevent the sore from advancing to something more serious.

Nursing home and assisted living residents are at high risk for developing pressure ulcers, and those residents that are bedridden, wheelchair bound, or those will limited mobility must be examined frequently for the development of bedsores. A small bedsore can quickly become a large sore if treatment is not promptly provided.

Studies show that the best way to prevent these sores is a multidisciplinary approach, where all departments of the nursing home are involved in the prevention and care of bedsores, including departments such as laundry and maintenance. If you are responsible for a resident of a nursing facility, insist that the staff check frequently for the early stages of pressure sores, particularly the areas of the lower back and coccyx, and on the heels.

For more information about bedsore prevention and treatment, visit the Mayo Clinics website on the topic here.

Posted by Randall Walton | Permalink | Email This Post

Posted In: Bed Sores , Decubitus Ulcer , Nursing Home Abuse and Neglect

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When there is sustained pressure in an area of skin that cuts off circulation to that area, the skin will start to breakdown creating what is common called a bedsore or pressure ulcer. If you've never seen one, consider yourself lucky. Not properly cared for, these sores and develop into wounds so deep that muscle and bone can sometimes be exposed.

It has been reported that two million Americans experienced pressure ulcers every year, usually the result of a combination of poor nutrition, dehydration, and immobility. Recent studies, however, suggest that fighting bedsores requires a team approach, enlisting not just the bedside caregivers, but many other nursing home employees.

A study by the Journal of the American Geriatrics Society involving 52 nursing homes around the United States reported a reduction of almost 70% of serious bedsores acquired in the facilities after utilizing a team approach to the prevention and treatment of sores.

“Preventing pressure ulcers is a 24/7/365 kind of job,” said Jeff West, a clinical reviewer at Qualis Health in Seattle, who helped to set up the collaborative in 2003. “It’s not as if one person can get it all done. And if it fails just a little bit, just during the weekends, for instance, you’re not going to get the results. It takes tremendous consistency.”

For example, laundry workers can help make sure clothes fit properly, kitchen staff can ensure proper nutrition, even the beauty parlor can help by assessing the risk of the customer and making sure a resident doesn't sit on one place for too long.

Bedsores should be rare events in nursing homes. While the development of these sores can not always be blamed on inadequate care, it is rarely the case that a State III or IV pressure ulcer could not have been prevented with proper attention and care.

Posted by Randall Walton | Permalink | Email This Post

Posted In: Bed Sores , Decubitus Ulcer , Nursing Home Abuse and Neglect

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The National Pressure Advisory Panel updated its definition of the four “stages” used to diagnose pressure ulcers or decubitus ulcers (often referred to as bed sores). It also added two new stages on deep-tissue injury and ulcers that cannot be staged. The updated stages of pressure ulcers were released at the conclusion of its 2007 annual conference held in San Antonio, Texas.

A pressure ulcer or bed sore is a localized injury to the skin and/or underlying tissue, usually over a bony prominence as a result of pressure, or pressure in combination with shear and/or friction. In elderly or disabled patients, sores can begin on the skin of the tailbone, back, buttocks, heels, back of the head, or elbows. Poor nutrition or dehydration can weaken the skin and make it more vulnerable.

The new staging definitions are as follows:

Stage I. Intact skin with non-blanchable redness of a localized area usually over a bony prominence. Darkly pigmented skin may not have visible blanching; its color may differ from the surrounding area.

Stage II. Partial thickness loss of dermis presenting as a shallow open ulcer with a red pink wound bed, without slough. May also present as an intact or open/ruptured serum-filled blister.

Stage III. Full thickness tissue loss. Subcutaneous fat may be visible but bone, tendon or muscle is not exposed. Slough may be present but does not obscure the depth of tissue loss. May include undermining and tunneling.

Stage IV. Full thickness tissue loss with exposed bone, tendon or muscle. Slough or eschar may be present on some parts of the wound bed. Often include undermining and tunneling.

Unstageable. Full thickness tissue loss in which the base of the ulcer is covered by slough (yellow, tan, gray, green or brown) and/or eschar (tan, brown or black) in the wound bed.

There is rarely a legitimate explanation for a pressure ulcer to reach the level of a Stage IV in hospital, nursing home, or assisted living setting. Any skin wound progressing to Stages III or IV should be viewed with a critical eye, and a physician should be involved in the care immediately. The development of pressure ulcers in the custodial care setting is one of the leading causes of lawsuits against nursing homes in the United States, and have been the subject of several lawsuits brought by the attorneys at Walton Barber.

Posted by Randall Walton | Permalink | Email This Post

Posted In: Bed Sores , Decubitus Ulcer , Elder Abuse , Nursing Home Abuse and Neglect

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The Centers for Medicare and Medicaid Services announced last month that, it will no longer reimburse hospitals for treating eight "reasonably preventable" conditions as of October 2008 the Wall Street Journal reports. Pressure ulcers are among the most prevalent, costly and dangerous on the list. In addition to interfering with recovery, lengthening hospital stays and causing extreme pain and discomfort, pressure ulcers can increase the risk of infection, with nearly 60,000 deaths annually from hospital-acquired pressure ulcers.

Nursing homes and long-term-care facilities have made strides of their own in prevention, motivated in part by the costs of lawsuits for failure to prevent bed sores. Prevention methods can include using ultrasound to identify skin breakdown before a pressure sore forms, special pressure reducing mattresses and ensuring that residents are turned at least every two hours.

Despite the availability of these, and other, prevention techniques, nursing homes have long failed to do much to prevent pressure ulcers as they had no real incentive to do so (other than the fear of lawsuits). Most commonly, nursing homes save money by not having enough staff on hand to ensure that residents receive the treatments required. They are then “rewarded” for this behavior by Medicare paying them extra money per patient to treat the decubitus ulcers. As of October of 2008, nursing homes will instead have to “pay” to treat pressure ulcers which they cause. Hopefully this disincentive will result in better care for all nursing home residents.

Posted by Randall Walton | Permalink | Email This Post

Posted In: Bed Sores , Decubitus Ulcer , Elder Abuse , Nursing Home Abuse and Neglect

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An elderly woman developed a large bed sore while residing in a residential care facility. Because of inadequate treatment, the skin wound worsened and the elderly resident died only 10 days after being sent to a hospital for proper wound care. Walton Barber represents the woman's family in prosecuting the assisted living facility for failure to provide adequate wound care and treatment.

Posted by Randall Walton | Permalink | Email This Post

Posted In: Bed Sores , Decubitus Ulcer , Elder Abuse , Nursing Home Abuse and Neglect

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