Too many nursing home residents suffer scald burns as a result of dangerously hot water in bathtubs, showers or sitz baths. Thermal burns also occur with the misuse of hot packs. These injuries often occur because nursing homes are understaffed, the nursing home staff is not competent, or the facility has been negligently maintained.

 

In the U.S. each year there are approximately 3,800 injuries and 34 deaths caused by excessively scalding hot water, according to the Consumer Product Safety Commission. A significant portion of these accidents involve the elderly. Burns will occur after a 6-second exposure to 140-degree water or after a 30-second exposure to 130-degree water. Even if the water temperature is 120 degrees, a 5-minute exposure could result in third-degree burns. 

 

The American Burn Association states the safest temperature for bathing is approximately 100 degrees.

 

In a 2006 Alert, the Michigan Department of Community Health warned: “The elderly are particularly at increased risk because their skin tends to be less sensitive and reaction times are reduced, causing a tendency to not pull away from hot water quickly enough to avoid scalding. Their thinner skin also burns full depth more quickly. A complicating risk is their decreased agility which may cause falls or other injuries while trying to get out of the way of a stream of hot water from a sink, shower or tub.”

 

The Michigan agency advised: “In nursing homes, there is a risk that residents may be scalded by excessively hot water discharged by plumbing fixtures in lavatories attached to their rooms, common bathing and shower areas, public restrooms, or other fixtures to which access is not strictly controlled. Nursing Home Rule 1317 (9) specifies that ‘The temperature of hot water at plumbing fixtures used by residents shall be regulated to provide tempered water not less than 105 degrees or more than 120 degrees Fahrenheit.’”

 

Some common causes of scald burns to the elderly include failing to check the water before exposing the person’s body to it, slipping and falling in the bathtub and not being able to get up, temperature changes that occur when water is being used in other areas, and a plumbing malfunction.

 

Nursing homes have a duty to provide a safe environment and equipment for their residents. In addition, nursing homes owe a duty to their residents to ensure that the resident environment remains as free from accident hazards as possible. These duties require that the facilities and environment remain safe for bathing the vulnerable residents of a nursing home. 

 

To do so, nursing homes should monitor and log water temperatures on a regular basis in all areas accessible to residents as part of routine maintenance procedures. Maintenance staff should use accurate thermometers when making these checks. Additionally, facility staff should immediately report water which seems excessively hot to the appropriate staff for quick correction. Maintenance staff should be knowledgeable about the operation of the facility plumbing systems and how to correct problems. Commercial plumbers should be used for complex systems. There are a variety of commercially available and relatively inexpensive anti-scald devices for use on outlets that shut off water automatically above 120 degrees.

 

In addition, nursing homes owe a duty to have sufficient and competent staff to ensure the well-being and safety of the residents. This requires proper training and supervision so that the nursing home staff safely bathe the nursing home residents, including ensuring a safe water temperature.