Stage 4 Bedsores in Nursing Homes

Bedsores in nursing homes are sadly too common, even though they shouldn’t happen at all. Stage 3 or 4 bedsores are often caused by nursing home neglect. If you or a loved one suffered a stage 3 or 4 bedsore in a nursing home, Sokolove Law may be able to help you take legal action and secure compensation.

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What Are Bedsores or Pressure Ulcers?

Bedsores are also known as pressure ulcers, pressure sores, or decubitus ulcers. They are injuries to the skin and deeper tissues beneath the skin that are caused by continual pressure, usually by remaining immobile.

The Centers for Disease Control and Prevention (CDC) estimates that 1 in 10 nursing home residents develops the painful skin condition.

Bedsores often occur on bony areas of the body, like:

  • Ankles
  • Back or sides of the head
  • Backs of arms or legs
  • Buttocks
  • Heels
  • Hips
  • Shoulder blades
  • Spine
  • Tailbone

There are four stages of bedsores, which range from the least severe (stage 1) to most severe (stage 4). Healthy skin can quickly advance to a stage 4 bedsore if not treated properly.

Since bedsores can be very painful, preventing them in vulnerable and frail nursing home residents is critical. Failure to do so can often be considered nursing home abuse.

Causes of Bedsores and Pressure Ulcers

Bedsores are often caused by a lack of movement. They can be common in people who are bedridden or use a wheelchair. People with mobility issues often need a fair amount of assistance. Sadly, those who don’t get help moving around are at risk for developing bedsores.

According to the Mayo Clinic, the three leading causes of bedsores include:

  • Pressure: Limited mobility can cause continual pressure on certain parts of the body, which can reduce the blood flow needed to deliver oxygen and nutrients to the tissues beneath the skin. A lack of blood supply created by prolonged pressure can damage the skin and kill the tissue underneath.
  • Friction: Repositioning the body can cause rubbing that breaks skin down. It can be worsened by rough clothing or sheets, especially in frail seniors who already have skin that has thinned with age.
  • Shear: When skin moves in one direction while bones stay still or move in another direction, skin can stretch and tear. This is likely to happen in beds that elevate since the body can slide down the bed.

Bedsores can quickly worsen if they are not treated promptly. With proper care, stage 3 and 4 bedsores are almost always preventable. That’s why bedsores at more advanced stages can be a sign of nursing home abuse.

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If you or your loved one experienced bedsores in a nursing home facility, an experienced nursing home abuse lawyer with Sokolove Law can help you understand your legal options.

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Stages of Bedsores

Bedsores fall into one of four stages based on their depth and severity. This staging system helps health care providers determine the best treatment to allow for the quickest recovery. If bedsores are caught early enough, they can heal in just a few days.

The four stages of bedsores are:

  • Stage 1: Redness of the skin that does not go away when pressure is removed
  • Stage 2: Thinning of the skin with a possible blister, abrasion, or shallow crater
  • Stage 3: Complete loss of skin thickness with a deep crater and exposed tissue
  • Stage 4: Exposed muscle or bone

Stage 1 and stage 2 bedsores are not necessarily indicative of negligence. However, you can bring up your concerns to your local nursing home ombudsman. The other two stages of bedsores, however, may indicate negligence has occurred in the nursing home or assisted living facility.

Stage 3 bedsores have broken through the top two layers of skin, affecting the fatty tissue beneath the skin. They may resemble a crater and may also have an odor.

Stage 4 bedsores are the most serious and have a high risk for complications, including life-threatening infections. This is because they extend into deep tissues like muscle, tendons, and ligaments. In some cases, they can even reach cartilage or bone.

Stage 4 Bedsores or Pressure Ulcers

Stage 4 bedsores or pressure injuries can be extremely painful. Symptoms of bedsores at this advanced stage are most noticeable around the affected area. There may also be a dark substance in the open sore called eschar, which is hardened tissue that has died because of the wound.

Stage 4 Bedsores Signs and Symptoms

The signs and symptoms of stage 4 bedsores are very troubling. There may be signs of severe infection, exposed muscles, and even visible areas of bone.

Additional signs and symptoms of stage 4 bedsores include:

  • Blisters, red edges, drainage, or pus near the affected area
  • Exposed tendons, ligaments, muscles, and bone
  • Heat at the site of the wound
  • Odor
  • Skin that has darkened or turned black

If you or a loved one have any signs or symptoms of stage 4 bedsores, seek medical advice as soon as possible. They can very quickly turn into life-threatening complications.

After seeking medical advice, you may be able to hold the care facility accountable for their negligence by taking legal action. Get a free case review or call (800) 995-1212 today to see if nursing home neglect lawyers with Sokolove Law can help you.

Who’s at Risk of Stage 4 Bedsores?

People who are paralyzed or have mobility issues are at greater risk of developing stage 4 bedsores, which puts elderly nursing home residents at particular risk.

Caregivers to those who are unable to move on their own must be especially careful to ensure blood is still flowing to areas that are compressed.

Some additional risk factors for stage 4 bedsores include:

  • Conditions affecting blood flow (like diabetes) or linked to decreased mental awareness (like dementia)
  • Dehydration or poor nutrition
  • Fragile skin, especially in the elderly
  • Infection
  • Obesity
  • Spinal cord injury
  • Urinary or fecal incontinence

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Stage 4 Bedsore Life Expectancy

With proper treatment, stage 4 bedsore life expectancy is high. According to the Merck Manual, 30% of stage 4 bedsores heal within six months, though some cases of stage 4 bedsores may take anywhere from several months to two years to fully heal.

Without treatment, however, the long-term prognosis for a stage 4 bedsore becomes poor. The following complications of stage 4 bedsores can be life-threatening:

  • Bone, joint, and blood infections
  • Cancer
  • Cellulitis
  • Sepsis

Stage 4 Bedsore Treatment Options

According to the CDC, 35% of nursing home residents with stage 2 or higher bedsores need wound care by trained professionals.

Treatment options for stage 4 bedsores often focus on: 

  • Administering antibiotics and dressing the wound to prevent infection
  • Keeping the wound moist to optimize healing conditions
  • Relieving the pressure from the affected area
  • Removing any damaged tissue from the area (during a debridement)

During treatment for stage 4 bedsores, emphasis should be placed on proper nutrition and hydration, which can be critical to support wound healing.

Unfortunately, surgery may be necessary in some cases to close the wounds if they are not healing properly with other treatments.

Get Help Pursuing Stage 4 Bedsore Lawsuit Settlement Amounts

Monitoring the care your loved one receives in a nursing home is of critical importance. Watching for stage 1 or 2 bedsores may help prevent the excruciating pain and needless suffering that can happen as bedsores worsen.

Because of the highly preventable nature of advanced bedsores, you may be able to hold the nursing home staff accountable for their negligence through a stage 4 bedsore lawsuit. Compensation from a lawsuit may also help you afford better care and life-saving medical treatments for your loved one.

As a national nursing home abuse law firm, Sokolove Law has decades of experience helping victims of nursing home abuse and their loved ones pursue justice and compensation for their injuries.

Over the last 45+ years, we’ve recovered over $273 Million on behalf of thousands of nursing home abuse clients nationwide.

Get a free case review or call (800) 995-1212 today to learn more about your options and see if Sokolove Law may be able to help.

Stage 4 Bedsores and Pressure Ulcers FAQs

Can you sue a nursing home for bedsores? 

In many cases, yes. You may be able to sue a nursing home if you or a loved one developed a severe bedsore while under the care of a medical professional, because bedsores are preventable with proper care.

Bedsores at stages 3 or 4 are often caused by neglect; otherwise, they would not have advanced. Learn more about filing a stage 4 bedsore lawsuit now for free.

What is the average stage 4 bedsore lawsuit settlement amount?

Generally, the average nursing home abuse settlement is worth around $400,000 — though we've recovered far more for many families.

In one case, we recovered over $1.5 Million in stage 4 bedsore settlements for a woman in Minnesota who suffered nursing home neglect.

See if your family may qualify for stage 4 bedsore lawsuit settlement amounts now.

What causes bedsores in nursing homes? 

Bedsores in nursing homes are usually caused by neglect, which is a form of elder abuse. This is because many nursing home residents need help moving around or spend most of the day sitting or lying down.

Without the assistance of nursing home staff, remaining immobile can put prolonged pressure on body parts and cause bedsores.

If the pressure is not relieved, bedsores can worsen in a very short period of time into stage 3 or stage 4, which may require medical treatment or surgery.

If you or a loved one suffered bedsores while in the care of a nursing home, contact Sokolove Law today.

What is a stage 4 bedsore? 

A stage 4 bedsore is the most severe and dangerous stage of bedsores. At stage 4, the injury is very deep, and the muscle or bone is exposed.

Serious complications can occur at this stage, usually caused by any number of common infections that can turn into sepsis.

How much are stage 4 bedsore lawsuit settlement amounts?

Stage 4 bedsore lawsuit settlement amounts vary based on the cost and severity of injury. This could include the cost of medical bills, the need to relocate to a different nursing home, or even wrongful death.

A skilled nursing home abuse law firm can help you:

  • Hold the care facility accountable for their negligence
  • Seek justice for what happened to you or your loved one
  • Pursue nursing home settlements

How common are bedsores or pressure ulcers in nursing homes? 

According to the Centers for Disease Control and Prevention (CDC), bedsores or pressure ulcers occur in more than 1 in 10 residents in nursing homes.

How long can you live with a stage 4 bedsore?

If a patient gets proper treatment, stage 4 bedsores are generally treatable. However, it can take up to two years for the sores to heal completely.

If a stage 4 bedsore gets infected and remains untreated, it can quickly lead to death, especially in already sick or frail nursing home residents.

Can you get sepsis from bedsores?

Sepsis can develop from any break in the skin. This is because sepsis is caused by common infections that worsen.

Open wounds are highly susceptible to germs and bacteria and must always be monitored for signs of infection to prevent the injury from becoming more severe.

What does a stage 3 bedsore look like? 

A stage 3 bedsore looks like an open wound with the tissue damage under the skin’s surface being visible.

A stage 3 bedsore tends to be crater-like and may also expose muscle or bone.

What does a stage 4 bedsore look like? 

A stage 4 bedsore is a very deep crater with skin that appears to be extensively damaged. Muscle and bone are likely to be visible in these cases.

What causes stage 4 bedsores?

Stage 4 bedsores are caused by untreated bedsores in the earlier stages. Bedsores can be prevented by inspecting the skin daily for redness, with special attention being placed on bony areas.

Because stage 4 bedsores are almost always preventable, bedsores at this stage are often caused by nursing home neglect or abuse.

Can you recover from stage 4 bedsores?

With prompt treatment, 30% of stage 4 bedsores resolve, according to the Merck Manual. However, if the stage 4 bedsore doesn’t receive proper care, the long-term outcome is poor.

If the wound ever heals, it can take years, and infection can quickly cause deadly complications.

Why are pressure ulcers issues in elderly care? 

The aging population is more likely to have mobility issues, incontinence, and chronic health conditions that can lead to pressure ulcers without proper care.

Since aging care facilities are notoriously understaffed, pressure ulcer issues are unfortunately very common.

If you or a loved suffered pressure ulcers in a nursing home, you may be able to file a nursing home abuse lawsuit. Contact Sokolove Law today to learn more.

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  2. Merck Manual. “Pressure Ulcers.” Retrieved from: Accessed on August 6, 2023.
  3. Johns Hopkins Medicine. “Bedsores.” Retrieved from: Accessed on August 6, 2023.
  4. Mayo Clinic. “Bedsores (Pressure Ulcers).” Retrieved from: Accessed on August 6, 2023.
  5. My Health Alberta. “Stages of Pressure Sores.” Retrieved from: Accessed on August 6, 2023.
  6. National Center on Elder Abuse. “Statistics and Data.” Retrieved from: Accessed on August 6, 2023.
  7. Centers for Disease Control and Prevention (CDC). “Pressure Ulcers Among Nursing Home Residents: United States.” Retrieved from: Accessed on August 6, 2023.
  8. A Place for Mom. “Elderly Bedsore Stages and Prevention.” Retrieved from: Accessed on August 6, 2023.
  9. Model Systems Knowledge Translation Center. “Recognizing and Treating Pressure Sores.” Retrieved from: Accessed on August 6, 2023.
  10. Wound Source. “Pressure Ulcers, Stages 3 and 4.” Retrieved from:,mobility%20and%20range%20of%20motion. Accessed on August 6, 2023.