How Bedsores Are Missed, and What Senior Care Facilities Can Do

How can something as serious and life-threatening as bedsores be overlooked by trained professionals? Well, as it turns out, it’s pretty easy. By understanding how bed sores get overlooked, senior care facilities can take steps to protect the residents while also reducing their liability exposures.

Bedsores Are a Serious Threat

Bedsores, also called pressure sores or pressure ulcers, can impact people with mobility issues, for example, when people are restricted to a bed or wheelchair and don’t change positions frequently. Johns Hopkins Medicine says that people who have chronic illnesses such as diabetes, are undernourished, smoke, or have fragile skin are particularly susceptible. Bed sores typically start as red, blue, or purplish patches that don’t turn white when touched and that can turn into blisters or open sores and become infected.

Lawsuits involving bedsores are common. In one case, AboutLawsuits says a Florida assisted living facility received a $12.5 million verdict in a wrongful death lawsuit involving allegations that the facility was negligent in the care given to a resident with Alzheimer’s, resulting in a bedsore and fatal bloodstream infection.

Two Common Ways Bed Sores Are Overlooked: Resistance and Refusal

Because of the risk to residents and the potential for litigation, assisted living care providers are highly motivated to watch for bedsores. However, in practical everyday situations, they often get missed. In fact, even with a fully staffed and trained team, you might not notice a bedsore until it’s too late. Often these scenarios involve patient resistance or inspection refusal.

Here’s one example of how it happens.

A resident with mobility issues and symptoms of dementia is incontinent and combative. She needs help with staying clean and showering, but she is highly resistant. Two staff members are needed just to get her into the shower. One person holds and supports her while trying to ensure she doesn’t fall – an extremely challenging task – both because she is struggling to get out and because everything is wet and slippery. The other staff member is washing her while being mindful of the resident’s privacy and dignity during this difficult process.

Later, they learned that the resident had a bed sore forming. Unfortunately, they didn’t see it because they were preoccupied with the immediate task of getting the resident safely showered.

In other scenarios, the resident may not be showing signs of dementia. While this means the resident may not be as combative, it also means the resident may refuse to be inspected. It’s not a process that many people find dignified, even if it is necessary.

How Can Senior Care Facilities Protect Their Residents and Their Business?

In ideal situations, bedsores would not be overlooked, but the reality is that situations often aren’t ideal, frequently for reasons that are out of the control of the facility and its staff.

What can facility operators do?

1. Train all workers on how to identify and respond to bedsores. New workers need training on what to look for and who is at risk, and veteran workers may need occasional refreshers. The goal is to spot bedsores before they develop into a serious health hazard.
2. Document your training. When it comes to liability, attorneys will argue that if it wasn’t documented, it didn’t happen.
3. Make attempts to check at-risk residents for bedsores. It isn’t always easy, especially when residents are combative or outright refuse, but your staff needs to continue to make the effort.
4. Document all attempts to check for bedsores. This needs to include failed attempts! Imagine a scenario in which your staff tries to check for bedsores, but the resident either refuses or resists, making it impossible. When a bedsore develops and the resident becomes seriously ill, your facility is blamed. Your staff members insist that they did everything they could, but the resident is unresponsive, and there’s no way to verify the facts. To avoid scenarios like this, write down every single time you offer and every time the patient refuses an inspection.

There’s one more thing that senior care facilities can do to control their risks: secure adequate insurance coverage. If you’re faced with a lawsuit, insurance coverage can help you with your defense as well as any settlements or judgments. Check your policy for restrictions, exclusions, and limits to verify that you have sufficient coverage for lawsuits involving bedsores.

Do you have the residential care home insurance you need to protect your facility against business income loss? Tangram provides residential care facility insurance through the Personal Care & Assisted Living Insurance Center (PCALIC). Learn more.