As soon as a person is spotted as a high-risk individual, certain measures have to be taken to reduce or eliminate the risk of him or her developing bedsores, pressure sores and decubitus ulcers.

It is imperative that the care provider, whether it is a nurse or a family member, is knowledgeable about these risk factors in order to be able to prevent the unnecessary and painful development of pressure sores, bedsores and decubitus ulcers.

The risk factors will vary according to the patient's specific circumstances; nevertheless, this is a list of the 5 most common risk factors:

Being confined to a bed, chair, or wheelchair:
Individuals who are confined to a bed, a chair, or a wheelchair, and who are not able to move by themselves, are at high risk of developing pressure sores extremely fast; in as little as a couple of hours, if the pressure is not relieved regularly.

Being unable to change positions without assistance:
Persons who are in a coma, who are paralyzed, and who are recovering from a hip fracture or other injury that limits mobility, are extremely prone to bed sores.

These patients must be moved consistently at regular intervals, and this is very difficult on caregivers, reason why it is imperative to get a pressure mattress to help both the patient and the caretaker.

Losing bowel or bladder control:
People who have to remain in bed for long periods of time or permanently and lose the capacity to control their bladder or bowels are in danger of getting bedsores because the continuous moisture on the skin due to urine, stool, or perspiration can irritate and weaken it.

Eating poorly, having an imbalanced diet and/or dehydration:
Pressure sores develop more easily when the body and skin of people who have lost most of their mobility are not adequately nurtured.

Losing mental awareness:
A person who is losing mental awareness may not have enough sensory perception or capacity to take action to prevent the development of pressure sores.

Many assisted living facilities however have special care units on premise that provide Alzheimer, Skilled Nursing and Rehabilitative and Hospice care services. Their residents have access to specialized, skilled nursing and other services such as physical therapy, occupational therapy, laboratory services, and use of other health-related equipment. These on premise units offer care for the less ambulatory residents and those with serious illnesses.

Bedsores owe their name to the observation that patients, who were bedridden and not properly repositioned, would often develop ulcerations or sores on their skin, typically over bony prominences.

Decubitus Ulcers are localized areas of tissue injury that develop when soft tissue is compressed between a bony prominence, (a hip for example) and an external surface for prolonged periods. The external surface may be a mattress, a chair or wheelchair, or even other parts of the body.

The soft tissues of the body, such as skin and muscle, depend upon blood vessels to carry nutrients to the tissues, and to remove waste products. Bedsores result when prolonged pressure prevents sufficient blood flow to supply the tissues with nutrients. The resulting bedsore represents the death of the involved soft tissues.

Bedsores, Pressure Sores;or decubitus ulcers:

Unexplained bruises or injuries Inappropriate use of restraints:

Failure to turn patients in bed or move them from wheelchairs, causingDecubitus ulcers, Pressure Sores or bedsores:

Slip and fall accidents due to staff inattention Malnutrition Dehydration:

Unexplained injury such as fracture Failure to use bedrails, resulting in falls Medication Errors

Needless to say, nursing home neglect is a dangerous situation that should be addressed as quickly as possible. Put your nursing home negligence case in the steady and caring hands of California Nursing Home Abuse and Neglect Attorney Steven C. Peck. The firm has years of experience with California Nursing Home Abuse and Neglect nursing home law. We also experienced in handling wrongful death actions against nursing homes.

Bedsores, Pressure Sores;or decubitus ulcers:

Unexplained bruises or injuries Inappropriate use of restraints:

Failure to turn patients in bed or move them from wheelchairs, causingDecubitus ulcers, Pressure Sores or bedsores:

Slip and fall accidents due to staff inattention Malnutrition Dehydration:

Unexplained injury such as fracture Failure to use bedrails, resulting in falls Medication Errors

Needless to say, nursing home neglect is a dangerous situation that should be addressed as quickly as possible. Put your nursing home negligence case in the steady and caring hands of California Nursing Home Abuse and Neglect Attorney Steven C. Peck. The firm has years of experience with California Nursing Home Abuse and Neglect nursing home law. We also experienced in handling wrongful death actions against nursing homes.

1) Bed sores. Decubitus ulcers, or bed sores, occur when a person if left lying in a fixed position for an extended period of time without proper movement. The pressure on the skin causes ulcers to form and, over time, these can turn into infected areas and ulcers that can be life threatening. Regular bathing and proper movement and repositioning can preven most bed sores.

2) Unusual bruises. If your loved one is incapicated or can't move without assistance, bruises are often associated with some sort of abuse. For those who can't care for themselves, it is important that their caretakers be trained in proper ways to move and carry the patient to preven falls or bruises.

3) Problems with medication. If you notice that your loved one is going through his or her medication too slowly or quickly, there may be a problem with the way medicaion is administered. Overmedication is sometimes a tactic used by nursing homes to keep the residents docile or immobile. Make sure to keep track of medication.

4) Sudden weight loss. If someone loses weight suddenly, it may be due to malnutrition or dehydration. Incapacitated persons may not be able to communicate their needs to you or their caretakers. Their caretakers, however, are paid to make sure that the residents are fed regularly and given fluids.

5) Unsanitary or unclean conditions. No matter a person's condition, he or she deserves to have basic needs taken care of including regular bathing and changing of sheets and clothes. If you notice foul odors coming from a resident's body, bed or room, it is likely that the nursing home has failed to provide adequate service.

Symptoms:

There are actually 4 levels of a bed sore based upon the level of severity. The levels happen to be formally indexed by the National Pressure Ulcer Advisory Panel. The phases are the following.

Level 1: The sore begins showing up as being a prolonged pink or reddish skin. It may itch or perhaps hurt, and also a touch on this area may well feel padded and warm.

Phase 2: Skin loss begins taking place - the external and also inner layers of the skin start getting lost - and also the pressure sores begin resembling blisters.

Level 3: The bed ulcer now will go deep directly into the tissues below the skin. A new hollow wound is clearly visible. By at this moment it really is quite painful.

Level 4: Chances are there may be destruction of underlying muscles as well as probable exposure of bones. The ulcer now is in very progressed stages.

Causes:

Bed sores develop from maintained pressure applied to a particular area of one's body. They're normally seen to occur a lot more above the portions having bones as well as cartilages. The principal factors behind these chronic wounds are the following.

Pressure: Sustained pressure put on some parts of the body is one of frequent cause of catching these ulcers. This particular occurs most often within instances where the patient is immobile. Good examples of immobility are fractures and paralyses, to name a few. The tissues under constant pressure get deprived of the desired levels of nutrients including oxygen. This leads to bed sores.

Friction: Friction happening often enough at given areas of one's body can potentially bring about these ulcerous wounds. Switching side-to-side constantly and skidding down the wheelchairs are some primary sources of harmful friction.

Prevention:

They say, prevention is better than cure. Your best option to safeguard yourself against decubitus ulcers is to protect yourself. Presently there are products specifically created for these purposes. The exact device to use depends upon the actual depth and stage of the ulcer, including its level of seriousness as well as position of the sore wound on the body. Generally, medical insurances cover the price of such devices - but it is best to double-check with your insurance provider before you commit.

Last but not least, disregarding bed ulcers can lead to severe complications. This includes but is not limited by cellulitis, sepsis, joint infections, bone issues and even cancer. Therefore it is critically essential that you take ample preventive measures in order to save yourself from bed sores.

Call us toll free at 1.866.999.9085 for a free no cost comprehensive evaluation of your case.. We are here to help you.

For example, people at risk for Bed Sores, Pressure Sores also known as Decubitus Ulcers says Van Nuys Nursing Home Abuse and Neglect Attorney Steven C. Peck include those with:

Incontinence problems - The dampness caused by incontinence can make the skin susceptible to damage
Illnesses, for example diabetes, motor dysfunction, immune deficiencies and nutritional disorders
Dementia, which can prevent people recognising discomfort and regularly moving their bodies in the normal way.
Those who are in a wheelchair, chair or bed for the majority of the time.

Identifying bed sores, pressure sores and Decubitus Ulcers:

The following symptoms are signs that someone may have a Bed Sore, Pressure sore, Decubitus Ulcers says Woodland Hills Elder Abuse Attorney Steven C. Peck or be at risk of developing one:

Is the skin discoloured? Look out for red or purple-coloured skin
Sometimes pressure ulcers can have a foul odour
The area is likely to be redder and warmer than the rest of the body
There will often be swelling
Ask the patient if the area is painful to the touch
Sometimes pressure sores ooze pus

Preventing pressure sores, bed sores and Decubitus Ulcers:

It's important to prevent bed sores as far as possible as they can deteriorate in condition and cause discomfort. Here are some tips on keeping pressure ulcers at bay:

The patient's position must be shifted regularly - a minimum of once every two hours or every hour for very frail individuals. Someone needs to be on hand to do this if they can't move themselves around.
Eating a healthy diet can help prevent pressure sores
The skin must be kept as clean and dry as possible. Although the skin should be moisturised to prevent dryness, it should never be wet to the touch.
Incontinence pads should be used if the patient is incontinent. They should be changed regularly.
If you're not a medical professional, consult a doctor or nurse if you think that pressure sores may be developing.
Use specially designed sheets, pillowcases, underwear and bootees which are designed to avoid friction and shear on the skin and tissue.

Treating pressure sores, bed sores and Decubitus Ulcers:

When you treat pressure sores, you want to avoid the ulcer becoming any worse.

Make sure pressure is relieved from pressure points at regular intervals - keep moving the patient every hour or so
Encourage the patient to keep pressure off vulnerable areas such as knees, elbows and hips.
Keep wounds clean and dry
Use non friction and anti-shear dressings so that there is no drag or rub on the wound

But two weeks into her stay in the nursing home, her health had deteriorated. She was rushed back to the hospital, where she died in 2008.

"If she had received proper care, she would still be alive today," says Encino Nursing Home and Abuse Attorney Steven C. Peck.

He sued El Dorado Care Facility and parent company Horizon West, which owns 27 nursing homes.

"She basically did not receive care. She was neglected, warehoused,"

Esco sued for elder abuse and wrongful death. The suit alleged the nursing home staff failed "to provide basic custodial and nursing care services, a failure to assess and treat her pain and a failure to prevent Mrs. Esco from developing a severe and life-threatening bowel impaction."

It also alleged that Horizon West "failed to staff El Dorado Care with sufficient numbers of trained and supervised caregivers."

In taped depositions, employees say they were understaffed.

Horizon West spokesman Dan Niccum would not comment on the Esco case, citing the Health Insurance Portability and Accountability Act and company patient privacy policies.

He did talk to KCRA 3 about overall patient care and staffing.

"It's our position that, in all instances, and it's our goal in every facility, that every resident receives appropriate and timely care," he said.

Niccum said since 2005, Horizon West has exceeded state minimum required staffing levels and is implementing quality improvement changes.

But Clement said her research shows Horizon West increased its acuity levels, accepting more of the sickest and most expensive Medicare patients, while at the same time, decreased the nursing staff qualified to care for them.

She said Horizon West puts profit above patient care.

"That is probably the most ridiculous statement that you could make about Horizon West," Niccum contended.

He said Horizon West has lost money in the past five years.

"I have a real issue with the portrayal of Horizon West as a greedy corporation, which it is not. Or B, being a corporation that doesn't care, because that is all we are about. We are a company that cares," Niccum said.

Esco and Horizon West settled the lawsuit out of court. They won't say for how much, but KCRA 3 is told the nursing home paid a significant amount of money to Esco.

The California Department of Public Health licenses and regulates 1,200 nursing homes statewide.

It also investigates complaints.

It released findings in the Esco case in April, finding El Dorado Care Center failed to consult with a physician and notify the patient's family when her condition worsened, failed to ensure prompt care and its staff failed to properly administer medications.

The public health department can cite and fine nursing homes; the most serious violations involving patient deaths draw fines up to $100,000.

In the Esco case, the state fined El Dorado Care Center $18,000.

"My wife's death was ruled unwarranted, but the facility was fined $18,000. That is ridiculous," Esco said.

The public health department issued a statement saying "The violations... while severe and likely to cause harm and possibly death to the patient, could not be isolated as the direct cause of death in this case."

It said it "levied the highest fine the law allowed."

Carole Herman, with Foundation Aiding the Elderly, is appealing the decision.

"She definitely died from the lack of care at this convalescent hospital, and the state did not give them the proper citation," Herman said.

Niccum said "the people who work in this facility today, are members of this community. They care about what goes on in this facility. They are in this industry because this is what they love to do."

KCRA 3 reviewed state records related to Horizon West's 27 nursing homes. In the past five years, the public health department has issued 195 citations, totaling $700,000 in fines.

Niccum said, as the largest skilled nursing provider in the Sacramento area, the numbers aren't surprising.

"Our entire team focus every day is on improving the quality of care we provide our residents," he said.

But advocates and Esco believe even one citation is too many.

Pictures of bed sores show that the abuse experienced in nursing homes is a severe problem, with some residents suffering such neglect that bed sores were not the only side effect. The nation has serious decisions to make in beginning to heal the vast problem of nursing home abuse and prevent instances of pictures of bed sores appearing in reports and articles. Nursing home abuse is one of the largest focuses that legislators must deal with since pictures of bed sores and other serious abuse effects have come into the spotlight.

On Tuesday, the Department of Managed Health Care took steps to bar a Folsom insurance agent from selling Medicare Advantage plans after she allegedly defrauded at least 12 capital-area seniors, who then incurred thousands of dollars in unexpected medical bills.

The agent, identified by state officials as Nadia King, allegedly canceled the existing Medicare coverage of her clients and enrolled them in Medicare Advantage plans run by private insurers.

King could not be reached for comment. She has until the end of the month to appeal the decision to revoke her privilege to sell Medicare Advantage products.

She is one of two dozen agents across the state getting legal scrutiny because of what officials said was deceptive marketing aimed at seniors.

Pauline Eckels, 98, of Citrus Heights was identified by the state as one of King's alleged victims.

Eckels, who has been on Medicare since 1977, recalls a day sometime before Christmas when King knocked on her door.

She said they spent about a half hour talking, and that she provided personal information to King during the conversation. "I already had insurance, but she said she was going to try and help me get cheaper insurance."

Eckels said she never authorized King to cancel her current plan. But to her surprise a week later, her pharmacist said her prescription coverage was no longer in effect.

She said she doesn't remember much of what was said during her talk with King. "Put yourself in the shoes of a 98-year-old," she said, adding that "It messed me up good."

Federal health officials have reached out to states to stamp out fraud and deception in the Medicare program.

"Every time there is a change in one of our programs, it always creates an opportunity to take advantage of someone who doesn't understand the change," said David Sayen, administrator for Medicare's San Francisco regional office.

As the national debate over health care legislation intensified, state and federal officials said they began seeing a marked increase in complaints from consumers about possible scams and insurance agents seeking to persuade seniors to change their Medicare coverage.

Confusion over changes to the country's health care system "opened up a floodgate of deceptive sales practices and fraudulent products," said Cindy Ehnes, director of the Department of Managed Health Care.

"Deceptive marketing is nothing new," she said. "Because of the recent rhetoric around health insurance, the lack of detail ... it has created a real opportunity for less-than-scrupulous operators who are out there."

State officials say scores of other seniors may have fallen victim to scams and unethical marketing ploys.

People who prey on vulnerable populations do so because they know their victims are less likely to contact authorities, said Michael McClelland, the chief of enforcement for the California Department of Managed Health Care.

The financial rewards for unscrupulous agents can quickly add up. Agents who enroll new customers in a Medicare Advantage plan typically receive commissions of $350 to $500, McClelland said.

In a traditional Medicare policy, the federal government acts as an enrollee's insurance company. Under Medicare Advantage, among the most powerful programs within Medicare, the federal government pays premiums to a private insurer to administer benefits.

According to the state's complaint, King enrolled her elderly clients into Medicare Advantage plans without their consent. She allegedly made misrepresentations while marketing the plans.

Six months later, Peske was charged with six felony counts of narcotics possession. But by that time, he had used a special "multistate" license to get a job as a traveling nurse at a hospital 1,200 miles away in New Bern, N.C.

"When I went to go for the job in North Carolina, I looked at the status of my license, and it was still active," says Peske, 36, who was later convicted of two felony drug charges. "That kind of surprised me, so I figured I would take it."

The ease of Peske's move illustrates significant gaps in regulatory efforts nationwide to keep nurses from avoiding the consequences of misconduct by hopping across state lines.

The two states in which Peske worked are part of a 24-state compact created to help get good nurses to areas where they are needed most. Under the decade-old partnership, a license obtained in a nurse's home state allows access to work in the other compact states.

But an investigation by the non-profit news organization ProPublica found that the pact also has allowed nurses with records of misconduct to put patients in jeopardy. In some cases, nurses have retained clean multistate licenses after at least one compact state had banned them. They have ignored their patients' needs, stolen their pain medication, forgotten crucial tests or missed changes in their condition, records show.
(Taken from USA Today Article)

Nursing home abuse can occur because of inadequate staffing, inexperienced staff, less training, negligent supervision and patient isolation. When the industry minimum standards for care are not met, interested parties can be held liable for damage caused by nursing home abuse and neglect says California Elder Abuse Attorney Steven C. Peck.