Stage 4 Bedsores: A Warning Sign in Nursing Homes

One of the common signs of nursing home neglect and abuse is pressure ulcers, or bedsores. Bedsores can occur from body pressure by lying in the same position for long periods of time, such as in a bed or chair. Some of the most common areas where bedsores can appear are on the:

  • Shoulders
  • Shoulder blades
  • Buttocks
  • Hips
  • Tailbone
  • Ankles
  • Feet

Nursing homes and their workers are responsible for the care and well being of each resident, and part of providing good care is to move the patients regularly to prevent bedsores from forming. Nursing homes that have frequent cases of bedsores are serious concern. If a family member or loved one is showing any signs of bedsores, especially stage four, immediate medical care is needed. You also may want to review legal options with a nursing home abuse and neglect attorney.

Stage 4 Bedsore Overview

Bedsores that have gotten to stage 4 are severe and life threatening. Data shows the mortality rate for people with stage 4 bedsores is up to 70%. Many of these patients die within 180 days of diagnosis. Overall the lifespan of patients with these sores is less than 50 days.

Some patients may not have pain with these lesions because of extensive nerve and tissue loss, but others may suffer excruciating pain. Because of the major difference between health conditions and environment with different patients, some treatment programs for this condition can focus on simply reducing pain, in the cases of those with terminal illnesses. Those who are not terminally ill may benefit from healing the wounds.

Stage 4 bedsores serious lesions that have been allowed to go through stages 1, 2 and 3. If the patient is left immobile or stationary for days or longer, bedsores can get worse and become infected. In nursing home neglect cases, stage 4 bedsores are one of the most common signs. Some of the symptoms of stage 4 bedsores are:

  • Severe amount of skin loss, including damaged dermal layers at site of sore, which may need reconstructive surgery.
  • Life-threatening infections and health complications, including sepsis. This is a common result of serious neglect and bedsores. There also may be osteomyelitis present, a type of bone infection that is very serious.
  • Potential permanent loss of sensitivity in affected skin, tendons, muscles and adipose tissue. Bones also may be affected at the site of the stage four pressure ulcer.
  • Recovery time for a stage 4 bedsore is more than 60 days for most elderly patients.

These bedsores tend to happen in the patient’s bony parts of the body, with little fat protecting deeper tissues. Stage 4 bedsores threaten life, and those who suffer from them could have several serious infections.

Because of the serious nature of these bedsores, medical treatment is necessary for the person to have a full recovery. However, be aware that health complications and risk of death rise with each stage of bedsores, especially stage 4. If bedsores are not treated within two months of discovery, health problems usually get worse. Thousands of nursing home and hospital patients die each year from untreated bedsores. There are thousands of others who must have amputations and other major surgical procedures.

Medical Options to Treat Stage 4 Bedsores

Stage 4 bedsore treatment is actually management in many cases; this is because many older patients may not be healthy enough for the bedsores to fully heal. There are many medical interventions available that focus largely on reducing pain. These management techniques include:

  • Regularly changing positions. The most important part of healing bedsores is to change the position the person is in regularly. Bedsores are caused by staying in the same position for days or weeks. By changing positions every few hours, pain will be decreased and the wound may heal.
  • This procedure removes dead tissue in the affected area to reduce chances of additional infection. Doctors often debride serious bedsores with enzymes, dressings, ultrasounds and general removal of the dead tissue. Some medical professionals may clean the bedsore with a saline solution to reduce infection.
  • There are several types of medications that can aid the healing of stage 4 bedsores. Some medications are still in the early phases of testing, but these can be useful. Antibiotics and pain relievers also can be helpful.

In addition to the typical bedsore treatment options highlighted above, medication combined with physical therapy is often advised for stage 4 bedsores.

Negative pressure therapy can be effective; this is a type of vacuum dressing that increases the efficacy and and immediacy of skin and tissue healing in many types of bedsore cases. This therapy is fairly new, but it has been shown through research to help the healing process for stage 4 bedsores. Older patients are especially more able to use negative pressure therapy; it is much less invasive than surgical procedures. If antibiotics are given to the patient in combination with negative pressure therapy, there is often less pain and faster healing.

Another effective option is air fluidized therapy. This is an advanced bedsore therapy that uses air fluidized beds. This may be the best option for deep tissue injury in the most elderly patients. It also can aid in preventing bedsores in the first place.

Legal Options for Stage 4 Bedsores

For stage 4 bedsores to develop, there must have been a prolonged period of poor nursing home care. Most situations where stage 4 bedsores are present constitutes a nursing home neglect case. If your family member or loved one has developed stage 4 pressure ulcers, speak to the director of the nursing home and the loved one’s primary care doctor immediately.

Also, fully document your efforts to address the bedsore situation in case you choose to pursue legal action. In the end, all residents of nursing homes are entitled to a standard level of care. If they do not receive such care and develop bedsores and other health problems, a nursing home neglect lawsuit could be in order.

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