Nursing Home Cases in Michigan: How do Bed Sores cause death?

Nursing Home Cases in Michigan:  How do Bed Sores cause death?

Why is it that one of the major problems occurring in nursing home is the decubitus ulcer, otherwise known as bed sore, or pressure sore.  It is something that wouldn’t occur to most of us in our day to day lives.  The old and elderly are at risk for this for a number of reasons including thinner skin, less ability to get around and move, less or no ability to get out of bed, or turn themselves over, incontinence ( urine can have a very corrosive effect), dehydration, etc….

The problem is compounded when the nursing home, rehabilitation facility, assisted living facility nursing staff or aids are not vigilant in following directions of the physician orders and don’t turn the resident, don’t document, wrongfully document, etc… The residents are cared for  by the nursing staff.  The physician is not there 24/7 generally.  The beginning of the bed sore may go undocumented.  The admission assessment may not identify the risk areas.  Because of poor documentation the sore may be allowed to grow, to fester in urine or feces, and interventions occur too late or not at all.

Bacteria can grow in the poorly, or untreated pressure bed sore.  It may be allowed to become an infection.  It begins as bacteremia.  Microorganisms naturally live on our skin, and everywhere, on the sheets, the hands of the aids, etc…  For healthy people this is of no moment.  However, the bed sore allows the microorganism to invade the person’s cells. After this invasion, the microorganisms must multiply to become infection.  The bedsore is a fertile ground for this multiplication.

Bacteremia is when the bacteria enters the blood stream thru the vessels exposed by the sore.  In a healthy person, the white blood cells of the blood can attack and kill the bacteremia.  However, when the bacteremia overwhelms the bloods defenses, and the INFECTION CALLED SEPSIS DEVELOPS. 

Sepsis is problematic in people whose immune systems are weak, such as the elderly.  Sepsis can lead to septic shock and death.   Be on guard for obvious signs of infection in the bed sore, high fever, etc… Sepsis is very serious and the risk of death very high.  That is why the assessment of risk to the  patient, and proper turning, and monitoring is so very important.  Prevention is key. Negligence in the assessment of risk, the recognition and documentation of the skin integrity  and developing bed sore, can lead to infection, sepsis, septic shock, organ shut down and death.




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