Stages of Bedsores
- Reviewed By
Anthony C. Lanzone, Founding Partner
- Bedsores, also called pressure ulcers, range from mild redness to severe tissue damage that exposes bone. Doctors categorize these injuries into four stages.
- Without prompt treatment, early pressure injuries can quickly progress to stage 3 and stage 4 bedsores, putting vulnerable nursing home residents at high risk of infection.
- If you or someone you love has developed pressure ulcers, it could indicate nursing home neglect.
- Learn about the stages of bedsores and how the bedsore attorneys in California at Lanzone Morgan, LLP, can seek justice for your family.
Bedsores are injuries to the skin and underlying tissue caused by prolonged pressure. They most commonly develop in nursing home residents who are immobile or neglected.
The severity of a bedsore is classified into stages, with higher stages indicating deeper, more dangerous wounds. These stages help guide the appropriate course of medical treatment and may also reveal neglect or abuse by nursing home staff.
Table of Contents:
- Understanding Bedsores and Their Dangers
- The 4 Stages of Bedsores
- How are Bedsores Diagnosed
- How to Spot the Warning Signs of Bedsores in Your Loved One
- Common Causes of Bedsores in Nursing Homes
- Who’s Responsible for What Happened to Your Loved One?
- Take the First Step Toward Justice and File Your Nursing Home Abuse Claim
Understanding Bedsores and Their Dangers
Bedsores, also known as pressure ulcers or pressure sores, are injuries caused by prolonged pressure on the skin. They often develop on bony areas such as the tailbone, heels, hips, or back. In nursing homes, bedsores can indicate inadequate care, poor monitoring, or neglect.
According to a 2004 report by the Centers for Disease Control and Prevention, about 11% of nursing home residents suffer from pressure ulcers each year. Advanced-stage bedsores are not just painful injuries; they are often a medical emergency and can become life-threatening if untreated.
The 4 Stages of Bedsores
Bedsores progress through four stages, from mild skin discoloration to deep wounds affecting muscles, tendons, or bones. Recognizing these stages is crucial for treatment and assessing potential legal liability if the facility failed to provide necessary care and services.
Stage 1 Bedsore: Reddened Skin
Stage 1 bedsores appear as persistent redness or discoloration on intact skin. The area may feel warm, firm, or painful.
At this stage, the damage is superficial, but that doesn’t make it less alarming. A stage 1 bedsore is an early warning sign that prolonged pressure is already damaging the skin. Because the skin is still intact, these changes can be easily mistaken for minor irritation, but they can progress to deeper injuries if not addressed quickly.
Stage 2 Bedsore: Partial-Thickness Skin Loss
Stage 2 pressure injuries involve partial-thickness loss affecting the top two layers of skin. The area may appear as a shallow sore with a red or pink wound bed, or as a blister.
By stage 2, the injury has progressed beyond surface redness and into an open wound. What may have seemed minor at first may now be much more concerning. A smooth recovery is still possible at this stage, but this is a critical point for intervention before the wound deepens or becomes infected.
Stage 1 vs. Stage 2 Bedsores
| Feature | Stage 1 Pressure Ulcer | Stage 2 Pressure Ulcer |
|---|---|---|
| Skin Integrity | Intact skin | Partial-thickness skin loss |
| Appearance | Redness or discoloration that does not turn white when pressed | Shallow open sore or blister |
| Symptoms | Pain, tenderness, warmth, or firmness | Pain, tenderness, swelling, or drainage |
| Infection Risk | Low risk of infection | Moderate risk of infection |
| Typical Treatment | Pressure relief, skin monitoring, and keeping the area clean and dry | Pressure relief, gentle cleansing, and applying a protective dressing |
| Recovery Outlook | May heal within a few days with prompt care | Often heal in one to six weeks with proper intervention |
Stage 3 Bedsore: Full-Thickness Skin Loss
Stage 3 pressure injuries involve full-thickness skin loss extending into the subcutaneous tissue, which is the fat layer beneath the skin. The sore may appear as a deep crater, and there is a high risk of infection at this stage.
Stage 4 Bedsore: Severe Tissue Damage
Stage 4 bedsores are the most severe. They involve extensive damage to the skin and deeper tissues. Muscle, tendon, or bone may become exposed.
When an open pressure injury exposes bone, bacteria can reach the bone tissue and marrow. This may cause a serious infection in the bone called osteomyelitis. The bacteria may also enter the bloodstream, leading to sepsis, a life-threatening response to infection that can cause organ damage.
How Long Does a Stage 3 or 4 Bedsore Take to Heal?
Stage 3 and 4 pressure sores often take more than six months to heal. Some bedsores may never fully heal. Recovery time depends on a wide range of individual factors, including the depth and size of the sore, whether infection occurs, the patient’s overall health, and how quickly appropriate treatment begins.
Unstageable Bedsores
An unstageable bedsore is covered by dead tissue or dark, scab-like tissue, making it impossible to determine its depth until the dead tissue is removed.
How are Bedsores Diagnosed
Healthcare providers diagnose bedsores through physical examinations, assessing the appearance, depth, and condition of the wound. In severe cases, they may also use imaging to check for bone damage.
The timing of a diagnosis can significantly impact legal timelines, as early documentation is important when pursuing a claim. Our firm uses detailed medical records, care notes, and facility logs to build strong cases that hold nursing homes accountable for neglect.
How to Spot the Warning Signs of Bedsores in Your Loved One
Remember, bedsores are usually preventable with proper nursing care and not an inevitable consequence of a resident’s health condition or age. Detecting the signs of injury early and acting on them can prevent serious complications.
Look for the following warning signs:
- Redness or discoloration in bony areas
- Warmth, firmness, or sponginess of the skin
- Complaints of pain in a specific area
- Blisters, open wounds, or drainage
- Foul odor from the wound site
If you notice a possible pressure injury, document your concerns and notify the nursing home’s administrators in writing. Ask what steps staff are taking to prevent the injury from worsening, and continue advocating for your loved one until you are satisfied that the facility is responding appropriately.
If the facility ignores your complaints or allows the injury to worsen, contact the California Department of Public Health at (800) 554-0354 for further assistance.
“And one of the main defenses in all of our cases is that whatever happened to this person wasn't because of neglect. What happened to this person was because of their underlying disease processes or their age. This was just inevitable. That's not true. People aren't supposed to get bed sores. Especially when the family's trying to do the right thing by entrusting the care and paying thousands of dollars so that this doesn't happen because they don't have the expertise to take care of them and keep them safe themselves.”
Common Causes of Bedsores in Nursing Homes
Bedsores are rarely just an unfortunate side effect of aging. They usually stem from serious lapses in care.
Bedsores often result from the following:
- Failure to reposition immobile residents
- Lack of proper hygiene or moisture management
- Poor nutrition and hydration
- Understaffing or inadequate training
- Ignoring risk assessments or care plans
These failures are preventable with attentive care. Unfortunately, bedsores often arise from systemic issues in nursing homes, such as understaffing and profit-driven neglect.
Who’s Responsible for What Happened to Your Loved One?
While not every pressure ulcer results from neglect, most do. Repeated or advanced-stage bedsores in nursing homes often indicate serious failures on the part of those entrusted with a resident’s care.
Nursing staff may be responsible for failing to regularly reposition the resident, failing to perform skin checks, or delaying treatment after a wound appears. The facility itself may be liable for inadequate staffing, poor supervision, or improper training that contribute to the harm. Doctors or hospitals may also share responsibility if they failed to diagnose or properly treat a pressure sore, allowing it to progress to more advanced stages.
Our attorneys can investigate the circumstances surrounding your loved one’s bedsores to determine whether neglect played a role and identify who may be at fault. From there, we can pursue a strong case against every liable party on your family’s behalf.
Take the First Step Toward Justice and File Your Nursing Home Abuse Claim
If your loved one has developed bedsores while residing at a nursing home or care facility, Lanzone Morgan can help. Call (888) 887-9777 or contact us online today for a free consultation with our skilled bedsore attorneys to begin your path to justice.
- Fact-Checked
This content has been legally reviewed and approved by nursing home abuse attorney, Anthony Lanzone. Anthony holds notable memberships with professional organizations including the American Association for Justice and Consumer Attorneys of California.
VIEW SOURCES
Chen, Z., Gleason, L. J., & Sanghavi, P. (2022, October). Accuracy of pressure ulcer events in US nursing home ratings : Medical care. Medical Care: Official Journal of the Medical Care Section, American Public Health Association.
https://journals.lww.com/lww-medicalcare/Fulltext/2022/10000/Accuracy_of_Pressure_Ulcer_Events_in_US_Nursing.7.aspx
Park-Lee, E., & Caffrey, C. (2009, February). Pressure Ulcers Among Nursing Home Residents: United States, 2004. Centers for Disease Control and Prevention.
https://www.cdc.gov/nchs/products/databriefs/db14.htm
Smith, D. M. (1995, September 15). Pressure ulcers in the nursing home. PubMed.
https://pubmed.ncbi.nlm.nih.gov/7639444/
Voss, A. C., Bender, S. A., Ferguson, M. L., Sauer, A. C., Bennett, R. G., & Hahn, P. W. (2005, September). Long-term care liability for pressure ulcers. Journal of the American Geriatrics Society. https://pubmed.ncbi.nlm.nih.gov/16137292/
- Fact-Checked
This content has been legally reviewed and approved by nursing home abuse attorney, Anthony Lanzone. Anthony holds notable memberships with professional organizations including the American Association for Justice and Consumer Attorneys of California.
VIEW SOURCES
Chen, Z., Gleason, L. J., & Sanghavi, P. (2022, October). Accuracy of pressure ulcer events in US nursing home ratings : Medical care. Medical Care: Official Journal of the Medical Care Section, American Public Health Association.
https://journals.lww.com/lww-medicalcare/Fulltext/2022/10000/Accuracy_of_Pressure_Ulcer_Events_in_US_Nursing.7.aspx
Park-Lee, E., & Caffrey, C. (2009, February). Pressure Ulcers Among Nursing Home Residents: United States, 2004. Centers for Disease Control and Prevention.
https://www.cdc.gov/nchs/products/databriefs/db14.htm
Smith, D. M. (1995, September 15). Pressure ulcers in the nursing home. PubMed.
https://pubmed.ncbi.nlm.nih.gov/7639444/
Voss, A. C., Bender, S. A., Ferguson, M. L., Sauer, A. C., Bennett, R. G., & Hahn, P. W. (2005, September). Long-term care liability for pressure ulcers. Journal of the American Geriatrics Society. https://pubmed.ncbi.nlm.nih.gov/16137292/