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Sepsis in Nursing Homes

Quick Answer

Sepsis in nursing homes is a life-threatening condition. It occurs as the most extreme response to an infection and is especially dangerous to the elderly population. Severe cases can lead to septic shock, a dramatic drop in blood pressure that results in organ damage or even death. Promptly diagnosing and treating infections in nursing homes is critical to keep residents safe from sepsis.

What Is Sepsis?

Septicemia, or sepsis, is blood poisoning caused by bacteria. This life-threatening emergency occurs when a chain reaction in the body is triggered by an infection. Without immediate treatment, sepsis can lead to organ failure, tissue damage, and even death.

Sepsis has a death rate of up to 50%. Immediate diagnosis and treatment are critical.

While most cases start as bacterial infections, sepsis can be caused by almost any type of common infection, including influenza or COVID-19.

Infections that most often lead to sepsis are those that start in the:

  • Gastrointestinal tract
  • Lungs
  • Skin
  • Urinary tract

Sepsis is not contagious — but the infections that cause sepsis may be. Therefore, it’s critical for nursing homes to take proper measures to prevent the spread of infections.

If someone you love suffered from sepsis while in a nursing home, get a free case review today. You may be entitled to compensation for medical expenses and suffering.

Who Is Most at Risk of Developing Sepsis?

There are several factors that increase the likelihood of someone developing sepsis. However, age is the biggest risk factor, with older adults being five times more likely to develop severe sepsis.

“Older adults, and particularly nursing home residents, have a disproportionately high incidence of and morbidity from severe sepsis.”

– National Institutes of Health (NIH)

Common risk factors for developing sepsis include:

  • Age (being 65 years or older or less than 1 year old)
  • Admission to the intensive care unit (ICU)
  • Chronic kidney or liver disease
  • Compromised immune system
  • Diabetes
  • Invasive devices, such as catheters and breathing tubes
  • Long hospital stays
  • Previous antibiotic or corticosteroid use

Nursing home residents may have several of these risk factors working against them. For example, when old age is coupled with a weakened immune system, sepsis in nursing homes becomes a significant concern. In fact, nursing home residents are seven times more likely than non-nursing home residents to develop severe sepsis, according to NIH.

What Causes Sepsis in Nursing Homes?

Sepsis in nursing homes is caused by several factors.

One of the biggest contributors is the number of people who come and go, including visitors and staff. Each person who enters a nursing home is coming from a different place, bringing with them whatever germs they’ve been exposed to elsewhere. This makes it easier for germs to spread, causing nursing home infections.

Some common sources of infection that lead to sepsis in nursing homes include:

  • C. Difficile (a germ that causes severe diarrhea and colitis)
  • Escherichia coli (E. coli)
  • MRSA
  • Some types of streptococcus
  • Staphylococcus aureus (staph)
  • Vancomycin-resistant enterococcus (a germ normally present in the body that becomes resistant to antibiotics)

Additionally, it is unfortunately common for nursing home residents to be transported to and from the hospital. Hospital transfers put patients at risk for developing healthcare-acquired infections (HAIs) that they can bring back into the assisted living facility. These infections can then spread to other residents and lead to sepsis in nursing homes.

Infections that may be likely to result in sepsis include:

  • Lung infections, such as pneumonia
  • Kidney, bladder, and other urinary tract infections
  • Digestive system infections
  • Infections in the bloodstream

Nursing home residents may also be at risk of sepsis if they have catheters, ventilator tubes, and/or IVs. Each of these requires openings in the body which can allow germs to enter and infections to start.

Nursing home residents are also at increased risk for bedsores. Since bedsores frequently cause breaks in the skin, they can become infected at any time. Local skin infections such as cellulitis and osteomyelitis can rapidly develop into sepsis. In fact, bedsores are one of the most common sources of infection leading to sepsis in nursing homes.

Sepsis Can Be a Sign of Nursing Home Neglect

Since it is often treatable, severe cases of sepsis can be a sign of nursing home neglect. In fact, nursing home neglect and sepsis often go hand in hand.

Nursing home residents should have appropriate supervision and be monitored regularly for any signs of infection. If sepsis develops, it could mean that an infection was overlooked by nursing home staff members and therefore not properly treated.

Sepsis Symptoms in Nursing Homes

Symptoms of sepsis in nursing homes may look like those of many other medical conditions. Sepsis is therefore easy to overlook and can be tricky to diagnose.

Since sepsis develops rapidly, it is critical to know the signs. Although most people can recover from mild cases, as it worsens, sepsis can lead to death. This is especially true in the elderly population.

What Are the Early Warning Signs of Sepsis?

A person with sepsis will rapidly become ill and may also experience a number of other symptoms that must be monitored.

Common warning signs of sepsis in nursing homes include:

  • Change in mental status
  • Cool hands and feet
  • Extreme pain or discomfort
  • Fever
  • High heart rate
  • Lethargy, anxiety, confusion, or agitation
  • Loss of interest in food
  • Nausea and vomiting
  • Sensitivity to light

Sepsis Rash

A sign of sepsis in nursing homes is sepsis rash, a cluster of tiny spots that look like pinpricks but don’t fade when pressed on. With sepsis rash, the skin may also feel cold or clammy, even if the person has a high temperature.

If sepsis rash is not treated, it will get bigger and begin to look like bruising. As it continues to worsen, the discoloration may join together and form large areas of damaged purple skin.

What Are the 3 Stages of Sepsis?

Sepsis in nursing homes generally progresses in three stages: sepsis, severe sepsis, and septic shock. As sepsis gets worse, blood flow to the vital organs becomes more and more impaired. It may also cause blood clots that could burst.

Since sepsis develops quickly, it is critical to seek immediate medical care. The earlier sepsis is treated, the greater the chance of survival.

Stage 1: Sepsis

The first stage of sepsis can usually be treated if caught early.

Early-stage sepsis can be diagnosed with:

  • Confirmed or suspected infection
  • Fever above 101ºF or a temperature below 96.8ºF
  • Heart rate greater than 90 beats per minute
  • Breathing rate greater than 20 breaths per minute

At least two of the symptoms above must be present for a doctor to diagnose sepsis.

Stage 2: Severe Sepsis

Stage 1 sepsis that is not successfully treated may quickly develop into severe sepsis, or stage 2 sepsis. Severe sepsis damages the organs from the body’s inflammatory response to infection.

Severe sepsis can affect any organ, including the heart, brain, lungs, kidneys, and/or liver. The symptoms that a person with severe sepsis experiences are based on which organ is affected.

Did you know

Severe sepsis causes roughly 750,000 hospitalizations and 215,000 deaths each year in the United States.

Stage 3: Septic Shock

Septic shock may develop if the earlier stages are not properly treated. This third stage occurs when there is an alarming drop in the patient’s blood pressure. Nursing home residents that develop septic shock are at a very high risk of death.

Signs that sepsis is progressing into septic shock include:

  • Needing medication to maintain a safe blood pressure
  • Having high levels of lactic acid in the blood

As sepsis advances, blood flow to vital organs becomes more impaired. While septic shock can be treated, the mortality rate is 40%, and survivors become more at risk for future infections.

Sepsis Diagnosis

Health care providers can diagnose sepsis by looking for physical symptoms such as low blood pressure, fever, and increased heart and breathing rates. Lab tests to look for signs of infection and organ damage may also be performed.

Since sepsis is difficult to diagnose, a doctor should be consulted for any infection or wound that has not responded to treatment.

Sepsis Treatment Options

Health care providers treat sepsis based on factors such as age, overall health, and medical history. Since sepsis is a life-threatening emergency, people with confirmed sepsis are hospitalized and treated immediately.

Treatment options for sepsis may include:

  • Antibiotics
  • Managing blood flow to organs
  • Oxygen and IV (intravenous) fluids
  • Treating the source of the infection

Some people with sepsis may need to be put on a ventilator for breathing or receive kidney dialysis. In some cases, surgery is used to remove tissue that was badly damaged by the infection.

Preventing Sepsis in Nursing Homes

Preventing sepsis in long-term care facilities must be taken very seriously since it can be deadly for residents. Infection control is the best way to reduce the risk of infection and sepsis in this vulnerable population.

Nursing home staff can practice proper infection prevention by:

  • Cleaning rooms and objects properly
  • Isolating residents who show signs of illness
  • Observing isolation protocol when necessary (masks, gloves, and/or gowns)
  • Washing hands before moving from one resident to the next when providing care

When family members or loved ones visit nursing homes, they should:

  • Not visit if they’re sick, even if it’s “just a cold”
  • Receive appropriate vaccinations
  • Report any signs of illness, open wounds, or infection to the staff
  • Wash their hands upon entering the nursing home

In addition to taking proper infection prevention measures, sepsis in nursing homes can be prevented by vigilantly monitoring for symptoms. Knowing and watching for the earliest signs of sepsis can save a loved one’s life.

Death From Sepsis in the Elderly

Sadly, death from sepsis in the elderly is very common, with the mortality rate being as high as 60% of those with severe sepsis and septic shock. Additionally, elderly patients with severe sepsis are up to 1.5 times more likely to die than younger patients.

Sepsis Survival Rate by Age

The following chart containing data from the NIH shows the unfortunate reality of sepsis in nursing homes. According to the data, almost 50% of nursing home residents who developed sepsis died from it while being treated in a hospital.

Age% Hospital Death% Discharged Alive% ICU Admission% Non-ICU Admission
18-445%18%4.3%14%
45-6424%28%32%25%
65-7931%28%32%32%
≥8039%26%28%29%
Nursing home resident48%20%39%21%

Nursing Home Wrongful Death From Sepsis

Nursing home neglect and sepsis can tragically — yet all too frequently — lead to death. Because of this, sepsis in nursing homes that leads to death may be considered wrongful death by state or federal law.

Nursing home wrongful death cases may occur if staff members:

  • Fail to diagnose or treat bedsores that turn into sepsis
  • Fail to diagnose or treat infections that turn into sepsis
  • Neglect residents’ health care needs

Families who have lost loved ones to this type of nursing home negligence may be able to pursue compensation through legal action. While it will not bring loved ones back, this compensation can be used for funeral costs and other expenses.

Nursing Home Sepsis Lawsuit

A nursing home sepsis lawsuit can help make sure that justice is served and compensation is received. Nursing home lawsuits can also help ease the pain and suffering of the loved ones who are left behind.

To file a lawsuit, many people work with nursing home abuse lawyers. These attorneys generally work for reputable personal injury law firms with experience handling nursing home abuse and neglect cases, including those involving sepsis.

Working with a nursing home abuse lawyer makes the legal process significantly easier. A lawyer with experience handling nursing home cases knows how to build a strong case. They have the experience and track record required to prove that your loved one would not have developed sepsis if the nursing home had taken proper precautions.

Almost all successful nursing home abuse lawsuits are resolved with money awarded through settlements, which are legal agreements between the victim’s lawyers and the lawyers for the nursing home/staff. On rare occasions, nursing home lawsuits may go to trial where a judge or jury decides the outcome of the case.

An experienced nursing home lawyer will know the best route to take for your specific case. They will also handle all of the heavy lifting so you can focus on your loved one.

Take Legal Action for Sepsis in Nursing Homes

Your loved one never deserved to develop sepsis while in a nursing home. The nursing home and its staff members should have taken proper precautions to keep residents safe. If they fail to do so, you may be able to file a legal claim against them.

Get a free case review today to see if you can hold a nursing home accountable through legal action. Our team is standing by to help you.

Common Questions About Sepsis

Top Question

Can sepsis be caused by bedsores?

Yes, since bedsores (pressure ulcers) progress into open wounds as they worsen, they can very easily get infected. Infected bedsores can quickly develop into sepsis.

What is a sepsis infection?

There is no such thing as a sepsis infection, but rather an existing infection that was caused by any number of common germs that develops into sepsis if it’s not properly treated.

Sepsis is life-threatening and should be considered a medical emergency. Without immediate treatment, sepsis can quickly lead to organ failure, tissue damage, and even death.

Is sepsis contagious?

No, you can’t spread sepsis to other people. However, the infections that lead to sepsis can be contagious.

Since nursing homes bring large groups of older people together under one roof, infections can quickly spread if the staff doesn’t properly address them, increasing the risk that more residents will also develop sepsis.

Nursing Home Abuse Support Team

The Nursing Home Abuse Center (NHAC) was founded to bring justice to those affected by nursing home and elder abuse. Our mission is to educate and empower victims of abuse and their families to take a stand against this unlawful mistreatment. We work to return dignity back to those who have been broken down by nursing home abuse and neglect.

View 8 Sources
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  2. Ginde, A. A., Moss, M., Shapiro, N. I., & Schwartz, R. S. (2013). Impact of older age and nursing home residence on clinical outcomes of US emergency department visits for severe sepsis. Journal of critical care, 28(5), 606–611. Retrieved May 23, 2021 from https://doi.org/10.1016/j.jcrc.2013.03.018
  3. Healthline. (n.d.) Sepsis. Retrieved May 23, 2021 from https://www.healthline.com/health/sepsis
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  5. Johns Hopkins Medicine. (n.d.) Chapter 30, Pressure Ulcers.. Retrieved May 23, 2021 from https://www.hopkinsmedicine.org/geriatric_medicine_gerontology/_downloads/readings/section8.pdf
  6. Mayo Clinic. (n.d.) Sepsis. Retrieved May 23, 2021 from https://www.mayoclinic.org/diseases-conditions/sepsis/symptoms-causes/syc-20351214
  7. Nasa, P., Juneja, D., & Singh, O. (2012). Severe sepsis and septic shock in the elderly: An overview. World journal of critical care medicine, 1(1), 23–30. Retrieved May 23, 2021 from https://doi.org/10.5492/wjccm.v1.i1.23
  8. Sepsis Alliance. (n.d.) Aging. Retrieved May 23, 2021 from https://www.sepsis.org/sepsisand/aging/
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