More than one in ten nursing home residents suffer from skin infections like pressure ulcers. These preventable conditions can lead to serious complications—and your loved one could be at risk. Skin becomes more delicate with age, making conditions like pressure sores and cellulitis develop quickly and heal up to four times slower.
If your loved one is in a nursing home, you might have noticed redness, irritation, or sores, raising concerns about whether they are receiving the proper care. These worries can feel overwhelming, but understanding common infections, their treatments, the warning signs, and effective prevention strategies can help you protect their health and comfort.
Why Skin Infections Are Common in Nursing Homes
Elderly residents in nursing homes often face a higher risk of many types of injuries, including skin infections. Past research has found that nearly 18% of care facility residents may experience these issues. Several age-related changes contribute to this increased vulnerability:
- Weakened immune systems. Aging reduces the body’s ability to fight off bacteria and viruses, leaving residents more susceptible to infection.
- Thinner skin. Aging skin becomes more fragile, making it prone to tears, abrasions, and cracks that can allow infections to develop.
- Chronic conditions. Health issues like diabetes, heart disease, or poor circulation slow healing and increase the chance of infection. One study showed that nearly 21% of nursing home residents with skin diseases had hypertension and 10% diabetes.
- Limited mobility. Reduced movement can lead to poor blood circulation and prolonged pressure on the skin, making it harder for wounds to heal and increasing the likelihood of infection.
These issues, combined with shared living spaces and frequent interactions with staff and visitors, make skin infections a persistent concern. Neglect or physical abuse can also increase the risk, making proper monitoring and support essential.
Six Common Skin Infections in Nursing Homes
Nursing home residents may suffer from various skin infections and complications, especially when staff fail to provide proper care. Here are six of the most common conditions:
1. Bedsores (Pressure Ulcers)
Bedsores, or pressure ulcers, form when prolonged pressure cuts off blood flow to the skin, causing damage. They often develop in areas like the hips, lower back, or heels, especially in residents with limited mobility who spend much of their time in bed or a wheelchair.
The damage caused by bedsores can include:
- Open wounds that are prone to infection
- Persistent pain and discomfort
- Reduced mobility due to complications
- Dangerous infections, like cellulitis or sepsis
Treating bedsores involves frequent repositioning, cleaning the affected areas, and proper wound care. Without intervention, they can worsen, leading to severe infections and lasting health problems.
2. Fungal Infections
One study found fungal infections to be the most common infectious disease in nursing homes, affecting 37.8% of residents. These infections thrive in warm, moist areas like skin folds, under breasts, or between toes and are often caused by limited mobility, poor hygiene, or moisture from incontinence or sweating.
Complications from fungal infections can include:
- Persistent itching and discomfort
- Cracked or peeling skin that increases infection risk
- Painful rashes or lesions that can spread if untreated
- Secondary bacterial infections from broken skin
If left untreated, fungal infections can lead to more serious issues, such as cellulitis, abscesses, or systemic fungal infections, which are harder to treat and can affect overall health. Prompt care with antifungal treatments and preventative measures is essential.
3. Bacterial Infections
Bacterial infections, including cellulitis, abscesses, and methicillin-resistant Staphylococcus aureus (MRSA), often develop when open wounds or damaged skin are exposed to harmful bacteria. In nursing homes, untreated injuries, poor hygiene, and close living quarters increase the risk. One study found cellulitis in 37% of cases, skin or soft tissue infections in 18%, and abscesses in 16%.
Bacterial infections can lead to:
- Redness, swelling, and pain at the infection site
- Fever or other systemic symptoms
- Spreading infections like cellulitis or abscesses
- Life-threatening conditions, such as sepsis
Treating bacterial infections requires proper wound care, antibiotic treatment, and close observation for any signs of complications. Delayed care can allow these infections to worsen, leading to severe health risks for the resident.
4. Scabies
Caused by tiny mites that burrow into the skin, scabies is a skin infestation that can cause intense itching and a rash. In nursing homes, close living quarters and shared spaces make it easier for scabies to spread through direct skin contact or contaminated items like bedding or clothing.
Worsening scabies can cause:
- Persistent itching that disrupts sleep and causes discomfort
- Secondary bacterial infections from excessive scratching
- Widespread outbreaks among residents and staff
Effective treatment includes prescribed topical or oral medications to kill the mites and washing all bedding, clothing, and personal items in hot water to prevent re-infestation.
5. Shingles
Shingles (Zoster) is caused by the reactivation of the varicella-zoster virus. It causes a painful rash, often appearing as a band on one side of the body. Elderly nursing home residents are more at risk due to weakened immune systems. Though shingles isn’t contagious, direct contact with the rash can spread the virus to someone who hasn’t had chickenpox or the vaccine.
Complications may include:
- Severe nerve pain (postherpetic neuralgia) that can last for months
- Open sores that increase the risk of secondary infections
- Vision or hearing loss if the rash affects the eyes or ears
- In rare cases, encephalitis (brain inflammation) or pneumonia
Early treatment with antiviral medications can reduce the severity and duration of symptoms. Without prompt care, shingles can lead to prolonged pain, permanent nerve damage, or life-threatening complications in older adults.
6. Diabetic Wound Infections
Residents with diabetes face an increased risk of wound infections due to poor circulation and slower healing. Small cuts, blisters, or ulcers can quickly become infected, particularly on the feet or lower legs, where blood flow is often reduced.
Diabetic wound infections can cause complications like:
- Chronic, non-healing wounds that worsen over time
- Increased risk of severe infections like cellulitis or gangrene
- Potential need for amputation if the infection spreads or damages tissue
To prevent these infections, staff must perform proper wound care, maintain blood sugar levels, and conduct regular foot inspections. Untreated diabetic wound infections can lead to severe complications, including chronic wounds, gangrene, or amputation if the damage becomes too extensive.
Steps To Take if You Notice a Skin Infection in a Loved One
While staff are tasked with providing proper care, instances of mistreatment, whether intentional or unintentional, can increase the risk of skin infections. As a family member, you can do the following to ensure your loved one receives the care they need:
| Step | What To Do |
| Document the Symptoms | Note the location, size, and appearance of the affected area, along with any redness, swelling, or unusual discharge. Include other symptoms like fever or pain that might indicate the infection is spreading. |
| Inform Nursing Home Staff Immediately | Report your observations and ask staff to evaluate the situation and address the condition before it worsens. |
| Request a Medical Evaluation | Ask a healthcare provider to examine your loved one to determine the infection’s cause and prescribe appropriate treatment, such as antibiotics or wound care. |
| Follow Up Regularly | Stay involved by checking their progress and asking staff for updates on treatment and recovery. |
| Escalate the Complaint | If the situation remains unresolved or you suspect mistreatment, consult a skilled nursing home abuse attorney to learn your legal rights and next steps. |
Legal Implications of Neglect or Abuse
When negligent care in a nursing home leads to severe harm or tragic wrongful death, you may be able to hold the responsible parties liable for damages. This typically involves filing a complaint with the proper authorities or seeking a settlement in a civil lawsuit:
- Report to CDPH. File a complaint with the California Department of Public Health (CDPH), which oversees nursing home care. This involves submitting details about the improper care online, by mail, or by phone. CDPH will investigate your claim, conduct inspections, and take corrective action if violations are confirmed.
- File a lawsuit. Work with a qualified nursing home abuse attorney to hold the facility liable and pursue compensation. Your lawyer can gather evidence, negotiate with insurers, or represent your case in court to help your family win damages for medical expenses, pain and suffering, and other damages, such as funeral expenses, if your loved one died due to their injuries.
Protecting Elderly Residents Starts With Awareness
Skin infections in nursing homes are a serious concern, but understanding the risks and advocating for proper care can make a difference. Paying close attention to your loved one’s health and acting quickly when issues arise helps prevent complications and ensures their well-being.
In cases where neglect or abuse contributes to harm, speak with an attorney to learn your options for holding facilities accountable and protecting your loved one’s rights.
