Bedsore Stages

What Are the Stages of Bedsores?

There are four stages of bedsores that describe how deeply a wound extends down into the skin and underlying tissues. Also known as pressure ulcers, later stages of bedsores are severe and require extensive treatment to prevent life-threatening complications.

If a bedsore’s stage is higher, it’s a more significant injury. Stage 4 bedsores are considered the worst, with muscle and bone being exposed in some cases.

These are the stages of bedsores:

• Stage 1
• Stage 2
• Stage 3
• Stage 4
• Unstageable bedsores or deep tissue injury

Some people also refer to the most severe deep tissue injuries as stage 5 bedsores, though it’s not an official medical term for that condition.

Understanding how each stage differs could help you recognize the severity of a bedsore and get help. You can also look at images of bedsore stages to verify what you see.

If you think your loved one’s bedsores are a sign of abuse or neglect, Her Case Matters can provide support. Reach out now to discuss your concerns and explore your legal rights.

Stage 1 Bedsores

Stage 1 bedsores may begin with subtle visual changes and may not require significant medical attention. The early stages of bedsores can be trickier to spot, so keep an eye out for gradual symptoms.

Here’s what stage 1 bedsores look like:

• Part of the person’s skin is pink or red, but there isn’t an open wound.
• The person may feel slight discomfort or tenderness when pressing on the area.
• The skin could feel warmer or cooler and may appear firmer or softer than normal.

Even though stage 1 bedsores or pressure ulcers aren’t severe nursing home injuries, they should still be cause for concern — particularly if they don’t get better over time. It’s easy to dismiss them and may be more challenging to spot on people with darker skin.

Because the skin has not yet broken down, stage 1 bedsores can often improve when pressure is relieved and the area is monitored closely.

Stage 2 Bedsores

Stage 2 bedsores are still shallow wounds, but may be more noticeable and painful than the first stage. At this stage, your loved one’s wound may resemble an abrasion or a ruptured blister.

Common stage 2 bedsore characteristics include:

• A blister filled with fluid
• A shallow open sore
• Abrasions from scratching at the wound
• Increased pain or tenderness
• Partial loss of skin tissue

Treatment often focuses on wound care, keeping the area clean, relieving pressure, and preventing infection while the skin heals.

If a bedsore’s stages worsen, it could be a sign of nursing home neglect or even abuse. Don’t delay in taking action if you think staff members aren’t properly caring for a bedsore.

Stage 3 Bedsores

Stage 3 bedsores look similar to stage 2, but they’re deeper because more skin has died. You may be able to see the fatty tissue that’s normally underneath the first layers of skin called the hypodermis.

Look for these stage 3 bedsore symptoms:

• An open wound
• Depth within the bedsore, like a crater
• Fatty tissue that looks white or yellow
• Pus or blood inside the bedsore

While muscle, tendon, and bone are typically not visible at this stage, these pressure ulcers are a concerning bedsore stage. They require immediate medical attention and a long-term recovery plan to reduce the risk of complications.

Stage 4 Bedsores

A stage 4 bedsore is an open wound that exposes the underlying muscle, joints, or bone. They’re severe injuries and could indicate long-term neglect or abuse in a nursing home.

Identify a stage 4 pressure ulcer by looking for:

• Bleeding
• Muscles, tendons, or bone within the wound
• Pus
• Skin discoloration around the bedsore

Bedsores at stage 4 often involve extensive dead or necrotic tissue, increasing the risk of bone infections or sepsis.

Call for emergency help immediately if you find a stage 4 bedsore on your loved one. They may need surgical debridement to remove dead tissue and skin grafts that help the wound heal.

Unstageable Bedsores or Deep Tissue Injuries

Bedsores with extreme skin discoloration may be deep tissue pressure sores, which some people call stage 5 bedsores or unstageable injuries. They also require immediate medical attention and surgery to remove the affected skin.

Symptoms of unstageable deep tissue injuries include:

• Black dead skin tissue
• Blood-filled blisters beneath the skin
• Maroon or deep purple tissue deep in the wound
• White, yellow, green, gray, or black slimy tissue (slough) covering the ulcer

These wounds are considered unstageable by medical professionals until the dead tissue is removed and the extent of damage can be assessed. Get your loved one to the nearest hospital right away for emergency medical treatment if they may have this kind of pressure ulcer.

“Severe bedsores are one of the clearest signs of nursing home neglect. These wounds take time to form and are almost always preventable with routine care.”

— Ricky LeBlanc, nursing home abuse lawyer

No one deserves to experience advanced bedsore stages. If you’re interested in taking legal action on behalf of your loved one, call us at (877) 640-6101 to discuss filing a nursing home abuse lawsuit.

Factors That Worsen Bedsore Stages

Without adequate circulation and daily care, skin tissue may begin to break down and form pressure injuries. These can develop in places like ankles, elbows, hips, heels, and tailbones.

Many factors, ranging from medical issues to even neglect, can cause bedsore stages to worsen.

Here’s what makes bedsore stages worse:

• Developing a disease that affects blood flow, including diabetes or heart conditions
• Eating a poor diet
• Experiencing prolonged neglect or abuse
• Having fragile skin
• Incontinence (lacking control of your bladder or bowels)
• Living with chronic health conditions, including diabetes and dementia
• Losing cognitive function due to illnesses like Alzheimer’s disease
• Needing mobility assistance
• Staying in one place for a long time, like a bed or wheelchair

Regular repositioning, skin assessments, proper hydration, and individualized care plans are important ways to prevent pressure injuries from getting worse.

It’s also important to note that while it only takes a few hours for early-stage bedsores to form, it can take months for them to reach the later stages. Nursing home staff should work to address early-stage bedsores. If they don’t, it could be a sign that nursing home abuse or neglect may be happening.

How Do Bedsore Stages Happen in Nursing Homes?

While some nursing home residents face a higher risk of developing pressure ulcers due to medical conditions or limited mobility, many bedsores are preventable.

Facilities that provide proper care will monitor residents, provide routine repositioning, and address skin concerns before they reach advanced stages of bedsores.

These issues make it more likely for residents to suffer serious bedsores:

• Inadequate wound attention or medical care
• Prolonged staff burnout
• Understaffed nursing home teams
• Staff failure to follow treatment plans
• Worsened nutrition or hydration

The Agency for Healthcare Research and Quality found that 2.5 million Americans experience bedsores every year.

In some situations, severe bedsores may be signs of elder abuse or medical malpractice. Older people may suffer if they are unable to advocate for themselves or get the care they deserve.

Complications of Advancing Bedsore Stages

When bedsore stages become severe, they can lead to complications. Nursing home residents may have health conditions or immune systems that make complications more likely.

Complications associated with advanced stages of bedsores include:

• Cancer: Residents with inflamed late-stage bedsores or pressure ulcers that won’t heal could develop cancerous Marjolin ulcers. These are ulcer masses that can be different types of cancers like squamous cell carcinomas, melanomas, basal cell carcinomas, or sarcomas.
• Cellulitis: Cellulitis is a skin infection that causes swelling and warmth due to inflammation. It can develop in a pressure wound and affect surrounding tissue.
• Joint or bone infections: Infections that develop in late-stage bedsores can sink into nearby bones or joints. They may reduce a person’s use of their limbs and cause chronic pain.
• Sepsis: Bedsores may lead to sepsis if an ulcer infection reaches deep enough to enter the bloodstream. Sepsis is a medical emergency and can be fatal.

Bedsores are preventable with adequate care and attention. Watch for signs of early bedsore stages to get your loved one help before they become at risk of complications.

What You Should Do if You See Signs of Bedsore Stages

Learning that your loved one has developed pressure ulcers can be overwhelming. However, taking action quickly may help prevent additional complications.

Take these steps to report nursing home abuse:

1. Dial 911 if it’s a medical emergency or if your loved one is unsafe.
2. Alert the nursing home staff about the pressure ulcer.
3. Request copies of medical records.
4. Document the bedsore, especially its appearance and progression.
5. Report your concerns about neglect or inadequate care to the facility’s upper management.
6. Contact your state’s long-term care ombudsman to help mediate conversations with staff.
7. Call your state’s Adult Protective Services (APS) program to report the facility.
8. Consider speaking with a bedsore attorney if your loved one’s injury seemed preventable.

Understanding a bedsore’s stage and how it developed can help families determine whether appropriate care was provided. If the bedsore was preventable, you may be able to hold the facility accountable by filing a bedsore lawsuit.

Talk with our team today to ask questions and figure out your next steps.

Get Legal Help for Nursing Home Bedsore Stages

If a loved one developed serious pressure ulcers while living in a nursing home, you may have questions about their care.

At Her Case Matters, we believe families deserve answers when preventable injuries occur. We’re here to help you understand your legal options, find support, and take steps to protect the people you love.

The law firm in our network has recovered $332 million to date for people who experienced nursing home abuse, including bedsores.

Get a free case review or call (877) 640-6101 to get support. We’ll listen to your concerns and connect you with a bedsore lawsuit attorney if you’re eligible.