Contractures are painful, disfiguring deformities
of the joints. Muscles shorten when a person endures long periods
of immobility. Infrequent use causes the muscles to become rigid
or fixed. Joints do not move as freely or smoothly as they once
did. Movement is painful when the joint is moved because the shortened
muscles are being stretched beyond their ability.
As contractures progress, a person loses all voluntary movement
in the contracted joint. Bathing, dressing, and daily care become
more difficult. It is harder to position a resident properly because
the contracture creates pressure points that may lead to pressure
sores.
Contractures progress through four stages based
on severity. A Stage I contracture can develop in as few as four
days. Stage II contractures develop after an additional week or
two. Unfortunately, most contractures are not identified until
they are at Stage III. Stage III contractures need many as 500
days (a year and a half) to work themselves out. By Stage IV, a
resident's muscles and joints are so stiff that the resident is
folded into the fetal position.
Joint movement is affected by age, body size,
genetics, and the presence or absence of disease. The normal movement
of the joints is called range of motion. Healthy people do range-of-motion
movements many times each day during normal activities. Residents
in long term care facilities may not move each joint through its
normal range each day. The muscles atrophy and eventually shrink.
To avoid contractures nursing home staff members
must exercise an immobile resident's joints to prevent deformities.
The staff should be trained to perform exercises on residents with
various physical and mental conditions. Active range-of-motion
exercises are done independently by residents each day. Those with
limited mental ability may need reminders. Some may need to use
stronger muscles and joints to exercise weaker ones. That's O.K.,
as long as the exercises get done.
Like pressure sores, contractures are much easier
to prevent than to reverse. Contractures are prevented by maintaining
a resident's range of motion. Range-of-motion exercises can be
conducted without a physician's order unless the resident has osteoporosis,
severe arthritis or other joint or bone-related illnesses.
Range-of-motion exercises prevent contractures
and atrophy, they stimulate circulation (thereby reducing the risk
of blood clots), and they improve the resident's general sense
of well-being.
If a loved is in a nursing home and you feel that
have been abused or neglected, please contact The Rasansky Law
Firm immediately to discuss your legal rights and options regarding
your loved one in a nursing home.
For more information about Nursing Home Claims,
you can also visit www.nursinghomelawyer.com,
a Rasansky Law Firm speciality site devoted exclusively to Nursing
Home Claims, Nursing Home Abuse, Nursing Home Neglect, and Nursing
Home Rights.
Signs that a Loved
One In A Nursing Home could be in trouble include Behavioral
Problems, Changes In Physical
Conditions, Dehydration, and Immobility to
name a few.
