4 Stages of Bedsores and When To Call a Lawyer About Neglect

Bedsores are pressure ulcers occurring on the skin, particularly in bony places. Bedsores typically happen when the skin is under prolonged pressure. People are at risk for bedsores if they lie in one position in bed for too long, sit in a wheelchair without changing positions, or are immobile in a cast. 

Older adults receiving long-term medical care and people with fragile skin, limited movement, and an inability to feel pain are all at heightened risk for bedsores. Basically, if the body's positioning cuts off blood flow, bedsores will eventually occur.

What are the stages of bedsores? Healthcare professionals diagnose bedsores — according to their appearance — as belonging to four stages. The first stage is a warning that bedsores are starting to happen. The second stage is a shallow wound. The third stage shows deep injuries. And the fourth stage shows severe damage and a large wound. Patients need medical care for all stages of bedsores, and the more extreme cases require surgery.

1st Stage: Early Warning

First-stage bedsores are pink or red marks on the top layer of skin. They can be warm to the touch. Bedsores form when blood flow to the skin cuts off, making previously healthy skin unhealthy, and they can develop in as little as a couple of hours. 

The skin may feel tender, hurt, burn, and itch in the beginning stages of bedsores. It's harder to see first-stage bedsores on people with darker skin, on whom the sores may seem blue or purple.  

Bedsores are preventable. Staff should move the patient regularly and provide adequate cushioning. First-stage bedsores are a warning that the person is not receiving the necessary level of care. 

First-stage bedsores are easily treatable. Early pressure ulcer treatment involves cleaning the wound with saline and covering it with bandages. The patient should return to regular movement or risk bedsores recurring.

2nd Stage: Shallow Wound

Signs of second-stage bedsores are skin loss, abrasions, or blisters. The wound may have spread to subcutaneous fat tissue. The skin looks damaged, and the red area might extend past the wound.  

This stage is painful. The wound may be hot to the touch and may swell. The second stage can also involve sepsis or infection. Signs of infection are redness, pus, and a foul smell.

3rd Stage: Deep Injuries and Tissue Damage                   

Third-stage bedsores mean there is a notable wound in the epidermis. It may look like a crater, with the primary injury under the skin. Dead tissue becomes a concern in this stage, and a doctor must remove or treat the bedsores.

At this stage, the pain will be significant. The risk of infections is high, as is damage to soft tissue. Stages three and four will probably require surgery, including skin grafts.

4th Stage: Severe Compromise

Fourth-stage bedsores penetrate all three layers of the skin, showing muscle, bone, and tendons. These are deep-tissue injuries that require surgery.

At the fourth stage, infection is likely and may spread throughout the patient's whole body. This is a life-threatening condition, and you must get treatment immediately. 

When To Call a Lawyer About Neglect

What is considered medical neglect? Bedsores are a big warning sign of medical neglect. Medical neglect happens when healthcare facility staff don’t adequately meet patients' needs. This happens all too frequently to the elderly, especially those with compromised communication abilities. 

Medical neglect goes beyond bedsores. It can be emotional, physical, or social. It can mean withholding medications, medical care, or even food. 

Other signs include poor hygiene, unsanitary living conditions, weight loss, malnutrition, dehydration, and lack of treatment for known health problems. If any of these are happening alongside bedsores, call an attorney immediately to get help. 

Unexplained Bedsores

The facility may be able to explain stage one bedsores adequately, but at the higher stages, the reason is neglect or abuse. Note the stages of bedsores and ask the healthcare team for immediate treatment. 

Inadequate Treatment

Bedsores are most often a sign of medical neglect. If the person is not being moved or cushioned correctly, thus allowing bedsores to form, they are likely not receiving proper care in other ways. 

Bedsores can appear anywhere but are most likely found in bony areas. Bedsores can be found in the following:

• Ankles
• Back
• Buttocks
• Elbows
• Heels
• Hips
• Tailbone

Multiple or Worsening Bedsores

If you find multiple bedsores, especially at stage two or above, this is a major warning sign. Call an attorney and do whatever is necessary to get your loved one treatment.

Poor Communication or Unresponsiveness

The patient may or may not let you know about their bedsores, as shame is often associated with the condition. The patient may not want to speak about it or other signs of neglect. If in doubt, a medical neglect lawyer can help.

Bedsores often happen when patients have limited mobility and cannot verbalize pain. If the patient is unresponsive, they cannot complain or ask for treatment. The staff should pay careful attention, but the patient's family and friends also need to be on the lookout for bedsores or other signs of neglect.

Preventing Bedsores and Protecting Your Loved Ones

If you are in pain and can do so, speak up. As the loved one of a patient at risk for bedsores, be aware of what each stage entails and ensure the staff moves the patient regularly. Even slight positioning changes can help.

If you think you or a loved one have a problem with bedsores and medical neglect, call an experienced medical neglect attorney. Sometimes something as simple as a letter from an attorney can turn an early case of bedsores around. Beyond that, you may need to sue for medical neglect to force changes.

In Virginia, the Commonwealth Law Group has attorneys with experience handling medical neglect cases. We know what to look for and will take your bedsores claim seriously. We listen carefully and greatly respect all our clients, regardless of age.