Proper initial assessment, follow-up and treatment of pressure sores (a.k.a. “bed sores” or “decubitus ulcers”) is critical in the nursing home environment. First, the proper “stage” should be noted at assessment:


Generally, pressure sores can be classified into four (4) “stages” as noted in this picture or “unstageable” (although “unstageable” can be questionable if there is an improper assessment).

Stage III and Stage IV pressure sores are clearly the worst and can result in “debridement” or surgical repair. Depending upon a physician’s recommendation, the surgery can go deeper or be minimally invasive. The U.S. Department of Health & Human Services describes the various treatments (at length) in its “Pressure ulcer prevention and treatment protocol” guideline which can be found here.

Bottom line, pressure sores should not even develop, much less attain a “Stage III” or “Stage IV” rating. Simple care, turning and positioning can be powerful means to avoid them altogether. Make sure your loved one has been given a proper skin assessment immediately upon admission to a nursing home, that there is follow up assessments (as in plural) and that you constantly ask your loved one if any areas of their skin are sore – especially the heels, hips, tailbone (coccyx), and back of their head. Look yourself and ask questions of the staff. Get involved.

If you find any bed sore on your loved one, take immediate action so it does not get worse and demand answers. Then contact a lawyer to assess whether there can be legal action taken. Nursing homes need to understand that they cannot simply collect their fees, ignore their responsibilities to residents and – worst – allow your loved one to unnecessarily suffer.

You can contact me here 24/7/365 (and I really mean that as I will answer my phone) if you have any questions and to learn how I may be able to help you or your loved one who may desire to discuss these difficult and sensitive nursing home care matters – in particular, you will find that I listen, take your phone calls and e-mails (and even text messages–BUT NOT WHILE DRIVING!!). I would be honored to help you with your matters – large or small.

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