6. Bed Sores in Nursing Homes: The Ugly Side of Nursing Home Neglect
Deezer In this episode Jonathan Rosenfeld chats with Anthony C. Lanzone an Attorney at Lanzone Morgan LLP. Here, they discuss:
Bed Sores in Nursing HomesThey discuss 5 key issues:
1) What are bed sores? 2) What causes bed sores? 3) What should nursing home and other care facilities be doing to prevent bed sores? 4) What complications can arise with bed sores? 5) Can a family file a claim when a family member develops a bed sore?
Read the Transcript
Jonathan Rosenfeld:
Hello everybody. I am Jonathan Rosenfeld. And today on the Personal Injury podcast, I am joined by attorney Anthony Lanzone in California. And we are going to talk about one of the most prevalent types of nursing home abuse cases out there, bedsores. You can call them bedsores, you can call them pressure sores, you can call them decubitus ulcers but at the end of the day, they're all the same. And Anthony is really a leader when it comes to elder abuse cases in California. And frankly, I'm really happy that he's joined me today so we can talk about this issue. Anthony, thank you for joining me. I appreciate it.
Anthony Lanzone:
Jonathan. Thanks for having me.
Jonathan Rosenfeld:
Well, to begin with, I think a lot of times people who may have a family member in a nursing home they may get a call at some point, or they may be going through their loved one's medical records and they see a term on there. There's frankly, a lot of medical terms in these records but they may see a term, decubitus ulcer, or pressure sore, or pressure ulcer. And they may not really know what that is. To begin with, can you give us an explanation about what these are? What is a pressure sore?
Anthony Lanzone:
Yeah. Bedsore it's exactly what the name suggests. It's a sore that can develop on the skin. They primarily develop on bony prominences and you can get those from sitting at a chair for extended periods of time, laying in bed for extended periods of time without relieving the pressure to those areas. And obviously the older we get, the more prone we are to those types of injuries. And so, it's essentially an ulceration or a sore that develops when you're lying in bed or sitting in a wheelchair, for extended periods of time without relieving the pressure to the area.
Jonathan Rosenfeld:
And when we're talking about these bedsores, we're typically not talking about a situation where there may be a bruise or a scab or something? These bedsores can really amplify as they develop and they really can open and really form large wounds or craters, in the body. Correct?
Anthony Lanzone:
That is correct. Bedsores just the term sounds nonchalant. Just a bed store, it's no big deal. But the reality of those bedsores, you're right, they could be very significant things that could really harm somebody. The biggest organ in the body is the skin, right? And so when you develop a bedsore and if you don't take care of it, that could do some serious damage to the biggest organ in your body. And it creates a portal for infections and all types of problems.
Jonathan Rosenfeld:
Now, nursing homes know that many of their patients are susceptible to develop bedsores. This is not a new medical condition out there. This is something that people in nursing homes and hospitals and other long-term care facilities, have really suffered with for some time. What steps should a nursing home or other type of care facility be doing to help prevent these bedsores, from forming or developing in the first place?
Anthony Lanzone:
Well, there's a lot to that question, Jonathan. I think the first thing I'd like to point out is that, people are not supposed to be getting bedsores. A lot of times nursing homes will communicate to the families and say, "Oh, he's got a bedsore. Don't worry about it. It's no big deal." And they play these types of injuries down. But the obligation of the nursing homes by statute, I should say by federal regulation and the state regulations here in California, they require people that come into the facility without bedsores, that they don't get them unless they can show through the clinical record and the clinical things that they've done, that they've taken every step possible to prevent that bedsore. Now you can imagine that's a pretty steep burden but the reality of it is, is that the nursing homes are aware that people are prone to bedsores when they get there but they're just not doing enough, to try to prevent it.
Anthony Lanzone:
The only way to prevent these wounds is to relieve pressure to the area. And we're in the middle of a pandemic and everyone's like, "Oh God, the nursing homes they're heroes and they're fighting to take care of everybody in the nursing homes." But it just takes one good pandemic to show how poorly the nursing homes have done over the past decade, at least. I would say decade plus, on just typical infection control protocols. And that goes for the same with bedsores. They're just not doing enough. It has to do with staffing, not having enough people to make rounds to turn and reposition folks. It has to do with money. Nursing homes, the vast majority of them, are owned by big, large companies that want to make a bunch of money. And all those factors go into why nursing homes do a poor job of making sure that, people that come into the nursing homes and don't have bedsores that they leave with the bedsores.
Jonathan Rosenfeld:
Now, I think one of the things that I've seen and really continue to see is that, these bedsores don't develop overnight. These are wounds that well, you may have an early stage bedsore after a few days or something. But by the time of a wound has manifested into... And they grade these wounds based on a system to try to make them objective on one to four. But by the time a wound becomes a stage four bedsore, that's a situation where it's not one person who is doing a poor job tending to a patient. It's really an overall breakdown in the type of care that the patient's getting. And if you see a situation where a patient has a stage four bedsore, what, if anything, would you suggest that the family do at that point?
Anthony Lanzone:
Well, the most important thing is the victim, right? The patient. They got to get in touch with the doctor. They got to be proactive. They have to get involved in the care. And I don't know about you, Jonathan but my gut is usually a good thing to follow. If your gut's telling you that there's something wrong, then you're usually right. Now what to do about that, as I said, you got to get involved in the victim's care. And unfortunately, a lot of nursing homes don't do a very good job of communicating clearly with the family members. And you just have to do everything you can to advocate that this person gets the care that they need, through the personnel and the physicians that are responsible for taking care of the individual.
Jonathan Rosenfeld:
Now, when a wound gets to an advanced stage, sometimes the call in a wound care expert, or they'll send the patient out for a surgical debridement where they actually remove some of the dead tissue, to try to help the wound heal. I always tell people, tell families, "Hey, these are keyword words to hone in on. And if you hear those terms, it's probably a more severe wound than the facilities letting on." Obviously, you've come in contact with these cases on a fairly regular basis. Would you agree that those are things that families should be on the lookout for? And if they do hear those terms, or even see a gaping wound on their loved one that they really do need to take some action?
Anthony Lanzone:
100%. Absolutely. In fact, even just leaving the bedsores aside for a second, I would make the argument that you have to be an advocate. You can't just simply rely on the people in the white coats and the nursing home. Generally speaking, a lot of these bedsores and problems that the nursing homes have, they don't really necessarily have to do with the hands-on caregivers. These people are really doing God's work and the vast majority of them want to do a good job, and they want to prevent people from getting bedsores and all those things. But the problem is, is the way the system is set up, the way they're organized. The way that these companies squeeze every penny out of it, for corporate profit. There's just not enough people and they don't do enough training. And that's why the people get the bedsores.
Anthony Lanzone:
So, if you're ever in a nursing home or you have a loved one there, you have to be there. You have to be there every day, watching and asking questions and making sure that they're getting the care that they need and that they're not being harmed. So yeah, if you ever hear stage four bedsore, that is a red flag that things are not going well. Many, many years ago when I first got into this business, I went to this seminar or something along those lines where they were discussing the elder abuse issues. And there was this prominent woman at the time, who owned several nursing homes in Southern California and was also the administrator of those homes. And she stood up in front of this crowd and said, "No nursing home residents should ever get bedsores on their heels. Ever. If you ever see a bedsore on a heel, that is 100% avoidable because all you have to do is float the heels."
Anthony Lanzone:
That really stuck with me throughout my career because i