Pressure Sores – Justice for Nursing Home Abuse

By Jeffrey J. Downey

“Elder abuse will not stop on its own. Someone else needs to step in and help.”

– National Institute on Aging (NIA)

Pressure sores are an ongoing problem in both nursing homes and hospitals, accounting for thousands of unnecessary injuries and deaths each year.  Pressure sores, also known as bedsores, pressure ulcers, or decubitus ulcers, are characterized by injury/damage to the skin that is under pressure from lying in bed, sitting in a wheelchair, or wearing a cast for a prolonged time.

Hospital and nursing home patients can be at high risk due to the inability to reposition themselves. Pressure sores are more likely to occur in elderly individuals and/or nursing home residents who are bedridden, immobile, or unconscious. Lack of mobility interrupts or stops blood flow leading to tissue damage and in severe cases, it can lead to tissue necrosis, which can necessitate extensive surgery.  Sometimes it can take over a year to fully heal the wound and your original skin integrity may be compromised.  Pressure sores can also result in death as well, as the open wound could act as a conduit for infection.

Key points about pressure sores

  • Most pressure wounds are preventable with proper care and attention
  • Pressure sores are ulcers that happen on areas of the skin that are under pressure from lying in bed, sitting in a wheelchair, and/or wearing a cast for a prolonged period.
  • Pressure sores can happen when a person is bedridden, unconscious, unable to sense pain, or immobile.
  • Pressure sores can be prevented by inspecting the skin for areas of redness (the first sign of skin breakdown) every day with particular attention to bony areas, with frequent turning and repositioning.
  • Pressure sores typically have 4 stages, from one to four, with four being the worst.























Stage II ulcers are partial thickness skin loss involving the epidermis and/or the dermis which present as an abrasion, blister, or shallow crater.

Stage III ulcers are full thickness skin loss “involving damage or necrosis of subcutaneous tissue that may extend down to, but not through, underlying fascia and present as a deep crater with or without undermining of adjacent tissues


Stage IV ulcers involve extensive destruction, tissue necrosis or damage to muscle, bone or supporting structures [such as tendon or joint capsule].



The prevalence of physical frailty among nursing home (NH) residents is high (from 19% to 75.6%). Nursing home residents are a vulnerable population as they lose their autonomy and are forced to rely on staff to meet their basic needs. In some cases, they are even exposed to various forms of abuse. According to data from the Mayo Clinic, there are over 200,000 U.S. cases of pressure sores per year, with 60,000 of those cases resulting in death. Pressure sores are common, increase patient morbidity and mortality, and are costly for patients, their families, and the health care system. Therefore, preventing pressure wounds—especially in nursing homes—is important because they contribute not only to morbidity and healthcare costs but also affect residents’ quality of life.

Other factors that increase the odds of experiencing a pressure sore include:

  • Immobility and dementia
  • Poor circulation
  • Excessive moisture
  • Skin irritants like urine and feces
  • Inadequate nutrition, usually leading to difficulty in healing
  • Friction, such as when a person who is confined to bed has sheets dragged from under them
  • Nursing home negligence including lack of staffing, lack of daily checks, lack of proper hygiene, lack of specialty beds


Next Steps if your loved one has developed a pressure wound or decubitus ulcer

Here’s what you should do if someone you know is has developed pressure wounds in a hospital, nursing home or assisted living facility.


  • Discuss the wound with the staff and patient. Insist on frequent toileting, hygiene and turning and repositioning
  • If the wound does not improve, ask for your loved one to be taken to a hospital or wound clinic to assess and treat the wound with advanced modalities (like a wound vac)
  • See the wound yourself and photograph it.
  • Ask to be part of the care plan and find out what the staff is doing in terms of prevention and treatment. Ask for additional preventive measures (i.e., frequent turning schedule, specialty mattress, special pillows for the wheelchair like a doughnut cushion, daily inspections, wound specialist consult, therapy to get the patient out of bed and moving, wound cultures and antibiotics if the wound appears infected)
  • Take notes of your discussions with the staff and ask the patient if he/she is being regularly repositioned. Stay with the patient for a few hours to see if the staff is doing what they need to do to reposition and clean the patient.
  • If you believe the wound had developed due to staff failures in care, contact an attorney who handles pressure sore cases to obtain the records and investigate the case.


Attorney Jeffrey Downey has extensive experience handling pressure sore or bedsore cases.  According to the National Center for Elder Abuse, 1 in 10 Americans over the age of 60 have experienced some form of elder abuse while in the hands of caregivers.  “The covid pandemic has made the situation worse as many nursing homes have had restrictions in visitation, which means it’s harder to be an advocate for your loved one,” explains pressure sore attorney, Jeffrey Downey.  “Additionally, isolation and lack of mobility can contribute to the development of preventable wounds.”

Adverse events in nursing homes are leading causes of morbidity and mortality, prompting facilities to investigate their causes. This is also where a nursing home attorney can help determine if you or your family are entitled to compensation for nursing home abuse.

A nursing home attorney may be able to get you monetary reimbursement/compensation for the following:

  • Medical Expenses
  • Future Medical Expenses
  • Pain and Suffering
  • Wrongful Death
  • Grief and Solace


A Call to Action

If you or a loved one has developed a pressure wound or suffered other bad outcomes at a nursing home, hospital, or assisted living facility, call the Law Office of Jeffrey J. Downey for a free consultation.  Mr. Downey has been representing elders in such cases for over 30 years and has a wealth of legal experience in this area. His case results speak for themselves. His staunch advocacy has resulted in numerous case precedents supporting the civil prosecution of elder neglect and abuse. Call the office today for a free consultation.

No attorney’s fees are charged unless there is a settlement or recovery, so call now as all claims are subject to time limits or statutes of limitations.


Jeff Downey, Representing clients in Virginia, Maryland, and Washington DC

The Law Office of Jeffrey J. Downey, PC

8270 Greensboro Drive, Suite 810

McLean, VA  22102

Phone: 703-564-7318 or 703-564-7357


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