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Jonathan Rosenfeld

March 2, 2023

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Pressure ulcer prevention is among nursing homes’ most essential duties. Failure to prevent pressure sores can result in devastating injuries for those at risk.

The personal injury attorneys Rosenfeld Injury Lawyers LLC can help you understand your legal options should your loved one have developed pressure sores as a result of a nursing home’s failure to prevent them. 

Are Pressure Ulcers Preventable?

Pressure ulcers in a nursing home setting are entirely preventable. Nursing homes can and should assess and manage pressure ulcer risk to keep the resident from developing bed sores. If the resident does develop pressure ulcers, nursing home staff should care for them in a way that keeps them from becoming infected.

Pressure Ulcer Prevention in Nursing Homes

Nursing homes that fail to prevent pressure ulcers are failing to live up to the duty of care that they owe to their residents. A nursing home must have a pressure ulcer prevention plan in place and implement all parts of it.

Here are some things that nursing homes should do to abide by the duty of care that they owe to their residents.

Frequent Repositioning

Remaining in one position for too long exposes the bony areas of the body to continuous pressure that results in ulcers. Part of the pressure ulcer prevention plan is that staff should change the resident’s position and relieve pressure frequently, so the same parts of their body are not continuously in contact with a hard surface.

Some plans require that staff members reposition the resident as often as every 15 minutes. Nursing homes that are short-staffed do not follow these plans and leave residents in the same position for an extended period of time.

Comprehensive Skin Assessment

Nursing home staff must conduct a comprehensive skin assessment to check for pressure ulcers and other skin abnormalities. Staff should pay close attention to areas that may be prone to pressure ulcers, such as the shoulder blades, heels, and other protruding areas.

They should perform these comprehensive assessments more often for residents who have a high risk of developing pressure sores or who already have them.

The five parameters of comprehensive skin assessment are:

  • Temperature
  • Turgor (firmness)
  • Color
  • Moisture level
  • Skin integrity

Recent trends in nursing home care research suggest that staff should perform a comprehensive skin assessment every 24 hours.

Maintaining Good Hygiene

Proper hygiene can prevent pressure sores. The risk of developing them increases if the skin isn’t clean, so staff should carefully monitor bath time to ensure no parts are missed. Caregivers should pay particular attention to armpits, groin folds, and other sensitive spots that may become irritated or inflamed.

Keeping Risk Areas Dry

Excess skin moisture is another contributing factor to developing pressure sores and skin breakdown. Keeping vulnerable areas of the skin that are at high pressure ulcer risk dry after cleaning them is essential.

Nutrition and Hydration

Proper nutrition and regular fluid intake are essential aspects of preventing pressure ulcers. To prevent malnutrition and dehydration, nursing homes must ensure a balanced diet in accordance with residents’ dietary needs.

Risk Factor Management

Nursing homes must perform a risk assessment on each patient based on their individual medical situation. If the patient has a medical condition that causes them to be immobile, such as dementia or weakened limbs, the nursing home needs a special plan to prevent pressure ulcers that staff must follow at all times.

Using Special Aids

Part of the plan to prevent pressure ulcers involves equipment that can relieve pressure on the parts of the body that may be at risk. One piece of equipment that a nursing home should use is a bed that allows for reduced air pressure to have more “give” and exert less pressure on the resident. Nursing homes may also use memory foam to reduce pressure.

Why Is It So Common for Patients to Develop Decubitus Ulcers in Long-Term Care Facilities?

When a nursing home resident develops wounds caused by sores, it might be due to nursing home neglect. Nursing facility neglect occurs when a nursing home and its personnel fail to provide adequate care, resulting in significant pressure injuries for a patient.

Pressure Ulcer Causes

Sustained pressure on a certain part of the body will cause blood flow restrictions. The human body needs blood supply to all parts as it carries oxygen, which is essential in keeping tissues alive.

Restricted blood supply is typically a result of the following:


Prolonged pressure between the bone and the surface of a bed, chair, or wheelchair may occur while lying or sitting for a lengthy period. Blood flow is reduced or halted due to this, depriving the skin’s tissue of oxygen and other nutrients.

An elderly resident who requires assistance with daily activities, such as bathing and incontinence care, may sit or lie in one position for an extended period, especially if nursing home workers do not check on them often. However, this might put too much strain on one area of the body and cause a decubitus ulcer.


Shearing occurs due to the movement or rubbing against two surfaces (bedsheets, support surfaces, or mattresses). When a nursing home resident’s skin moves one way while their bones move in another, shear may cause injury to their skin.

Shear may occur in nursing facilities when:

  • Moving residents onto their sides to prevent bedsores may cause the skin on the back to move, leading to personal injury.
  • Residents sleep on their sides, causing the skin on one body area to move.
  • Residents are not turned over often enough.

Shear can be avoided by placing nursing home patients’ heads at a 30-degree angle (or lower). In addition, residents should be lifted rather than dragged.


Bedsores caused by friction are common among nursing home residents, who are more susceptible to skin damage owing to their age.

The skin’s surface is rubbed against an object or other surface, such as carpeting. For example, friction can occur when a person slides out of their chair and drags their buttocks along the ground. When residents are moved between surfaces (from a bed to a wheelchair), friction may also happen.

In addition to these traditional methods, nursing home employees may use a variety of creative approaches to decrease friction. For example:

  • Placing strips of material, such as foam or cloth, underneath the resident’s skin to provide padding.
  • Use special linens that can be removed and washed often. These might include T-shirt sheets made specifically for patients who use catheters.
  • Keeping the skin clean and dry to avoid excess moisture
  • Caring for patients in a prone position whenever possible, like positioning them on their stomachs. This position reduces friction because it limits movement compared to turning the patients onto their sides.
  • Offering patients frequent sponge baths. These might be more effective and inflict less discomfort than simply wiping with a towel after each use.

Other common causes for developing pressure ulcers include:

  • Skin breakdown from urinary and fecal incontinence.
  • Radiation burns from repeated exposure to radiation.
  • Frostbite from a lack of circulation.
  • Contact Dermatitis from a chemical irritant on the bedsheets, such as bleach or an iron-on patch.
  • Water beds and over-washing of linen can cause dermatitis.
  • Heat rash caused by moisture buildup around the patient’s skin.
  • Blisters caused by friction from wheelchair, bed linens, or clothing

Pressure Sore Risk Factors

Limited Mobility

Restricted mobility is the most common risk factor for bedsores. Pressure sores are significant issues caused by excessive pressure, friction, and shear if an older person has difficulty moving around independently.


The elderly and children are more likely to develop bedsores.

An older person can have difficulties with bladder function, which may result in being incontinent with urine. It can lead to bedsores around the hips, tailbone, shoulders, and ankles.

Disease or Personal Injury

  • Diabetes: Chronic poor blood flow leads to a higher risk of developing pressure sores.
  • Cancer: Decreased immunity can result in sore development when wounds like radiation burns go untreated.
  • Skin Conditions: Eczema, psoriasis, or other chronic skin conditions place patients at very high risk for bedsores.
  • Spinal Cord Injury: Bedsores are the most common type of ulcer that people with spinal cord injuries get. It usually results in a lack of sensory perception.
  • Heart Disease: Poor circulation, high blood pressure, and respiratory disease can lead to bedsore development.
  • Multiple Sclerosis: Patients with this degenerative condition have decreased sensation in their skin, making them more susceptible to pressure injury during times of reduced mobility.

Poor Nutrition

The body needs proteins, vitamins, and minerals to heal properly. When a person isn’t getting enough of these nutrients, essential healing can be delayed or prevented altogether.

Vitamin C deficiency may lead to the development of bedsores. This is why some healthcare professionals recommend vitamin C supplements in conjunction with topical wound care products for pressure sore treatment.

Other Health Complications

Poor general health or a weakened immune system makes a person more susceptible to bedsores.

Mental impairment is a major factor for bedsores in nursing facilities. Nursing home staff members are required to make daily assessments to determine if a patient needs proper care because of their condition.

If the mental impairment is severe enough that they can’t recognize or communicate pain, then bedsores may develop without any obvious signs of skin damage.

To prevent common bedsore causes and risk factors, nursing home personnel should pay particular attention to at-risk patients. Caretakers should perform head-to-toe skin exams on individuals with mobility problems on a regular basis, as well as reposition them if ICU is necessary.

Nursing Home Failure to Prevent Bed Sores

If your loved one was injured by a pressure sore at a nursing home, your family may be entitled to financial compensation. You may file a nursing home abuse lawsuit against the nursing home. If you can prove that they were negligent, your family may qualify for financial compensation for what happened.

Damages in a Pressure Ulcer Lawsuit

Your family may be entitled to a variety of damages if you win a pressure ulcers lawsuit, or if you reach a settlement in your case.

Your damages may include:

  • Medical costs to treat your loved one’s injury
  • The pain and suffering that they endured
  • Loss of enjoyment of life

If your loved one died, your family may receive wrongful death damages that would compensate for what you lost when your family member passed away. You would still receive the damages listed above. In addition, you may be able to get punitive damages when a jury finds that the nursing home’s actions were egregious.

How a Nursing Pressure Ulcers Lawyer Can Help

It is not easy to beat a nursing home when you are acting on your own. They will always deny liability or try to stonewall you to protect themselves. You need an experienced nursing home neglect lawyer when the nursing home has failed at preventing pressure ulcers. They can do the following for your case:

  • Obtain your loved one’s medical records when the nursing home is making it difficult for you to get what is legally yours
  • Investigate what happened to your loved one and gather evidence that the nursing home was to blame for their injuries
  • Work with expert witnesses to establish that the nursing home’s lack of care constitutes negligence
  • Negotiate a settlement with the nursing home or try your case in front of a jury

Contact our Chicago bed sore attorneys today at 855-947-8723 for more information and get a free legal case review.

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