The Essential Guide to Spotting Bed Sores in Seniors

Where to Check: Common Bedsore Locations 

When you do a daily skin check, pay special attention to these areas: 

• Lying Down: The back of the head, shoulder blades, elbows, lower back/tailbone (sacrum), and heels. 

• Seated: The buttocks (especially the ischium or “sit bones”), the tailbone, and the backs of the knees. 

Stage 1 & 2: What to Look for in Early-Stage Bed Sores 

Identifying damage in the earliest stages is crucial for prompt healing. 

Stage 1: The Warning Sign 

At this stage, the skin is still intact, but it’s showing a change in color, temperature, or feel. This is a critical warning sign that damage is starting underneath. 

• On Light Skin: Look for a red area that does not blanch (turn white) when you press on it gently. The area may feel warmer or cooler than the surrounding skin. 

• On Dark Skin: Redness is often not visible. Instead, the skin may appear purple, blue, or gray. It might also look darker than the surrounding area. Check for areas of unusual warmth, firmness, or sponginess, and ask if the spot is painful or itchy. 

Stage 2: Shallow Open Sore or Blister 

In Stage 2, there is some partial thickness loss of the skin. 

• The sore may look like a shallow, open wound with a pink or red wound bed, or it may present as an intact or ruptured blister filled with clear fluid. 

• Caregiver Tip: If you catch a sore at Stage 1 or 2, relieving the pressure immediately and consistently maintaining dry, clean skin often allows the wound to heal quickly. 

Stage 3 & 4: Recognizing Deep Tissue Damage and Critical Pressure Ulcers 

These are serious wounds that require immediate professional medical help. When these stages appear, it often signals a serious failure in daily care. 

Stage 3: Visible Fat Tissue 

• The wound is deeper and has full thickness tissue loss. 

• You may be able to see fat tissue in the wound bed. 

• The sore often looks crater-like, and the edges of the wound may appear rolled inward. 

Stage 4: Muscle or Bone Exposure 

• This is the most severe stage, involving extensive tissue damage. 

• Muscle, tendon, or bone may be visible. 

• There may be slough (yellow, stringy tissue) or eschar (dark, leathery, dead tissue) covering parts of the wound. 

Unstageable & Deep Tissue Injuries (DTI) 

Not all pressure injuries are immediately visible or easy to identify. Some wounds may appear mild on the surface but extend deep beneath the skin, hiding serious tissue damage. These cases require careful evaluation by medical professionals to determine how extensive the injury truly is. 

Sometimes the full depth of the wound is hidden. 

• Unstageable: The wound bed is covered in slough or eschar, making it impossible to tell the true stage. 

• Deep Tissue Injury (DTI): The skin may look intact, but a deep, bruised area of purple or maroon discoloration indicates severe damage to the tissue beneath. The wound will often rapidly worsen. 

The appearance of a Stage 3 or 4 bed sore can be deeply upsetting and cause significant emotional distress for both the senior and the family. Do not delay. Call a doctor right away. 

Reducing the Risk of Bed Sores 

Bed sore prevention begins with consistency and attention to detail. Daily routines that promote circulation, mobility, and skin integrity can make a lasting difference in a senior’s comfort and safety. Small, steady habits, like frequent repositioning and gentle skin checks, help stop damage before it starts. 

Preventing bed sores in seniors focuses on relieving pressure and supporting skin health every single day. 

The Daily 3: Key Steps for Skin Inspection and Repositioning 

Bed sore prevention is not complicated, but it does require regular attention and follow-through. By setting a predictable daily routine, caregivers can spot small issues before they turn into serious wounds. These three steps form the foundation of effective care and protection. 

Step 1: Inspect 

Perform a daily, head-to-toe skin check, ideally in the morning and evening. Use a mirror to check the tailbone, hips, and other hard-to-see areas. Look for the color changes, warmth, and firmness noted in the Stage 1 description. 

Step 2: Relieve Pressure 

The golden rule is to reposition every 1–2 hours if the senior cannot move themselves. Follow professional guidance for proper repositioning techniques to avoid friction or shear. Use pressure-reducing mattresses, special cushions, or heel protectors as needed. 

Step 3: Support Healing 

Maintain clean, dry skin, especially after incontinence episodes. A protein-rich diet and adequate hydration are essential, as good nutrition provides the building blocks for skin repair. 

Why Documentation is Key 

Tracking small changes is the best way to prevent them from becoming major problems. 

A simple Daily Skin Check & Repositioning Log helps you track: 

• Date and Time of the check and repositioning. 

• Location of any discoloration, warmth, or blisters. 

• Color or Changes (e.g., “red spot on left heel,” or “no change, skin clear”). 

Consistent, detailed notes help when consulting a doctor and are critical if you ever suspect nursing home  neglect. They provide an undeniable record of the care that was or was not provided. 

When Bed Sores Signal a Failure of Care 

A Stage 3 or Stage 4 pressure ulcer should almost always be viewed as a warning sign. While some medical conditions make skin breakdown harder to prevent, most severe bed sores are preventable with consistent, high-quality care. 

When you see a severe bed sore, it may be an indication of substandard care in a nursing home or assisted living facility. 

Warning Signs of Neglect 

• Multiple or Recurring Sores: Sores that keep coming back, or sores found at multiple stages of severity. 

• Poor Hygiene: Sores caused by infrequent cleaning after incontinence. 

• Infrequent Repositioning: A pattern of care that ignores the 1–2 hour rule. 

• Staff Dismissiveness: Staff or facility management ignoring your complaints or dismissing your loved one’s pain. 

Witnessing avoidable harm to a loved one can be emotionally devastating. It can make you feel helpless and betrayed by the facility you trusted. 

If a severe bedsore appears, or if you suspect neglect, seek medical attention immediately. You should also know your legal options. A personal injury attorney who specializes in nursing home negligence can help you understand if negligence may be involved and how to protect your loved one’s rights. 

We Stand Up for Our Seniors 

We understand the challenges you face in managing the care of an elderly family member. It’s a job that demands constant vigilance, love, and tireless effort. Your advocacy, early detection, and consistent prevention are what protect your senior loved one’s dignity and health. Know that you can take steps today to reduce risk and seek help when you need it. 

If you are concerned about a severe bedsore or the level of care your loved one is receiving in a facility in the Reno, NV area, we are here to offer guidance. 

Jensen Personal Injury Law focuses on securing justice for seniors who have been harmed by the systems entrusted with their care. Our firm acts as an immediate shield to investigate and preserve evidence while you focus on your loved one’s recovery. 

We are aggressive, experienced litigators, but we are also compassionate. With over 40 years of experience, we have the local expertise and trial reputation to maximize the compensation your family deserves. We work on a contingency fee basis, which means there is NO FEE unless WE WIN! 

Bed Sores in Seniors FAQ 

How fast do bed sores form?  

They can form in as little as a few hours if the pressure is constant and the person is immobile. 

Can bed sores heal on their own? 

Early stages (1 and 2) can often heal with immediate and consistent pressure relief and proper wound care. Stages 3 and 4 rarely heal without professional medical intervention. 

What should I do if a sore doesn’t improve after a few days? 

Call your loved one’s primary care physician immediately for a wound care consultation. 

How can I protect a loved one in a nursing home? 

Visit frequently, ask questions about their repositioning schedule, and document everything you observe.