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Stage 4 bedsores, also called pressure wounds, pressure ulcers, and decubitus ulcers, are caused by prolonged pressure to any part of the body or friction to the skin.
The compromised state of the person can be due to:
These lead to a decrease in blood supply and nutrients, making the person susceptible to stage 4 bedsores.
According to the CDC (Centers for Disease Control and Prevention), health statistics show that most patients are at risk of severe bedsores, especially those with a neurological impairment who cannot feel pain.
The Department of Human Services shows that pressure ulcers in long-term care facilities are high, with a study finding that 44% of care home residents have at least one stage 3 or 4 pressure wound.
Stage 4 bedsores are also seen in patients confined to bed for extended periods, especially if they are obese or have a compromised immune system.
Other factors that may reduce blood flow or blood supply leading to pressure ulcers include poor skin integrity (thickening skin), smoking, paralysis, and prolonged exposure to moisture.
A resident's health is compromised when they develop bedsores from the failure to provide the standard of care that is reasonable and necessary. Nursing home neglect includes, but is not limited to, providing preventive measures against the development of bedsores, which can lead to serious complications.
Bedsores are caused by pressure and friction on the skin. They can develop on any part of the body that is in contact with a surface for an extended period.
The causes include:
The most common areas for bedsores to develop are the back, hips, and heels. Bedsores can cause significant pain and discomfort for the resident. They can also lead to serious health complications, like infection and sepsis.
Contributing factors of stage 4 bedsores include:
The National Center on Elder Abuse states that bedsores are often the result of nursing home staff failing to provide adequate care. The Centers for Medicare and Medicaid Services (CMS) has established many skincare protocols for treating pressure sores at all four stages.
Nursing staff allowing a facility-acquired pressure ulcer to progress to a stage 4 bedsore could be the first sign of elder abuse or neglect. If left untreated, a stage 4 pressure ulcer could become a deadly wound if infection or gangrene reaches the deeper tissues.
A pressure sore appears as warmer or reddened, darker skin than the surrounding area in its initial stage. However, the pressure sore could develop into a skin ulcer with a yellow or white color in an advanced stage.
Johns Hopkins reports that pressure ulcers are the second most common type of hospital-acquired infection. Stage 4 bedsores are the most serious due to significant dead tissue damage.
According to National Pressure Ulcer Advisory Panel (NPUAP), multiple pressure ulcer sore stages include:
Early-stage bedsores involve the topmost layer of the skin and are considered minor pressure injuries requiring minimal treatment by competent health care providers to restore the area to healthy skin.
Stage 2 pressure ulcers involve damage to both the epidermis and dermis skin layers, leading to fatty tissue bleeding. With this type of pressure wound, there may be tenderness and pain in the affected area, and a slight depression for the underlying dead tissue is forming a crater.
Stage 3 pressure ulcers now appear as a deep tissue injury exposing the dermis and subcutaneous fat. These pressure ulcers cause extreme pain and could lead to severe infection. In some cases, the crater exposes:
A stage 4 bedsore destroys all deeper tissues beneath the skin and can be life-threatening. Fat may show in the sore along with muscle, tendon, or bone.
These stages of pressure sores are essential to understand because they provide a guideline for healthcare professionals when treating patients. Nurses should also be keenly aware of these stages and report any changes in the patient's condition to health care providers immediately.
In addition to the four stages of pressure injuries, nursing home residents can also develop unstageable bedsores and suspected deep tissue injuries.
At this stage, the skin surface appears as a stage 1 or stage 2 pressure wound on the skin's surface, hiding a significant injury underneath the skin surface, similar to stage 3 or stage 4 bedsores.
The opened wound appears was significant debris in the crater that is likely necrotic (dead) tissue, dried blood, or other substances blocking the diagnostician's view needed to accurately stage the wound.
The symptoms of stage 4 bedsores which are typically called pressure sores, can include:
A failure to recognize and treat stage 4 bedsores in nursing homes could be the first sign of nursing home abuse, mistreatment, or negligence. Treatment is essential in the early stages of stage 4 bedsores to save the patient's life.
Stage 4 bedsore at this stage indicates that the skin has been so damaged by being unrelieved from pressure or shear factor for extended periods that the dermis and underlying layers have essentially died. At this stage, life-saving medical treatments in an emergency room or hospital setting are typically necessary to avoid serious complications.
If left untreated, stage 4 bed sores will lead to life-threatening infections. Severe tissue damage can destroy muscles and bone (osteomyelitis, a bone infection), leading to septic shock and death in severe cases.
Stage 4 bedsores with life-threatening complications typically result in permanent damage where the wound can never heal completely.
If a newly developing bed sore is treated properly, it may heal within a few weeks. However, if left untreated, a stage 4 pressure sore could take months or years to heal and may lead to serious health complications, such as:
Any location on the body can experience a stage 4 bedsore. However, pressure wounds commonly appear on bony areas such as the heels, spine, and hips. They can also occur on many other sites, including the buttocks and shoulders.
In many cases, the location of the stage 4 bedsore is based on the patient's health condition or limited mobility issues. Any individual remaining in one position for an extended period of time could be at significant risk of developing pressure ulcers. The most affected areas include:
Nurses involved in patients' skin care protocols should follow proper precautions to ensure that stage 4 bedsores don't develop. The following are some safety measures used to prevent pressure ulcers:
Bedsores are a common issue in nursing homes. They can develop when a person is inactive or confined to a bed or chair for long periods of time. The increased pressure on the skin from lying in one position for an extended time can cause the skin to break down and form a sore.
Nursing home staff members must conduct skin assessments when a resident is admitted to the facility and then every three months. A skin assessment is important to ensure that any bedsores are caught early, before they have a chance to become more serious.
If a bedsore is detected, the nursing home staff will take steps to treat it. It may include repositioning the resident, using special mattresses or cushions, and applying dressings or bandages to the area.
It is important for nursing home residents and their families to be aware of the risk of bedsores and to recognize any signs of developing pressure wounds. If you have concerns about your loved one's skin health, speak with the nursing home staff.
Failing to conduct routine skin assessments based on currently accepted professional principles could indicate nursing home abuse and neglect. Failing to follow the procedures and protocols outlined in the patient's care plan that leads to stage IV bedsores could indicate negligence.
Medical treatment for stage 4 bedsores will include debridement (removal devices like mattresses, cushions, etc.).
Skincare is another crucial aspect of treating pressure sores. The damaged area tends to be black or dark brown due to clotting, restricting blood circulation underneath the healthy skin tissue.
The proper treatment could include:
Proper treatment might take several months for a patient suffering from stage 4 severe bedsores to experience healing, especially if there are other health conditions. However, many patients' pressure injuries completely heal and return to normal activities.
A study done at the Department of Veterans Affairs showed that patients with stage 4 ulcers had a higher mortality rate if they were age 75 or older, had an acute illness, and suffered malnutrition.
Many patients with degrading sores will recover completely. However, for others, stage 4 ulcers could have a deadly outcome.
According to the National Institutes of Health, stage II and stage III sores have a better prognosis than those with stage 4 bedsores and are at a very high risk of infections.
Examples of a poor health prognosis for individuals with progressive serious pressure wounds include:
The evidence, facts, and medical conditions involved in every stage 4 bedsore event make every case unique. Because of that, it is difficult to identify the case's merits and value without an extensive assessment.
However, our personal injury attorneys use your specific valuation tools to determine a claim's value. Typically, we will determine the value of your case on certain factors, including:
Our abuse attorneys at Nursing Home Law Center provide a free legal case review for any individual or loved one who has been the victim of nursing home abuse or neglect.
We understand how difficult this question can be to answer. It is not always easy to predict how long a case might take because many factors are involved. Typically, the time it takes to resolve a matter depends on:
A personal injury case involving a simple car accident typically takes a few months to resolve. In contrast, a case involving nursing home abuse, neglect, or wrongful death may take several years.
Call us today if you suspect abuse or neglect at a nursing home or assisted living facility! We have years of experience helping families get justice for victims abused by nursing home abuse pressure ulcer management in America!
Our team of experienced attorneys will fight hard on your behalf so that you can focus on what matters most – getting better wound care for your loved ones while holding abusers accountable!
Don't wait another day. Contact our office right now to start working together towards justice today!
Have you lost a loved one to a stage IV pressure sore? You can file a wrongful death lawsuit to sue the facility based on nursing home abuse or negligence. However, proving elder abuse can be complicated.
Why should you hire a lawyer? A lawyer can provide immediate legal help to navigate the complex legal process and fight for the financial compensation you deserve.
An attorney from our law offices will also:
We aim to give you immediate legal assistance and representation as soon as possible after your injury.
When you come in for your free case review, our experienced nursing home abuse attorneys will go over the details of your case and answer all your questions. In addition, we will provide you with highly confidential legal advice tailored to your case and specific circumstances.
Call an abuse lawyer at (800) 926-7565 to schedule a free, no-obligation consultation with an attorney specializing in personal injury cases. Let us provide legal help and discuss receiving financial compensation for your damages.