Coronavirus Update: Impact on Nursing Home Patients Learn More ›

Stage 4 Bed Sores in Nursing Homes

Do you suspect nursing home abuse? If you're concerned about your loved one, it is important to act immediately.

At Nursing Home Law Center, LLC, our personal injury attorneys are legal advocates for injured nursing home residents harmed through caregivers and other patients' negligent or careless actions.

Call our bedsore injury lawyers at (800) 926-7565 or use the contact form today to schedule a free legal case review.

Have you ever visited a loved one in a nursing home and noticed something was off? Maybe they seemed scared, or their caregiver wouldn't let them speak freely.

Or maybe there were bruises on their arms that didn't seem to make sense. You might have thought it was nothing at the time, but now you wish you had paid closer attention. We can help and get justice for what happened.

What are Bedsores?

Bedsores, also referred to as pressure sores, pressure wounds, pressure ulcers, decubitus ulcers, are caused mainly by prolonged pressure to any part of the body or friction to the skin.

In addition, the compromised state of the person can be due to age, impaired sensory perception (numbness), impaired mobility (paralysis/unable to move), illness (fever), leading to a decrease in blood supply, and poor nutrition hence making the person susceptible to bedsores.

Bedsores are often seen in people in nursing homes confined to wheelchairs for a long time.

According to the CDC (Centers for Disease Control and Prevention), patients most at risk of severe nursing home bedsores involve those with neurological impairment and individuals who cannot feel pain even when receiving proper care for their medical conditions.

In these cases, the nursing home residents do not know when they are getting pressure ulcers, especially those with advanced dementia or children who cannot communicate that their skin is getting sore from prolonged sitting or lying down on one spot.

It is common for patients with long-term pressure ulcers to have other caregivers, physicians, and nurses providing professional medical advice concerning serious health problems in the healthcare environment.

These caregivers include physical therapists, occupational therapists, speech-language pathologists, and dietitians who play a vital role in preventing bedsores in their clients.

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 in the body leading to pressure ulcers include poor skin integrity (thickening skin), high BMI (body mass index), smoking, paralysis, and prolonged exposure to moisture.

Were you or a loved one injured by a facility-acquired bedsore? Stage 4 Bedsores and Pressure Sores: What is the Difference?

Medically speaking, bedsores are also called pressure sores by doctors and other medical professionals. However, some doctors use different phrasing, including pressure sores, pressure wounds, and a bit our ulcers to mean something different or more advanced than typical bedsores.

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.

Doctors will use numerous staging categories to clarify the extent of a bedsore injury, its measurement, wound depth, and other factors. Stage 4 bedsores are the most serious due to significant tissue damage.

The Stages of Pressure Sores in a Nursing Home

According to National Pressure Ulcer Advisory Panel (NPUAP), Pressure ulcers affecting healthy skin can be further classified as:

  • Stage 1 bedsore: Early-stage bedsores involve the topmost layer of the skin and are considered a minor injury requiring minimal proper treatment by competent health care providers.
  • Stage 2 bedsore: Involves damage of both the epidermis and dermis, thus causing tissue bleeding. With this type of pressure wound, there may or may not be pain present.
  • Stage 3 bedsore: Involves damage to deeper tissues below the dermis and subcutaneous fat; this type of pressure ulcer causes extreme pain and may lead to infection; there is also a possibility that it may involve bone, tendon, or muscle tissue.
  • Stage 4 bedsore: This type of pressure wound involves destroying all soft tissues beneath the skin and can be life-threatening. It does not involve any bone, tendon, or muscle tissue but can damage them if it directly contacts the afflicted area.
  • Unstageable: Sometimes, the build-up of debris, necrotic (dead) tissue, and other particles block the diagnostician's ability to stage the pressure wound accurately.
  • Deep Tissue Injury: This type of pressure wound may not initially cause pain and does not involve bone, tendon, or muscle tissue. However, if left untreated for a long time, it can kill the patient.

Bedsores symptoms are often difficult to spot at home because there are no external symptoms apart from skin discoloration and painless open wounds that do not bleed. Although the injured area might be swollen, the skin may appear shiny and white, identifying existing sores.

The symptoms of pressure sores can include:

  • Blisters on pressure point areas on the body
  • Bright red, purple, or black discoloration of the affected area
  • Skin breakdown with no blisters present
  • The sensation of intense pain in the affected area
  • Fever sore that does not heal
  • A wound that has a white or yellow color
  • An open wound that does not bleed
  • If the patient has diabetes, they may also experience:
  • Dry and matted skin
  • Red and scaly skin

A failure to recognize and treat bedsores in nursing homes could be the first sign of elder abuse, mistreatment, neglect, or negligence. Treatment is essential in the early stages of bedsores to prevent wounds from worsening, requiring antibiotics, debridement, and skin grafts.

Why Are Stage 4 Bedsore so Dangerous?

According to the National Pressure Ulcer Advisory Panel and the National Council on Aging, a deep tissue injury is a stage 4 bedsore.

In other words, 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 skin and underlying layers have essentially died.

Stage 4 Bedsore – Tissue Necrosis (Dead Tissue)

Because a stage 4 bedsore indicates that the skin has been so damaged by being unrelieved from pressure or shear factors for extended periods, the tissue necrosis created by stage IV pressure ulcers is alarming.

Tissue destruction can destroy muscles and bone (osteomyelitis – bone infection). It can cause septic shock and death in severe cases, making stage 4 bedsores particularly difficult to treat.

Ongoing Treatment Needed for Stage 4 Bedsore

What makes treating a stage 4 bedsore especially challenging is that it requires ongoing attention and care. In addition, because of the damage done to the skin tissues, these bedsore injuries are likely to progress over time if they are not continually treated to prevent further skin deterioration.

In addition, when the skin has been damaged to this extent, it is more difficult for the injured area to self-heal.

The ongoing care needed to treat bedsores includes regularly evaluating a medical professional, ensuring no further complications or conditions with the nursing home resident developing bedsores, and preventing any other problems from occurring.

Debridement and Other Surgical Procedures

In some cases, the surgeon or wound care team will recommend a debridement, where necrotic tissue is surgically removed during the procedure.

The removal of the dead skin and underlying tissue might improve the appearance of the wound, but it does not repair the injury because the tissue destroyed by pressure ulcer stage 4 is gone and cannot be replaced.

After a debridement, dressings and daily care with advanced hydrotherapy treatments will help to stimulate the healing process. The wound care drains fluids from the area and providing oxygen, nutrients, and moisture directly to the injury.

According to Johns Hopkins Medicine, the most effective way to care for stage 4 pressure ulcers is to identify them early and begin treatment right away.

While it might be tempting to put off pressure ulcer evaluation if the patient is unresponsive or there are other life-threatening conditions, doing so can only delay the healing process and increase the damage done by the injury.

Locations for Stage 4 Bedsores

Any location on the body can experience a stage 4 bedsore. However, pressure wounds most commonly appear on bony areas where bones are located close to the skin surface, such as the heels, knees, and hips.

However, not all stage 4 pressure ulcers affect bony areas – they can also occur on many other areas, including the buttocks and shoulders.

In many cases, the location of the Stage 4 bedsore is based on the patient's health condition or mobility issues. Any individual remaining in an isolated position for more than 90 minutes could be at risk of developing pressure ulcers on the:

  • Back of the legs
  • Soles of the feet
  • The buttocks
  • Shoulders and shoulder blades
  • Elbows and forearms
  • Back of the head
Prevention of Stage 4 Bedsore

The best way to prevent stage 4 bedsores is through regular monitoring of patients for changes in skin color, temperature, or other signs that might indicate an injury. If any redness, blisters, pain, or itching are discovered, it is important to immediately get the patient to a medical professional.

Early treatment is critical for preventing further injury and ensuring that advancing pressure wound patients heal quickly and thoroughly. In addition, proper nutrition and hydration are crucial for healing lower stage bedsores to minimize damage if treated promptly.

If your loved one has been diagnosed with progressing bedsores or if you suspect that they might be developing, get them to a wound care specialist immediately. The earlier this type of injury is identified, the better chance your loved one has of full recovery.

Treating Bed Sores

The treatment of bedsores starts with prevention; this is why nurses involved in the care of patients should follow proper precautions to ensure that bedsores don't develop. The following are some safety measures used to prevent pressure ulcers:

  • Proper positioning of the patient every 2 hours using pillows or other positions that redistribute pressure
  • Use of pressure-relieving machines and beds that redistributes weight and increases blood flow
  • Use of foam wedges and proper mattresses to prevent pressure ulcers
  • Keeping the skin clean and moist with lotion while observing cracks, blisters, or redness in the skin

Medical treatment for Stage 4 bedsores will include debridement (removal devices like mattresses, cushions, etc.

Skincare is another important aspect in the treatment of bedsores. Initially, they are red and inflamed, but later they tend to be black or dark brown due to clotting, restricting blood flow underneath the skin tissue.

Finally, a nurse might shave off some of the hair around the bedsore so that the wound can breathe.

For patients suffering from stage 4 bedsores, care aims to prevent the progression of the injury and treat pressure sores and their associated complications. In addition, doctors in nursing homes will evaluate any current or previous infections that might have contributed to the degrading skin.

If a serious infection is identified, antibiotics are given to stop the infection from getting worse. The treatment could include:

  • Antibiotics, pain relievers, and other medication
  • Sterilized gauze and dressings
  • skin grafting
  • Vacuum-assisted closure (negative pressure wound therapy
  • Hyperbaric oxygen therapy

Disinfecting the area around a skin ulcer may not be enough to slow down or stop active life-threatening infections or prevent bedsores from recurring. In these cases, antiseptics and antibiotics may be necessary. Having a pressure-relieving mattress can also help with pain control during treatment for stage 4 bedsores.

Regular and frequent inspection of the stage 4 pressure wound is done by a healthcare professional to determine if it's healing or not. If no progress has been made in 7-10 days, changes to treatment will be made, including reassessing risk factors to determine why bedsores occur in that area, placing the patient at high risk.

It might take several months for a patient suffering from stage 4 bedsores to recover, especially if there are health conditions other than nursing home bedsores. However, many patient's pressure injuries heal well and go back to their normal activities.

Health Prognosis for Nursing Home Residents with a Stage 4 Bedsore

A study done at the Department of Veterans Affairs showed that patients with stage 4 pressure ulcers had a higher mortality rate if they were age 75 or older, had an acute illness, or suffered malnutrition.

According to the National Institutes of Health, Stage II and Stage III pressure sores have a better prognosis than stage 4 bedsores. Many patients with degrading pressure sores will recover completely. However, for others, stage 4 pressure ulcers could have a deadly outcome.

Examples of health prognosis for individuals with progressive serious pressure wounds include:

  • Serious bedsore on heels of a patient with multiple sclerosis.
  • A large wound on the heels of a patient with Crohn's disease.
  • Stage III decubitus ulcer, sacral area of a patient with spinal cord injury.
  • Dermatitis on the right ankle harmed a bed-ridden patient for three months due to pressure from the edge of the mattress and friction from the sheet. Dermatitis started as a blister and progressed to Stage II before it was recognized.
  • Patient with leukemia in remission lying in bed. Decubitus ulcer (bed sore) on the scrotum, with necrosis, where the skin dies, undermining the scrotal skin. The skin ulcer was caused by a benign tumor which prevented the patient from rolling over in bed until it was surgically removed several weeks later.
  • Positioning devices prevent the development of bedsores and nursing home residents with mobility challenges.
  • A patient with chronic lung disease lies in bed at home with a pressure sore on the bottom of the foot.
On Average, How Long Can a Person Live with Stage 4 Bedsores?

According to the CDC (Centers for Disease Control and Prevention), most nursing home residents with stage 4 decubitus ulcers will survive. However, the prognosis depends on certain factors like age, current illness, and the patient's nutritional status.

What Are Some Examples of Health Prognosis for Individuals with Stage 4 Nursing Home Bedsores?

In their early 30’s or younger, patients in nursing homes have a better chance of healing than adults over 75 years old. The best prognosis for stage 4 bedsores is observed in healthy people without any significant illnesses or injuries.

Most people who have decubitus skin ulcers are older adults with fragile skin. Many of these individuals are confined to bed because of their condition, usually involving immobility. As a result, the affected area is often subjected to pressure.

According to experts, some nursing home residents who had stage 3 and stage 4 decubitus ulcers died within a year of the diagnosis. However, the median survival time is typically longer than one year for most people with stage 3 and stage 4 bedsores.

Many of these cases involve nursing home abuse and neglect for the victim developed a preventable stage 4 bedsore.

How much is your nursing home Nursing Home Neglect: Is Compensation Available for Stage 4 Pressure Ulcers?

Yes. Any caregiver in a nursing home, assisted living facility, rehab center, hospital, or at-home is a legal responsibility to ensure the safety and well-being of their patient. Developing a facility-acquired bedsore is often the sign of negligence by the nursing staff, caregivers, employees, or others.

If you have developed a decubitus ulcer at the hands of negligent caregivers, please get in touch with the Nursing Home Law Center, LLC at (800) 926-7565 to speak with a personal injury attorney specializing in nursing home abuse cases.

What Do I Do If I Think That Nursing Home Abuse Caused Injury or Malpractice?

If you have been the victim of nursing home neglect or injury due to abuse or medical malpractice, notify the state department of Health and Human Services. To do so, you can call the Ohio Department of Health at (800) 686-1568.

You may also want to contact a nursing home abuse lawyer if you feel your loved one has been mistreated or neglected while residing in a nursing facility, assisted living center, or another long-term care facility.

You can contact our experienced attorneys at Nursing Home Law Center LLC by calling (800) 926-7565 today to schedule a free case evaluation. Learn more about your legal options if you believe your loved one has been the victim of negligence or abuse.

What is My Stage 4 Bedsore Injury Case Worth?

The evidence, facts, and medical conditions involved in every stage 4 bedsore case are unique. Because of that, it is difficult to identify the case's merits and value easily.

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 specific factors, including:

  • The cost of medical expenses and hospitalization bills
  • Any lost wages and future lost earnings
  • The pain and suffering endured as a result of the injury
  • Mental and emotional distress
  • The expense of any future treatment
  • Funeral & burial costs in wrongful death cases

Nursing home abuse attorneys at Nursing Home Law Center LLC provide a free case review for any individual or loved one who has been the victim of nursing home neglect.

Moreover, an experienced legal professional will consider these factors when making an offer for your case.

Please note, our law firm accepts all cases involving nursing home abuse or neglect on a contingency fee basis, which means we only get paid if there is a recovery of monetary damages.

If you accept our offer, we will provide immediate legal representation and work hard on your behalf to ensure you receive the highest possible compensation for your injuries.

How Long Does a Personal Injury Case Take?

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 case depends on:

  • The severity of your injuries
  • The number and type of witnesses involved in your case
  • The strength of the evidence supporting your claim
  • Any complicated legal issues or procedures that come up during the litigation process
  • Your attorney's availability

Typically, a personal injury case involving a simple car accident takes a few months to resolve. In contrast, a case involving nursing home abuse, neglect, or wrongful death may take several years.

If you suspect abuse or neglect at a nursing home, call us today! We have years of experience helping families get justice for victims abused by caregivers in nursing homes across America!

Our team of experienced attorneys will fight hard on your behalf so that you can focus on what matters most – getting better care for your loved ones while holding abusers accountable!

Don't wait another day. Contact our office right now so we can start working together towards justice today!

Nursing home abuse lawyers ready to work on your behalh Expediting Your Case with the Help of Nursing Home Law Center LLC

Our goal is to give you immediate legal assistance and representation as soon as possible after your injury. To achieve that objective, we offer free consultations and flexible hours for clients under a time crunch.

We are open seven days a week to accommodate your schedule and can visit you at home or the nursing home if necessary.

What You Can Expect at Your Consultation with Nursing Home Law Center LLC

When you come in for your free consultation, our experienced nursing home abuse attorneys will go over the details of your case and answer all of your questions. In addition, we will provide you with highly confidential legal advice tailored to your case and specific circumstances.

We will also let you know what we can do to help you and how our experienced attorneys will ensure you deserve the compensation.

At your consultation, we will not try to "sell" you by hiring our firm or pressuring you into deciding your case that day. It is very common for our clients to take some time after their initial meeting with us to consider all of their legal options before deciding to hire us.

Please call a nursing home abuse lawyer at (800) 926-7565 to schedule a free, no-obligation consultation with an attorney who specializes in these types of personal injury cases. Let us provide legal help and discuss receiving financial compensation for your damages.

Resources:

Client Reviews

★★★★★
Jonathan did a great job helping my family navigate through a lengthy lawsuit involving my grandmother's death in a nursing home. Through every step of the case, Jonathan kept my family informed of the progression of the case. Although our case eventually settled at a mediation, I really was impressed at how well prepared Jonathan was to take the case to trial. Lisa
★★★★★
After I read Jonathan’s Nursing Home Blog, I decided to hire him to look into my wife’s treatment at a local nursing home. Jonathan did a great job explaining the process and the laws that apply to nursing homes. I immediately felt at ease and was glad to have him on my side. Though the lawsuit process was at times frustrating, Jonathan reassured me, particularly at my deposition. I really felt like Jonathan cared about my wife’s best interests, and I think that came across to the lawyers for the nursing home. Eric