Bedsores in Nursing Homes: When Pressure Injuries Become Neglect

Pressure injuries, commonly known as bedsores or decubitus ulcers, are among the most common red flags for nursing home neglect and a frequent basis for claims under the Illinois Nursing Home Care Act. While not every bedsore automatically proves neglect, the development of serious pressure injuries in a care facility raises significant legal and medical questions. For families in Peoria and throughout Central Illinois, understanding how bedsores develop and when they cross the line into actionable neglect is critical for protecting a loved one’s rights.

How Bedsores Develop

Bedsores form when sustained pressure on the skin reduces blood flow to soft tissue. They most commonly develop on bony areas of the body such as the heels, tailbone, hips, elbows, and shoulder blades. Residents who are immobile, use wheelchairs, or are confined to bed are at the highest risk. Without regular repositioning, adequate nutrition, and proper skin care, pressure injuries can develop within hours and progress rapidly through increasingly severe stages.

Stages of Pressure Injuries

Medical professionals classify bedsores into four stages based on severity. Stage 1 involves reddened, unbroken skin that does not blanch when pressed. Stage 2 presents as an open wound or blister with partial-thickness skin loss. Stage 3 involves full-thickness tissue loss where fat may be visible, and Stage 4 is the most severe, with deep tissue damage that can expose muscle, tendon, or bone. Unstageable pressure injuries, where the wound bed is covered by dead tissue, and deep tissue injuries that start beneath the skin surface are also recognized categories.

Advanced-stage bedsores are painful, prone to infection, slow to heal, and can be life-threatening for elderly residents. Infections from Stage 3 and Stage 4 pressure injuries can lead to sepsis, osteomyelitis, and death. The presence of advanced bedsores in a nursing home resident is a serious warning sign that the facility may be failing to provide adequate care.

Why Bedsores Often Indicate Neglect

The medical community widely recognizes that most bedsores in nursing home settings are preventable with proper care. Standard prevention protocols include repositioning immobile residents at least every two hours, maintaining adequate nutrition and hydration, keeping skin clean and dry, using pressure-relieving mattresses and cushions, and conducting regular skin assessments.

When a nursing home fails to implement these basic preventive measures, the development of bedsores can constitute neglect under the Illinois Nursing Home Care Act. A facility’s failure to follow its own care plan for pressure injury prevention is particularly strong evidence of neglect. Understaffing is frequently the root cause, as overworked aides simply cannot reposition and monitor every at-risk resident on the required schedule.

Evidence in Bedsore Neglect Cases

Building a strong legal case around bedsore neglect requires specific types of evidence. Medical records showing the timeline of wound development, turning and repositioning logs, nutritional assessments, wound care documentation, and staffing records all play important roles. Photographs documenting the progression or severity of pressure injuries provide compelling visual evidence that can be difficult for facilities to dispute.

Expert medical testimony is often essential in these cases to establish that the bedsores resulted from inadequate care rather than unavoidable medical conditions. Understanding who is legally responsible for the neglect helps families identify all potential defendants, including the facility, its parent company, and any management organizations.

The Facility’s Common Defenses

Nursing homes frequently argue that certain residents are at such high risk for pressure injuries that bedsores are unavoidable despite proper care. While it is true that some medical conditions increase risk, this defense has limits. Facilities are required to assess each resident’s risk factors upon admission and develop individualized care plans that address those risks. A facility that fails to create or follow an adequate prevention plan cannot credibly claim that the resulting injuries were unavoidable.

Protecting Your Loved One

If you notice bedsores on a loved one in a nursing home, document what you observe with photographs and written notes. Ask the nursing staff about the wound’s origin, what treatment is being provided, and what prevention measures are in place. Request a copy of the care plan and any wound assessment documentation. If the facility is unresponsive or the injuries are progressing, contacting a Peoria nursing home injury attorney promptly can help preserve evidence and protect your family’s legal options.