Prevention & care of bedsores



The number one complaint received by our office is with regards to bed sores also known as pressure ulcers or decubitus ulcers.  Bed sores are injuries to skin and underlying tissue resulting from prolonged pressure on the skin. Bedsores most often develop on skin that covers bony areas of the body, such as the heels, ankles, hips, and tailbone.  Bed sores are dangerous and can rapidly worsen in a matter of days. Left untreated, it can create irreversible damage to one’s health and even cause death.

Stage I, II, III and IV


Bed sores are categorized as Stage I, Stage II, Stage III and Stage IV.

Stage I bedsore is identified by redness to the outer skin layer.

Stage II bedsore is identified by breaking of the skin. Blistering or an open wound is often noticed.

Stage III bedsore occurs when the next layer of skin, the fatty layer, has been compromised.

Stage IV bedsore occurs when the tendons and or muscles become affected. Bed sores can develop past the tendons and muscles and become “unstageable.”


Preventing bedsores


As soon as a bedsore is detected, care providers are required to properly document it’s progress and take all measures to stop its growth.  Documenting requires taking photographs, measuring the wound, and dressing it with gauze. Some measures that may be taken to prevent its growth are as follows: 1) regular manual rotations; 2) an air fluidized bed; 3) regular cleaning to the area and 4) proper nutrition.


It is important to regularly turn a patient, especially if their condition is such that their movement is limited.  For example, if someone has undergone a surgical procedure or experienced a fall that leaves them bedridden, it is critical to reposition the patient on a regular basis.  How regular?  The answer may be every two hours. Another example of a patient whose movement is limited is someone who is unable to walk or someone who has behavioral issues and is placed on restraints. It is important to anticipate a bed sore in those patients whose blood flow has been compromised by other medical factors or medication they are



An air-fluidized bed is one that is inflated with air. It allows for decreased pressure to the affected area.  If a specialized bed as not been provided for you or your loved ones, you may want to demand one right away.  These beds are costly but may be necessary to treat bed sores.


Proper hygiene is also an important preventative measure to prevent the growth and development of bacteria.


Lastly, nutrition can play a key role in the growth of a bed sore.  Once a bed sore is identified, a protein-rich diet is essential to one’s healing process.


Bed Sore versus Deep Tissue Injury


Bedsores can be prevented, however, a deep tissue injury may not.  It may be helpful to think of a bedsore as an event starting from the skin and moving into the body.  A Deep Tissue Injury or DTI is more like a volcano that begins from within and works itself outward.  It is often difficult to diagnose or know how a DTI is formed.  Once it forms, it will play itself out.  Sometimes a DTI will develop into a bed sore.  In such event, the same precautions are taken to treat the bed sore.


Mandatory Reporting


The Department of Public Health mandates that health care providers report bed sores which have are Stage III in nature. If you suspect a bed sore has developed, you can inquire into an investigation or initiate one yourself.


If you would like to speak to a legal professional regarding a bed sore issue, we are here to help you.


Call us at: (510) 400-6146
Email us at

Sexual Abuse in Nursing Homes

Sexual abuse in nursing homes is a difficult thing to comprehend. The initial reaction for most is shock and disbelief. Yet, in nursing homes all across the United States, sexual assault and molestation occur on a regular basis. Reputable agencies estimate that only 30% of cases are actually reported to anyone. In the best case scenario, hundreds of incidents of sexual abuse occur every year. In the worst case scenario, thousands of patients are being assaulted. These statistics teach us that we must stop thinking about sexual abuse in terms of an isolated event or something out of the ordinary. In accepting the truth, perhaps we will be able to effectuate change by proactively looking for signs of abuse.

Why the Elderly?

The elderly represent one of society’s most vulnerable groups. Elderly patients diagnosed with dementia and Alzheimer’s cannot properly recall events and lack the ability to effectively communicate their circumstances. Moreover, they may be completely dependent on those working in the nursing home for their daily needs such as bathing, using the restroom and changing their clothing. Those working with the elderly are in a position of power and authority.

Who is in the Best Position to Detect Sexual Abuse?

Employees of nursing homes, including directors, doctors, nurses, therapists, caretakers, nutritionists, etc., are in the best position to detect sexual abuse. In other words, anyone coming into regular contact with the elder. Family members and other visitors of the patient are also in a position to detect signs of abuse.

What are some warning signs of Sexual Abuse?

The following may be indications of sexual abuse:
· Sudden, unexplained changes in your loved one’s behavior or personalities such as anger and fear.
· Isolation
· Injuries such as bruises, scars or welts. Take special note if the injuries are symmetrical (occur in roughly the same place on opposite sides of the body) or occur around the genitals.
· Infections that are typically transmitted sexually (venereal diseases or sexually transmitted diseases).
· Bleeding from the vagina or anus.
· Bloody or stained underwear.
· Blood on the bed.
· Torn clothing.
· Sudden, unexplained incontinence (if not previously incontinent), or reoccurring urinary infections in women who are not incontinent not catheterized.

Please note that these signs may also be present in someone who is not being sexually abused. For example, it is common for an elderly person to get angry, violent, disruptive and or defiant. These may be signs of general neglect and abuse and not sexual abuse. Any sudden changes in behavior should be thoroughly investigated and monitored.

In 2014, I represented an elderly woman who had been sexually assaulted in a nursing home. The incident or incidents would likely have gone unnoticed had a female employee not caught the perpetrator in the act. The perpetrator was a janitor who had been asked to transport the patients from time to time. In doing so, the janitor had increased physical access to the patients. This janitor regularly entered into patients’ rooms.

When the female employee walked into the room on this particular evening, the victim’s breasts were being fondled and her undergarments lowered. The female employee informed the owners of the facility, who eventually called the police. Formal charges were brought against the janitor but then were later dropped. The family members of the victim felt they had no choice but to hire a lawyer to bring an action against the care home for allowing such abuse to go on as it did.

After the suit was brought against the residential care facility, the female employee was immediately fired. It goes without saying, that the case resulted in a significant recovery for the victim.

If you or a loved one has suffered one or more of these types of abuse in a nursing home and you have any questions about your experience, don’t hesitate to contact us!

Phone: (510) 400-6146

Home Care Aides

Home Care Aides are individuals who come into one’s home (whether it be a nursing home, assisted living, or private residence) to help them with activities of daily living for a few hours a day all the way up to 24/7 care. These individuals may assist with chores, diet monitoring, planning and preparing for meals, light housekeeping, running of errands, laundry, making beds, assistance with shopping, transportation to appointments, assistance with bathing, dressing, grooming, and toileting, call 911 in the event of an emergency, reminders to take medicine and companionship. A home care aide is not required to have any medical knowledge or training and therefore is unable to provide any medical services.

Reporting Suspected Abuse or Wrongdoing by a Home Care Aide

The Home Care Services Bureau (“HCSB” an extension of the Community Care Licensing Division) is responsible for licensing Home Care Organizations including processing applications, receiving and responding to complaints and conducting unannounced visits to ensure compliance. HCSB is also responsible for the Home Care Aide application process and maintenance of the Home Care Aide Registry. California law established the Home Care Services Consumer Protection Act which, as of January 2016, requires Home Care Organizations to be licensed and creates a public online registry for Home Care Aides who have been background checked. This law is intended to promote consumer protection for elderly and disabled individuals who hire private aides to come into their homes and provide assistance with activities of daily living.

Home Care Services Bureau
744 P St. – MS T8-3-90
Sacramento, CA. 95814



Elder Abuse and Neglect in Residential Care and Skilled Nursing Facilities

Our law firm receives numerous calls a year from families and loved ones of seniors residing in Residential Care Facilities and Skilled Nursing Facilities. Many times the abuse and neglect which they are inquiring about is obvious to the individuals, other times it is not. The following are definitions of neglect, abuse and abandonment as stated in California Welfare and Institutions Code § 15610.10, et seq.:


(a) “Neglect” means either of the following:
(1) The negligent failure of any person having the care or custody of an elder or a dependent adult to exercise that degree of care that a reasonable person in a like position would exercise.
(2) The negligent failure of an elder or dependent adult to exercise that degree of self care that a reasonable person in a like position would exercise.
(b) Neglect includes, but is not limited to, all of the following:
(1) Failure to assist in personal hygiene, or in the provision of food, clothing, or shelter.
(2) Failure to provide medical care for physical and mental health needs. No person shall be deemed neglected or abused for the sole reason that he or she voluntarily relies on treatment by spiritual means through prayer alone in lieu of medical treatment.
(3) Failure to protect from health and safety hazards.
(4) Failure to prevent malnutrition or dehydration.
(5) Failure of an elder or dependent adult to satisfy the needs specified in paragraphs (1) to (4), inclusive, for himself or herself as a result of poor cognitive functioning, mental limitation, substance abuse, or chronic poor health.”

§ 15610.07.

“Abuse of an elder or a dependent adult” means either of the following:
(a) Physical abuse, neglect, financial abuse, abandonment, isolation, abduction, or other treatment with resulting physical harm or pain or mental suffering.
(b) The deprivation by a care custodian of goods or services that are necessary to avoid physical harm or mental suffering.”

§ 15610.05.

“Abandonment” means the desertion or willful forsaking of an elder or a dependent adult by anyone having care or custody of that person under circumstances in which a reasonable person would continue to provide care and custody.”

Often times, the intuition and gut feeling of a family member or loved one is on point. If you or someone you love suspects the neglect, abuse or abandonment of an elderly person, please call our law firm at 510-400-6146.