How Bedsores Develop: Warning Signs Families Should Never Ignore

Bedsores rarely start with a single, obvious moment of harm. Instead, the condition forms quietly, often over days or weeks, while a person is already vulnerable due to illness, injury, or limited mobility. 

Families are frequently nearby when the earliest signs appear, but those signs can be easy to miss or misunderstand without clear information. Understanding how bedsores develop, and what they look like in their earliest stages, can help families recognize when something isn’t right and take concerns seriously before harm escalates.

What Bedsores Actually Are (And Why They Form)

Bedsores, also known as pressure injuries or pressure ulcers, are injuries to the skin and underlying tissue caused by prolonged pressure to one area of the body. They most often develop when someone spends extended periods in a bed, wheelchair, or recliner without regular repositioning.

The human body relies on steady blood flow to keep skin and tissue healthy. When pressure cuts off circulation for too long, the affected area doesn’t receive enough oxygen or nutrients. Over time, the tissue begins to weaken and break down. This process can start quietly beneath the surface, long before an open wound is visible.

Older adults, people recovering from surgery, individuals with spinal cord injuries, and those with chronic illnesses are at higher risk. But bedsores are not an unavoidable part of aging or illness. In many cases, they develop when basic preventive care is inconsistent or missing.

How Bedsores Develop Over Time

Bedsores develop step by step, starting with pressure you can’t see and becoming more serious if nothing changes.

Prolonged Pressure and Limited Movement

Bedsores often begin when pressure is concentrated on one part of the body for too long. Common pressure points include the heels, hips, tailbone, lower back, shoulders, and elbows. 

When someone cannot shift their weight independently, regular repositioning becomes essential. Turning schedules and mobility assistance are essential in care settings, as they’re meant to relieve pressure before damage occurs. 

When repositioning is delayed, skipped, or rushed, pressure builds quietly.

Reduced Blood Flow and Skin Breakdown

As pressure continues, blood flow to the affected area decreases. Without adequate circulation, skin and tissue become fragile. The earliest damage often happens beneath the surface, making it difficult to detect at a glance.

At this stage, skin may appear red, discolored, warm, or unusually firm. Importantly, redness that does not fade after pressure is relieved can signal that tissue damage has already begun.

Worsening Injury When Nothing Changes

If pressure isn’t relieved and care doesn’t improve, weakened tissue can break open. What began as subtle skin changes can progress into open sores that extend into muscle or bone. Once the skin barrier is compromised, the risk of infection increases significantly.

Advanced bedsores can cause severe pain, delayed healing, serious infections, and prolonged hospital stays.

Early Warning Signs Families Should Notice

Families are often the first to notice small changes, especially during visits or daily care routines. Paying attention to early warning signs can make a critical difference.

Changes in Skin Color or Texture

One of the earliest signs of a developing bedsore is a change in the skin’s appearance or feel. This may include:

• Redness that doesn’t fade after pressure is relieved
• Darkened, bluish, or purplish areas of skin
• Skin that feels warm, firm, or spongy to the touch

These changes often appear over bony areas and should not be ignored, even if the skin is intact.

Complaints of Pain, Burning, or Tenderness

Pain is an important signal, even when the skin looks normal. Individuals may describe discomfort, burning, itching, or tenderness in one spot. Some patients, especially those with cognitive impairments or communication challenges, may express pain through restlessness, withdrawal, or changes in behavior instead of words.

Any repeated complaint about discomfort in the same area deserves closer attention.

Swelling, Odor, or Drainage

As tissue damage progresses, swelling may develop. In more advanced cases, families might notice fluid, drainage, or an unusual odor. These signs can indicate infection or deeper tissue injury and should be addressed immediately.

When “Normal” Explanations Miss the Bigger Picture

Families are often reassured that early signs are expected or unavoidable. Comments like “that happens at their age,” “they don’t move much,” or “we’re monitoring it” can sound reasonable, especially in medical or long-term care environments, but they might not be entirely truthful.

Bedsores are not simple cosmetic issues or minor skin irritations. They are injuries caused by sustained pressure and inadequate prevention. While certain conditions increase risk, the presence or progression of bedsores often reflects gaps in routine care, gaps that allow a bedsore to form, worsen, and force someone to suffer. 

Some families might feel awkward asking questions, but it’s the only way to uncover the truth about your loved one’s care. If a nursing home treats questions as threats, it’s a red flag, one that you should get an attorney to take a look at.

What Bedsores Can Reveal About Quality of Care

Preventing bedsores depends on a small set of basic care practices being done consistently. In most care settings, that means:

• Regular repositioning to relieve pressure
• Routine skin inspections to catch early changes
• Proper hygiene to protect fragile skin
• Adequate nutrition and hydration to support healing
• Ongoing monitoring and documentation of risk

These practices form the baseline of safe care in hospitals, nursing homes, and assisted living facilities. Anything less borders on negligent, careless behavior.

When Care Promises Falls Short

Families know their loved ones best. When something looks wrong, feels off, or doesn’t line up with the reassurances being given, it is reasonable to pause and ask questions.

Speaking up may feel uncomfortable, but it can protect a loved one from avoidable harm. And when bedsores appear or continue to progress, families deserve clear answers about how they developed and whether proper care was in place.

For many families, those answers don’t come easily. Nursing homes aren’t always cooperative, but that’s where having the right attorney becomes truly important. 

At Morgan & Morgan, our attorneys work with families to understand what happened, review care records, and hold facilities accountable when preventable harm occurs. With more than 1,000 trial-ready attorneys nationwide and offices across the country, we have the resources to stand up for families when care falls short – and you pay nothing unless we win.

Talk to an elder abuse attorney today with a free, no-risk case evaluation.

Frequently Asked Questions

1. How quickly can bedsores form?

Tissue damage can begin within hours when pressure is not relieved, even if visible sores take longer to appear. This is why regular repositioning and early skin checks are so important in nursing home care practices.

2. Where on the body do bedsores most often appear?

Bedsores typically form over bony areas where pressure is concentrated, such as the heels, hips, tailbone, lower back, shoulders, and elbows. These areas require the most consistent monitoring.

3. Are bedsores preventable with proper care?

Many bedsores can be prevented with consistent basic care, including repositioning, skin inspections, good hygiene, and proper nutrition. When these measures are missed, the risk of injury increases.

4. What should families do if a bedsore appears or worsens?

Families should document what they see, ask how pressure is being relieved, and request clear explanations about care. If answers are unclear or concerns persist, Morgan & Morgan’s team can help bring clarity.