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The Rohrstaff Law Firm

The Rohrstaff Law Firm

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Pressure sores are easily preventable. They can cause severe injuries and death in the elderly, and Medicare has declared them "never events."

One of the most serious - and most easily preventable - conditions that elderly family members develop is the pressure sore (also called a pressure ulcer, bedsore, or decubitus ulcer). Aging itself does not cause pressure sores, but changes in skin as a person ages make pressure sores more likely to develop.

A pressure sore is an area of skin that breaks down when a person is in one position for too long and doesn't move around to shift the body's weight. The constant pressure of the body's weight against the skin reduces the blood supply to the affected area and the tissue dies.

The areas of the body most susceptible to pressure sores are buttocks, heels, and other parts of the body with bones close to the skin. It may start out as a reddened area of the skin (Stage I) but can develop into shallow skin loss, including blistering (Stage II), then an open sore with full-thickness skin-loss down to a layer of fat (Stage III) and ultimately a crater with full-thickness skin-loss exposing underlying muscle, tendon or bone (Stage IV). Pressure sores do not always progress through every stage, and the first sign may actually be a late-stage sore. If not treated properly, pressure sores can become infected and can become life threatening.

In late 2008, Medicare announced that it would no longer pay hospitals for additional care necessitated by "never events," including bed sores, that were "reasonably preventable" treatment errors. Medicare's decision not to pay hospitals for reasonably preventable treatment errors should give hospitals financial incentive to create and put into operation patient-safety measures to prevent bedsores.

Unfortunately, Medicare's policy does not apply to nursing homes or assisted living facilities, so nursing homes and assisted living facilities do not have the same financial incentive as hospitals to take extra precautions to prevent pressure sores. Medicare reimbursement is very important to any health care facility, so the fact that Medicare did not include nursing homes and assisted living facilities in its expanded definition of "never events" is disappointing.

When you visit a loved one in a nursing home or assisted living facility, find ways to look at their feet and shoulders and elbows and ask the nursing staff when the last time was that the resident's buttocks was examined for signs of a developing pressure sore. Preventing pressure sores LINK to article is very important because they can be very hard to heal once they have developed.
Sandra Rohrstaff
Virginia Child Injury and Elder Abuse Attorney