Resources of Record

Carole L. Farace
Katherine D. Johnson
P.O. Box 771774
Orlando, FL 32877
407-856-6949
904-672-9569
866-856-7705 (Fax)
info@healthcarelegalconsultants.com
healthcarelegalconsultants.com

Pressure Sores or Decubitus Decubitus is an ulcer of the skin, often known as pressure sores or bed sores. They are caused by prolonged pressure and usually occur when people are confined to a bed. The combination of low blood supply, pressure, friction, shearing forces, and moisture actually cause the tissue to die. Left untreated, the ulcers progress from simple erosion (Stage One) to underlying deep skin, (Stage Two) muscle (Stage Three) and bone (Stage Four). If treatment is not pursued vigorously at the onset of the first stage, the condition progresses through Stages Two, Three and Four. At Stage Four sepsis is likely. Death often occurs for immuno-compromised patients, unable to fight the sepsis. The links below depict various samples of this condition.  Some viewers may find these images offensive. Image A - decubitus to sacral area on an elderly white female Image B - decubitus to the right hip of an elderly white female Image C - decubitus to right inner leg of an elderly white female Image D - decubitus to left heel (with necrotic tissue) of an elderly white female Image E - decubitus to right heel (with necrotic tissue) of an elderly white female Images are courtesy of Zebersky & Associates, P.A., Attorneys at Law, Plantation, Florida.

Malnutrition Malnutrition is the result of inadequate intake or digestion of nutrients. If malnutrition occurs in a nursing home, it should be detected by low protein levels in the blood. Nursing home residents generally reduce their food intake, even under normal conditions. However, disease often contributes to malnutrition as sick people eat less and absorb fewer nutrients. Lack of proper nutrition, combined with an underlying disease, may place these patients at higher risk for malnutrition. According to the Nutrition Screening Initiative, 2 in 5 elderly patients in nursing homes are malnourished. A lack of nutrients weakens the ability to resist and recover from illness. Malnutrition may also cause an immuno-compromised condition, thereby forcing the patient to use stored protein resulting in virtually no ability to grow new tissue or to maintain healthy tissue.

Dehydration Dehydration is common in the elderly and occurs when the body loses more fluid than it takes in. The most prevalent cause of dehydration in a nursing home resident is lack of water. Excessive fluid loss can be caused by Foley Catheters which are used to combat incontinence. Patients with catheters are at greater risk for infection, thereby necessitating the use of antibiotics. Antibiotics often further contribute to dehydration. It is imperative that the cathetered, incontinent, antibiotic treated patient increase fluid intake. As much as 40 percent of the total nursing home population is incontinent. Of this 40 percent, at least 15 percent are cathetered.

Starvation Starvation is the most severe form of malnutrition and is caused by a prolonged lack of food. In nursing homes, it is normally caused by the lack of protein. In a state of starvation, the body attempts to mobilize its own tissues as a source of energy, an effort which eventually results in destruction of organs, muscles and tissue. Prolonged starvation can result in weight loss of up to 50 percent. Conditions are most obvious in areas of the body where fat normally exists. Muscle mass shrinks, bones protrude, and the skin becomes thin, dry, pale and cold. The hair is dry and thin and falls out easily.