Nursing Home Abuse and Neglect: Recognizing and Addressing Elder Mistreatment

Elder abuse in nursing homes and long-term care facilities is a serious problem affecting vulnerable populations. Understanding the signs of abuse and neglect can help protect loved ones and hold facilities accountable.

Types of Nursing Home Abuse and Neglect

Physical Abuse

Physical abuse involves the intentional use of force that causes injury or pain:

• Hitting, slapping, pushing, or kicking
• Improper use of physical restraints
• Force-feeding or improper medication administration
• Rough handling during care

Neglect

Neglect is the failure to provide necessary care, including:

• Inadequate food, water, or nutrition
• Failure to assist with hygiene and toileting
• Failure to reposition immobile patients (leading to bedsores)
• Inadequate supervision leading to falls
• Failure to administer medications properly
• Ignoring calls for assistance

Emotional/Psychological Abuse

Emotional abuse causes psychological harm through:

• Verbal threats, intimidation, or humiliation
• Isolation from family and friends
• Treating residents like children
• Ignoring or dismissing residents

Financial Exploitation

Financial abuse involves misuse of an elder's assets:

• Theft of money or belongings
• Forging signatures
• Coercing changes to wills or financial documents
• Unauthorized use of credit cards or accounts

Sexual Abuse

Any non-consensual sexual contact with a nursing home resident, including those who cannot consent due to cognitive impairment.

Warning Signs of Abuse or Neglect

Signs that may indicate mistreatment include:

• Unexplained bruises, cuts, or injuries
• Bedsores (pressure ulcers)
• Sudden weight loss or signs of malnutrition
• Dehydration
• Poor hygiene or unsanitary living conditions
• Unusual changes in behavior or mood
• Withdrawal or depression
• Unexplained STDs or signs of sexual trauma
• Missing money or belongings
• Fear or anxiety around certain staff members

Legal Protections for Nursing Home Residents

Federal and state laws provide protections for nursing home residents:

Federal Nursing Home Reform Act

Establishes minimum standards of care and residents' rights for facilities receiving Medicare or Medicaid funding.

California Elder Abuse and Dependent Adult Civil Protection Act

Provides enhanced remedies for elder abuse, including the possibility of attorney's fees and punitive damages in certain cases.

Factors Contributing to Abuse

Research identifies several factors that increase risk:

• Understaffing and high staff turnover
• Inadequate staff training
• Poor management and oversight
• Residents with dementia or communication difficulties
• Inadequate background checks on employees

Documentation and Evidence

Evidence in nursing home cases may include:

• Medical records documenting injuries or conditions
• Photographs of injuries or living conditions
• Facility inspection reports and citations
• Staffing records
• Incident reports
• Witness statements from staff or other residents