Pressure Ulcers

What Are the Warning Signs of Nursing Home Abuse and Neglect in California?

August 31, 2026 | by Yeroushalmi Law

The clearest warning sign of nursing home abuse or neglect is a sudden, unexplained change in your loved one — physically, emotionally, or financially. Injuries no one can account for, rapid weight loss, a person who has gone quiet, money moving in ways that make no sense. Any one of these is worth asking about.

Most families do not walk in and see abuse happening. They notice something small that does not add up, dismiss it, and then notice it again. This is a guide on what signs to look for and what to do next if you suspect abuse or neglect.

What are the most common physical warning signs?

How Can Pressure Ulcers and Bed Sores Be Prevented?

November 5, 2018 | by Yeroushalmi Law

Pressure ulcers are severe and sometimes life-threatening medical conditions that affect a high number of patients and residents living in nursing homes and assisted living facilities. Several studies show that as high as one-in-five patients and residents of these facilities have experienced signs of a pressure ulcer at some point in their admission.

Pressure ulcers are a form of elder abuse and neglect and are often caused by nursing home staff failing to care for the basic needs of a patient or resident. These injuries do not happen instantaneously. It is important to understand how to prevent pressure ulcers to ensure that you or your loved one is receiving the best medical care possible. Contact a Los Angeles nursing home lawyer if you believe that your loved one has been a victim of this type of neglect.

What Are Pressure Ulcers?

Pressure ulcers, which are also referred to as pressure sores or bed sores, are skin and tissue injuries caused by persistent pressure or friction to certain areas of the body. The most common areas for pressure ulcers are the back, buttocks, elbows, hips, heels, and ankles. Patients and residents with limited mobility, especially people in wheelchairs or who are bed-bound, have a greater risk for pressure ulcers than others because they typically spend long periods of time in one position.

New Definition Added to the Criteria of Pressure Ulcer Development by the National Pressure Ulcer Advisory Panel

December 22, 2016 | by Yeroushalmi Law

Some recent discoveries have shown that there is a need to redefine the National Pressure Ulcer Advisory Panel’s (NPUAP) definition of deep tissue injury. Although etiological studies of deep tissue injury (DTI) primarily pertained to the characterization of biomechanical factors influencing its onset and progression, new findings suggest that the criteria of DTI should be evaluated and refined. According to a recent article published by Ostomy Wound Management (OWM), there are several reasons why the current definition is insufficient:
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Long-Term Care Staff Must Strive to Prevent Pressure Ulcers

June 28, 2016 | by Yeroushalmi Law

The prevalence of chronic wounds located in the lower extremity area is high among older adults. Not only can they be extremely deleterious and pose major health risks, they also increase socioeconomic burden because of the high expenses of wound care, long duration of healing time, increased complication rate and negative effect on patients’ and loved ones’ quality of life. Chronic wounds are related to heightened mortality and significant morbidity because of infection, loss of ability to perform daily activities, pain, and psychosocial issues. Health care clinicians must be trained to identify and diagnose wounds, as well as provide proper management of their etiology. The four most common chronic wounds are venous leg ulcers, diabetic foot ulcers, pressure ulcers, and arterial ulcers. Although there have been recent advances in wound care, care providers are still struggling to provide the best quality of care in this area, especially for elderly people living in nursing homes and assisted living facilities.

New Nursing Home Rating System to Better Evaluate Quality of Care

October 13, 2014 | by Yeroushalmi Law

According to the New York Times, the federal government will be implementing significant changes to the rating system of nursing homes in the United States. Currently, the ratings are based on a five star system that is scrutinized by the public. This five star rating system “has been criticized for its reliance on self-reported, unverified data.” The current system was implemented five years ago and evaluates staffing levels and quality of care, which is reported by the nursing homes and not audited by the federal government. This flawed rating system “relied heavily on unverified and incomplete information that even homes with a documented history of quality problems were earning top ratings.” In 2009 37% of nursing homes had ratings of four or five stars and by 2013 over 50% had exceedingly high ratings. With more than 15,000 nursing homes in the United States, it is crucial that the optimal quality of care is guaranteed by skilled nursing facilities. Continue Reading

2014 State Long Term Services and Support Scorecard

July 9, 2014 | by Yeroushalmi Law

The American Association of Retired Persons (AARP), the SCAN Health Plan, and The Commonwealth Fund produced the second annual State Long-Term Services and Supports (LTSS) Scorecard, which gages system performance from the perspective of service users and their families. The finest quality of care in a skilled nursing facility should be a guarantee, especially with the influx of senior citizens our nation will encounter within the next ten years. The “Baby Boom Generation” will rapidly increase the percentage of elderly residing in a nursing facility which in turn, will generate a higher demand for excellence in quality of care. Therefore, the slow pace of improvement must speed up to be better equipped for the aging of the baby boomers. The LTSS Scorecard is designed to measure how each state performs in its assistance and support for the elderly, adults with disabilities, and their family caretakers. It is intended to help states improve their LTSS systems so that the elderly and adults with disabilities can better choose and control their lives, in an effort to maximize their welfare and independence. Continue Reading

Exploring the Social and Psychological Effects of Pressure Ulcers

October 15, 2013 | by Yeroushalmi Law

Unfortunately, pressure ulcers are preventable, yet common conditions which arise in elderly individuals who reside in nursing homes and other healthcare settings. Not only do these severe wounds cause physical discomfort and pain, but a study published in Wounds delved into the social and psychological effects of pressure ulcers which contribute to a reduced quality of life. For example, studies have shown that those who have pressure ulcers for six or more months are more likely to suffer from pessimism, which may affect their nutrition, susceptibility to depression, and ability to heal.

Pressure ulcers are known to impact general physical health, as complications and even death may occur. Additionally, pain almost always accompanies the presence of a pressure ulcer, and studies have shown that 84% of those with pressure ulcers have reported pain even while they are at rest, with some expressing their pain to be at an excruciating level. In addition, many have expressed experiencing fatigue due to sleep disruptions because of the presence of the ulcers. Thus, because of these ongoing factors, patients already experience a diminished quality of life.

Studies Show Correlation between Pressure Ulcers and Skin Changes that Occur with Age

October 10, 2013 | by Yeroushalmi Law

Recent research has been conducted to explain why the elderly population may be at higher risk for pressure ulcer development. Our skin functions as a defensive barrier against physical and chemical trauma and disease. However, research has uncovered correlations between skin changes that occur with age which may serve as risk factors for pressure sores. This is because various changes in the skin’s structure occur with time, impacting the skin’s ability to heal wounds quickly and leaving it more vulnerable. The skin of elderly individuals has increasingly fewer epidermal cell layers thus deteriorating its ability to serve as an effective barrier. Additionally, as people age, subcutaneous fat will deteriorate. This will have the effect of decreasing support of one’s skin from underlying bone. In addition, skin will generally respond with less vasodilation when there is external pressure, furthering the likelihood for pressure sore development.

Because of these changes, elderly individuals in nursing homes are highly susceptible to the development of pressure ulcers. Despite the fact that it is highly preventable, statistics reveal that about 2.5 million people develop pressure sores every year in the United States alone. Of these individuals, up to 24% develop pressure sores in long term care facilities, while 38% develop pressure sores during their stay at acute care hospitals. Pressure sores not only diminish an individual’s quality of life but may also lead to death. Thus, early identification and treatment are critical in preventing the development and worsening of sores, and the complications that may result due to their development.

New Study Explores Link Between Hypotension and Pressure Ulcer Development

September 20, 2013 | by Yeroushalmi Law

Many elderly residents who are hospitalized or living in nursing homes frequently develop pressure ulcers, the development of which risk further complications and even death. Consequently, caretakers for the elderly, particularly those in hospitals and nursing homes, must take precautions to prevent pressure ulcer development within this population. Studies have been conducted demonstrating a correlation between hypotension, or low blood pressure. Specifically, hypotension has been demonstrated to be an important risk factor in the development of pressure ulcers because research has found that hypotension in elderly patients, particularly those in poorer health, contributed to decreased blood flow at pressure points. This, in turn, would contribute to the death of cells and tissue in that area, leading to pressure ulcers.

However, a legal doctrine known as the ‘egg-shell skull’ rule can apply in this context. This rule holds an individual responsible for all consequences arising from their injury-causing actions towards another, even if the resulting injury to the victim is one that is unusually severe due to an underlying or pre-existing condition. Therefore, those caring for the elderly must be especially vigilant in protecting patients against pressure sores, particularly if an elderly patient is at risk for hypotension. This can be done by promptly identifying which elderly patients have hypotension, or those who are susceptible to developing hypotension, and allocating proper attention and resources to such patients. By doing so, caretakers can identify which elderly patients are particularly vulnerable to pressure ulcer development due to their clinical condition and can take early preventative measures before pressure ulcers arise and complications occur.

Pressure Ulcers Linked to Patient Mortality and Hospital Re-admittance

January 25, 2013 | by Yeroushalmi Law

A new study published by the Journal of the American Geriatrics Society concluded that there is a direct correlation between pressure ulcers (bedsores) developed during hospitalization, patient mortality and hospital re-admittance. According to the study, not only did seniors that developed pressure ulcers during their hospital stay have a higher chance of returning to the hospital within 30 days, but they also had a higher chance of dying during this subsequent hospital stay.

The lead researcher of this study by the UCLA School of Nursing, Dr. Courtney Lynder, was quoted saying, “It is incumbent upon hospitals to identify individuals at high risk for these ulcers and implement preventive interventions immediately upon admission”. The study found that approximately 4.5 percent of the patients being tracked in the study developed a pressure ulcer during their hospital stay. The majority of these patients developed the bedsores in the pelvic area such as the hip and tailbone. Of the nearly 3,000 patients that were admitted to the hospital with a pressure ulcer, 16.7 percent developed a new pressure ulcer on another part of their body during their hospital stay.

This study uncovers how serious the issue of pressure ulcers really is, especially in patients who are already at high risk of developing these wounds. Whether pressure ulcers are developed within the confines of a hospital or a nursing home, they are extremely painful and detrimental to the health of residents. Skilled nursing facilities must be vigilant to prevent such conditions from occurring by taking the necessary precautions such as alternating the position of immobile bedridden patients at least every hour and properly assessing the level of severity of the pressure ulcer, in order to implement the appropriate treatments. Effective treatment and prevention of pressure sores, however, is only possible with sufficient staff that are well-trained. If your loved one has developed multiple pressure ulcers, this may be a sign that his or her nursing home is understaffed. Unfortunately, maintaining a high quality of care is not always a priority in some nursing homes, especially in those that seek to increase profits by understaffing. This is an affront to the dignity and respect that nursing home residents deserve and a direct violation of their Patients’ Rights.