As our parents and grandparents grow older, their physical and mental needs start to change, sometimes very quickly. They become less able to care for themselves, and ultimately, need full-time, professional care. Undoubtedly, one of the hardest decisions in life is when to put a loved one into a nursing home or assisted living facility. You intentionally put off the decision as you try to keep them in their homes or yours. You’ve heard the horror stories, and you feel tremendous guilt and fear for even considering such an option. You do your research. You go online and check out ratings and reviews. You go to government regulatory agencies to see what they know about different homes. You even go to several yourself to check out the available facilities. In the end, you do the very best you can, and then hope and pray everything will be fine. We hope so, too. But, things don’t always turn out the way they should.

People today are living longer well into their 60s, 70s, and even 80s due to better health care and a focus on well-being. The dream is to stay active and relatively fit and live out life in your own home and surroundings. Unfortunately, as we age, other health issues often arise such as heart disease, diabetes, arthritis, and others that change us.

As we progress through life, we notice how things start to change. When young, we enjoyed running. As we hit middle age, running became too hard on our joints, so we started riding bicycles. As we got even older, that hobby became too labored and dangerous. So now, we walk or get on a treadmill. Even that simple activity will get eventually become too much, and we will stay indoors even more. That’s not good. As we slow down, it seems our age catches up and can soon overcome us. It’s just part of life, and it will happen to each of us as we go through various stages. When it becomes unsafe to live alone, we have two choices. Either live with family or “retire” to a nursing home. And individuals with serious, debilitating health conditions may not even have the option to live with family. They require skilled nursing care and professional caregivers. While we all hope for the best, many residents become victims of nursing home neglect. Neglect can come in a variety of forms. I’ll explain below.

By the time it becomes necessary to consider assisted living, our elderly loved ones are typically quite frail and vulnerable. As children, they are literally at the mercy of those who care for them. Contrary to what insurance companies for nursing homes imply when sued, we do not place our family members in skilled nursing facilities “to die.” Rather, we want and expect them to be cared for so they can live out their remaining lifetimes happy and safe. It is these frailties that cause us to turn to nursing homes in the first place. However, despite extremely high fees charged, many facilities are woefully understaffed and do not have the proper equipment to care for their residents. And while the caregivers themselves are often very good people, they simply cannot adequately care for the overwhelming number of patients in their charge. And when they cannot get to everything, bad things can happen. And quickly.


The primary risk of serious injury to elderly residents is falling. Falls can happen in an instant and can result in broken hips, broken bones, and even head injuries. When falls happen, the nursing home staff will try to justify what happened by saying falls can occur anywhere, even if they were living with family. That is true if the person is stable and fully ambulatory. However, when a patient is admitted to a nursing care facility, a “fall assessment” should be done to determine what type of fall risk is presented. Then, periodically, that assessment must be updated as the resident’s needs change. If an assessment is not part of the file and followed, then a serious but preventable fall can and will eventually occur. Don’t make the mistake of thinking a fall is only compensable if there is a pattern of falling. You can hold the nursing home accountable if they do not properly anticipate the risks presented when they accept a new patient.

Dehydration and Malnourishment

As we age, we lose our appetite and interest in food. The elderly must focus and make themselves eat and drink. They tend to sleep much more and will stay in bed for days if not properly attended to. Nursing home staff barely have time to deliver food trays, but it is imperative to make sure residents are eating and drinking. Otherwise, they can very quickly become dehydrated and malnourished. Dehydration can literally occur in a matter of hours, especially if they have other systemic conditions like diabetes. And malnourishment can take effect in just a few days. And once these processes start, it can be very difficult to recover. Many times, the resident has to be taken and admitted into the hospital and given intravenous liquids and nourishment. In some cases, the state of decline is too far gone, and even intensive care is not enough to reverse course.

Decubitus Ulcers

As a direct consequence of dehydration, malnourishment, and being immobile, decubitus ulcers or bedsores can form in a frighteningly short period. When I was a Registered Nurse (RN) working in an Intensive Care Unit (ICU), my patients were usually in a coma and on a breathing ventilator. They were unable to move at all. Bedsore prevention was a constant concern, and we had to physically turn patients every two (2) hours at a minimum. We also had to manually massage pressure areas (those parts of the body where decubitus ulcers typically form) and apply lotion to maintain skin integrity. The turning prevented undue and prolonged pressure, the massage increased blood flow to tissues, and lotion protected against skin breakdown. We also made certain our patients were adequately hydrated with IVs and nourished through liquid feedings directly into the stomach. While these may seem fairly extreme care procedures, an incapacitated nursing home resident is just as vulnerable and requires similar care to prevent breakdown and ulceration.

If these steps are not taken, bedsore first starts as a reddened area, usually around the heels, lower back, and buttocks. When all of the above conditions are present, skin breakdown can occur in a day or two, and then it just gets worse until dead tissue is rotting away while your loved one stays in bed. Decubitus ulcers are graded for the degree. A level four is dead tissue all the way down to the bone. It is obviously a life-threatening condition as sepsis (total body infection) can develop which will result in wrongful death. In cases where the resident has advanced diabetes, the breakdown process occurs even more quickly, and death can occur in just a matter of days. An autopsy is usually performed to show the cause and manner of death, and it should always be classified as an accident. Dying from sepsis due to decubitus ulcers is NEVER a natural cause situation. And, no matter what you may be told by staff or administrators from the nursing home, there is NEVER any excuse for bedsores. they are absolutely, completely preventable with proper care.

Attorney Robert J. Reeves is a practicing trial attorney with over 24 years of experience. He is a former Registered Nurse (RN) who has actually treated seriously injured patients, including those with advanced decubitus ulcers and sepsis. Mr. Reeves is a member of the Million Dollar Advocates Forum as well as the National Trial Lawyers Top 100 and Super Lawyers. He has handled many different types of nursing home neglect and abuse cases in both South Carolina and North Carolina. He would be honored to meet with you personally to discuss your situation. You can contact Mr. Reeves directly by calling his mobile phone 803-554-4157 or email .

If you suspect something is not quite right, call us and we will help you find out if you are worried about anything or if something really is wrong. If your loved one has already been injured or worse, call us immediately. First, we will try to get you answers. And then, we will seek to hold all responsible parties fully accountable. That’s our pledge to you.

We offer a state-wide practice in South Carolina, including Rock Hill, Fort Mill, Indian Land, Lancaster, Columbia, Spartanburg, Greenville, and Charleston. We also practice and help those injured in North Carolina, including Charlotte, Monroe, Gastonia, and Statesville.

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