What Is a Stage 4 Bedsore?
Bedsores, also called pressure sores or pressure ulcers, are most commonly described in 4 stages based on the depth of soft tissue damage. Pressure ulcer stages range from least severe (stage 1) to most severe (stage 4).
- A stage 1 bedsore is not an open wound but it may be painful.
- At stage 2, the skin breaks open or forms an ulcer that might look like a scrape or shallow crater.
- During stage 3, the bedsore gets worse and may show fatty tissue but not muscle or bone.
- A stage 4 bedsore is very deep, and muscle or bone may become exposed, causing a significant risk for serious infection.
A bedsore may begin at stage 1 and advance to a stage 4 bedsore if it is not treated properly or promptly.
Who Is at Risk for a Stage 4 Bedsore?
Anyone with an existing bedsore may be at risk of developing a stage 4 bedsore. In nursing homes, this generally happens when residents are left to lie in bed, in a chair, or in a wheelchair without being properly tended to.
Those most at risk include people who have:
- Decreased mental awareness
- Diseases that affect blood flow, such as diabetes
- Fragile skin
- Hypoxemia (low oxygen levels in the blood)
- Immobility or limited mobility
- Ischemia (restriction of blood flow to a part of the body)
- Neurological disease
- Neuropathy (nerve damage that causes pain, weakness, and/or numbness)
- Poor nutrition or dehydration
- Spinal cord injury
- Urinary or fecal incontinence
Causes of a Stage 4 Bedsore
Stage 4 bedsores may occur when the less severe bedsore stages are not treated in a timely or proper manner. Any stage of bedsore can form if an older adult cannot reposition themselves regularly when lying in bed or sitting down.
When blood supply to the skin is cut off for more than two to three hours, the skin tissue starts to die — and the bedsore starts as a red, painful area. Left untreated, the skin then turns purple and can break open. A bedsore’s stage increases as the wound deepens.
With proper care, it is usually possible to prevent a stage 4 bedsore. Therefore, if a nursing home resident develops one, it is often a sign of nursing home abuse or neglect.
Symptoms of Stage 4 Bedsores
A stage 4 bedsore is usually a very deep, big, and painful open sore. Symptoms are most noticeable around the affected area, meaning the skin that has been damaged.
Patients with stage 4 bedsores may have:
- Discolored or blackened skin
- Signs of infection (blisters, red edges, pus, odor, heat, and/or drainage) near the skin
- Exposed deeper tissues, tendons, ligaments, muscles, and bone
Seek medical help immediately if you notice that your loved one is displaying any symptoms of a stage 4 bedsore.
Stage 4 Bedsore Prevention
The best way to prevent a stage 4 bedsore is by being proactive. If your loved one is at risk for bedsores, you can help them take the following precautions.
Preventative steps for stage 4 bedsores:
- Keep skin clean and dry
- Use moisturizing skin care to protect the skin
- Check skin (especially the shoulder blades and tailbone) daily for warning signs
- Shift weight about once an hour
- Perform wheelchair pushups if the individual has enough upper body strength
- Consider specialty wheelchairs that can be tilted to relieve pressure
- Purchase special mattresses or cushions to position the body properly
- Elevate bed to no more than 30 degrees at the head
- Change bedding and clothing on a regular basis
- Avoid buttons on clothes and wrinkles in bedding
- Avoid doughnut cushions, as they can add pressure to surrounding areas
Stage 4 Bedsore Treatment
Doctors treat stage 4 bedsores by properly dressing and removing infected or dead tissue from the wound, creating moisture levels for the best healing, and protecting the wound from infection. They will also try to relieve the pressure caused by the bedsore.
Proper nutrition and hydration should be a priority to help with healing, but surgery may be necessary to close the wound if it does not heal on its own.
If your loved one has developed a severe bedsore while staying in a nursing home, there may be financial compensation available to help you pay for the costs of care. Contact the Nursing Home Abuse Justice team to learn more about accessing compensation.
Complications From a Stage 4 Bedsore
A dangerous complication of a stage 4 bedsore is a serious bacterial infection. Some bacteria can become resistant to the same antibiotics used to fight them. With high bacteria counts in a stage 4 bedsore, tissue may be unable to heal.
Stage 4 bedsores can also cause cellulitis, which is a bacterial infection of the skin that causes it to become swollen, red, and painful. Left untreated, cellulitis can spread to the bloodstream or lymph nodes and quickly become life-threatening.
Severe bedsores, especially those in stage 4, can cause systemic or metastatic infections, such as bacteremia, meningitis, and endocarditis. These deep-seated infections are difficult to treat and can turn deadly. If the bedsore progresses far enough, osteomyelitis (infection of the bone) or sinus tracts (where the wound tunnels down into the body) can also occur.
Aside from bacterial infections, tissue calcification is another potential complication of a stage 4 bedsore. This painful condition occurs when built-up calcium hardens. This hardened calcium can cause an inflammatory reaction that slows the healing of the bedsore.
Staying in a hospital to treat a stage 4 bedsore can cost your family thousands of dollars.
“The costs incurred from stage 4 pressure ulcers are much greater than previously estimated. Halting the progression of early-stage pressure ulcers has the potential to eradicate enormous pain and suffering, save thousands of lives, and reduce health care expenditures by millions of dollars.”
– American Journal of Surgery
If you or a loved one developed a severe bedsore while staying in a nursing home, you may be able to take legal action against the nursing home that should have kept you safe. Compensation from a legal settlement can be used to help pay for treatment and more.
Prognosis for Bedsores Stage 4
The prognosis for less severe bedsores is excellent with prompt and proper treatment, but healing generally takes a long time. It can take anywhere from three months to two years for a stage 4 bedsore to properly heal.
However, if wound care for the stage 4 bedsore cannot be improved, the long-term prognosis is poor — even if short-term healing occurs. Without treatment, stage 4 bedsores can even cause deadly complications like sepsis.
Compensation for Stage 4 Bedsores
It is critical to monitor the care your loved one receives in a nursing home. Understanding the signs and knowing the statistics of nursing home abuse are the best defenses.
If your loved one has developed a stage 4 bedsore in a nursing home, they may be the victim of ongoing abuse or neglect. You may be entitled to compensation through a nursing home lawsuit that can help pay for better care and life-saving medical treatments.
Contact us today to get a free legal case review. Our team can help determine if you can file a claim to access financial compensation.