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INsight | Nursing Home Safety

February 19, 2020

Dave Farnbauch sits down with ABC's INsight to talk about what families can do to keep their loved ones safe in a nursing home. The secret? Check their skin. 

You can read the full transcript below, or access a PDF version here

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Charity: Well, welcome back. I'm here with Dave Farnbauch and today we're going to talk about what families can do to keep their loved ones safe in a nursing home and as it pertains to their skin, really. Why is it important that we keep an eye on our loved one's skin in the nursing home? 

Dave Farnbauch: Well, Charity, the reason I think that there needs to be an emphasis by families or that they need to keep an eye out for what happens with their loved one's skin is because of the risk of a couple of different things that happen with elderly people in nursing homes that are bed bound. One is what we call pressure ulcers or pressure sores and another condition they can develop, it's known as a deep tissue injury, which is sort of a variation of a pressure ulcer or a pressure sore when they develop a wound underneath the surface of their skin. 

Charity: Let's tell people what are pressure ulcers or pressure sores. 

Dave Farnbauch: Pressure ulcers, Charity, develop when a person who is primarily bed bound or confined to a chair or whatever, when the quality of their tissue is such, in their age and their tissue quality is such that when they are laying in bed for a long period of time or they are putting weight on one of their extremities, a common area is the heel or their elbows, but the ones that are particularly problematic are the ones in the hip area. What we call the coccyx, right above their hips where they're laying in a bed. That pressure that's exerted from their weight that is put down on their skin up against the mattress, that tends to compromise the circulation and the blood. Then in turn, it will cause a wound to develop from the pressure. 

Charity: You brought along, you've got this visual aid that kind of shows us where the most common points or sites for pressure sores are. 

Dave Farnbauch: Right. Yeah, so up on the screen, on the screen right now, Charity, we're looking at the most common areas where patients can develop pressure ulcers. The next thing that we're going to show on the screen is I talked about before the risks that a bed bound patient will develop a pressure ulcer in their coccyx. These are the ones that are particularly problematic because these can develop very quickly. If a patient is not turned on a regular basis, they can develop these wounds and these wounds, they can develop a tunneling type of a feature where they become very large and very open. I've been involved in cases where, this is no exaggeration, I would be able to put my fist inside a wound that developed on the coccyx because that wound is tunneling down inside the patient. The obvious risk there is a patient who has that kind of wound, it can become infected and then if it becomes infected then you can develop sepsis and as soon as you develop sepsis, it can be a very touch and go situation to save your life because sepsis can cause multi-system organ failure. 

Charity: In general as we age, these are not things that we can battle as easily or quickly. Those infections are not something we can do. What can families do to protect their loved ones from these wounds? 

Dave Farnbauch: Well, the biggest thing that I've noticed over the years, I've been doing these cases for a long time, is the common theme that runs among families when they come to see us about these wounds is they visit their loved ones on a regular basis. They just never have a look at their backside. They don't look at their heels, they're covered up. So what I always tell people is if you're going to go visit a loved one, insist that your loved one be sort of rolled on their side or rolled on their stomach. Even though the nurses are telling you there's no pressure ulcers, their skin looks good, their heels look good. Insist as the family member that you have a look at their skin, so you can verify that they aren't developing any reddened areas, aren't developing wounds because if you have a look at those and see that they're not addressed, you can take it up with the charge nurse or the director of nursing and say, "Look, I have some concerns. I see that my loved one is starting to develop some pressure ulcers." 

Charity: It's so important for us to be advocates for our loved ones. If you've had an issue with neglect or care in a nursing home, all you have to do is give Sweeney Law Firm a call, 420-3137. We'll be right back.