Signs of Nursing Home Abuse

When you entrust a nursing home to care for your loved one, the last thing you want to happen is elder abuse or neglect. Every resident deserves to be treated with care, respect, and dignity, but that doesn’t always happen. Nursing home abuse remains far more common than it should be. 

Understanding the warning signs of nursing home abuse or neglect is essential for those with a loved one in a facility. When you can spot the warning signs of elder abuse, you can better protect your family members and other residents in long-term care facilities and ensure they receive the care they deserve. 

Abuse Statistics of Nursing Home Residents

Elder abuse is an unfortunate event that happens everywhere, including in an assisted living facility. The World Health Organization (WHO) states [1]: 

• 1 in 6 people over the age of 60 have experienced some form of elder abuse in a nursing home or other community setting within the last year 
• Rates of elder abuse are higher in nursing homes and communities, with 2 out of 3 staff members admitting to abuse within the last year
• Nursing home employees report 64.2% of all nursing home abuse, 15.7% by nursing home residents, and there’s not enough data on residents’ proxies reporting
• Residents’ proxies report psychological abuse 33.4% of the time and physical abuse 14.1% of the time 

The nursing home abuse statistics are overwhelming, but it’s important to remember many incidents of elder abuse go unreported. 

Physical Abuse

Physical elderly abuse in nursing homes requires direct contact with the resident. This type of abuse can have traumatic and devastating consequences on an older adult, especially since elderly bodies tend to be slower to heal. It’s crucial to look for signs of physical abuse to protect your loved one.

Unexplained Injuries

There are several potential warning signs of physical abuse in nursing homes. Elderly people tend to be more fragile as they age, so severe injuries might happen. Be on the lookout for: 

• Fractures or broken bones 
• Sprains or dislocations 
• Unexplained bruises, especially in clusters or regular patterns 
• Burn injuries from cigarettes, hot water, or chemicals 
• Cuts, scratches, or welts without an explanation 
• Dental injuries or broken teeth 
• Open wounds
• Head injuries
• Internal injuries manifesting as difficulty breathing or moving 

Behavioral Changes

A nursing home resident who has experienced abuse may have behavioral changes, including: 

• Depression or mood swings 
• Unexplained withdrawals from social activities 
• Anxiety around specific employees 
• Flinching when approached or when someone tries to touch them 
• Fear of being touched 
• Increased aggression or agitation 
• Changes in sleeping or eating patterns
• Hesitant to speak openly when staff are around 

Restraint Marks

A common physical sign of abuse in nursing homes is improper use of physical restraints. This serious form of abuse may leave signs like: 

• Psychological trauma from being unnecessarily restraints
• Rope marks or bruisings on ankles or wrists 
• Skin tears in areas where restraints are usually used 
• Pressure marks from inappropriate restraint devices 
• Decreased muscle strength from prolonged immobilization 
• Bed rail injuries 

Medication-Related Signs

Nursing home staff members may participate in medication abuse. Warning signs that medication abuse is happening include: 

• Extreme confusion or lethargy 
• Sudden behavioral changes can suggest over-medication 
• Missing medications or inconsistent medication records 
• Physical symptoms of medication withdrawal 
• Unexplained appetite changes or weight loss
• Refusing to take medication from a certain caregiver

Emotional Abuse

Even though this doesn’t require physical contact, emotional elderly abuse can be just as damaging to nursing home residents. Emotional abuse will affect the resident’s mental health and well-being, which is tied to their physical health. 

Verbal Abuse

Common forms of verbal abuse against an elderly individual are: 

• Name-calling or derogatory language 
• Yelling or screaming at nursing home residents 
• Threatening to withhold care or privileges 
• Mocking an older adult
• Threats of punishment or abandonment 
• Cursing or hostile language 
• Making demeaning comments

Isolation and Ignoring

Staff might use isolation to facilitate emotional neglect or abuse. This can look like: 

• Restricting visitor access when it’s not medically necessary 
• Preventing residents from participating in social activities, which is social neglect
• Leaving residents alone for long periods 
• Ignoring their requests for companionship or help 
• Deliberately isolating an older adult who complains about care 
• Preventing them from speaking with loved ones

Humiliation and Belittling

As a family member, these are the warning signs of humiliation and belittling you’ll want to be aware of: 

• Public shaming or ridicule 
• Forcing residents to wear inappropriate clothing 
• Making fun of physical or mental limitations and medical conditions 
• Treating adults like children 
• Making residents perform degrading tasks 
• Intentionally embarrassing residents 
• Minimizing or dismissing residents’ feelings

Gaslighting

Gaslighting is another tactic commonly used in elder abuse and neglect. This can present as: 

• Making vulnerable residents question their perceptions or memory 
• Caregiver denying that an older adult remembered something clearly 
• Dismissing legitimate complaints as imagination 
• Convincing residents that they’re “just confused” when they’re not 
• Blaming residents for nursing home staff’s mistakes 
• Manipulating situations to cause residents to doubt themselves 

Neglect

Nursing home neglect is another common form of elder abuse. This can be a staff member’s failure to meet the residents’ primary care needs, which can be intentional or out of negligence. 

Basic Needs Neglect

Meeting their basic needs is essential to living with dignity and improving health outcomes. Some warning signs of neglect are: 

• Unchanged bedding 
• Poor personal hygiene 
• Unwashed or soiled clothing 
• Pressure sores
• Dehydration or malnutrition 
• Inappropriate clothing for the weather 
• Lack of assistance with activities of daily living (ADLs) 
• Missing or broken hearing aids, dentures, or glasses 

Medical Neglect

When staff members purposely ignore a resident’s medical care needs or fail to provide proper care it’s called medical neglect. This can manifest as: 

• Lack of adequate wound care 
• Open wounds
• Untreated medical conditions 
• Delayed response to medical emergencies
• Medication errors like missed or incorrect doses 
• Missing medical appointments 
• Ignored requests for medical treatment or attention 
• Failure to follow prescribed treatments in their care plan

Signs of Neglect

You can see red flags indicating neglect by paying attention to the nursing home’s environment and the residents: 

• Unsafe living conditions 
• Pressure ulcers (bedsores)
• Pest infestations 
• Unsanitary living conditions
• Unexplained weight loss or malnutrition
• Untreated infections or wounds 
• Strong urine and feces smell 
• Soiled clothes

Financial Exploitation

Financial elderly abuse or exploitation is becoming increasingly common in nursing homes and among the elderly. This can devastate the residents’ economic security and affect their quality of life. 

Unexplained Financial Transactions

Always watch out for signs of financial exploitation, like unexplained financial transactions: 

• Unauthorized account access 
• Unusual ATM withdrawals
• Unexplained bank account activity 
• New names added to their accounts 
• Missing valuables, cash, or other financial documents  
• Sudden changes in spending patterns 

Changes in Wills or Beneficiaries

Some people at the nursing facility might try to take advantage of elderly persons by convincing them to change their will or beneficiaries or do it for them. This is a serious risk, so watch for: 

• Missing legal documents 
• Sudden and unexplained changes to legal documents 
• Pressure to sign financial documents 
• Addition of unknown beneficiaries 
• New power of attorney assignments 
• Unexplained asset changes 
• Unexpected changes to trusts or wills 

Missing Belongings

Since the nursing home is a resident’s home, they’ll often bring their most important belongings to make the transition easier. Unfortunately, a caregiver might steal these, whether valuable or not. Pay attention to: 

• Disappearance of prepaid cards or gift cards 
• Lost clothing or personal care items 
• Missing cash or jewelry 
• Disappearance of personal valuables
• Medication theft 
• Missing decorative items or furniture 
• Unexplained disappearance of sentimental items 

Missing belongings can be financial abuse and psychological abuse. Whether something holds financial value or not, if it’s important to the resident, having it go missing can negatively affect their mental health and well-being. 

Sexual Abuse

Sexual elderly abuse is any non-consensual sexual contact. All abuse is horrific, but sexual abuse tends to be particularly heinous. There are warning signs a family member can look for to help put an end to it. 

Physical Signs

The physical warning signs of sexual abuse in older adults can be similar to non-sexual physical abuse, but there are some specific differences to watch for. Signs of sexual abuse in nursing homes are: 

• Sexually transmitted infections 
• Genital infections
• New onset of incontinence 
• Bruising around genitals or breasts 
• Torn or stained undergarments 
• Unexplained vaginal or anal bleeding 
• Difficulting sitting or walking  

Behavioral Changes

Behavioral changes can happen in a nursing home for a variety of reasons, including when sexual abuse happens. Look for warning signs like: 

• Insomnia or nightmares 
• Unusual sexual behavior 
• Extreme withdrawal or depression 
• Fear of specific nursing home staff members 
• Reluctance to be changed or bathed 
• Self-protective behaviors
• Anxiety or panic attacks 

Emotional and Psychological Effects

There are long-term emotional and psychological impacts that sexual abuse can cause for nursing home residents: 

• Post-Traumatic Stress Disorder (PTSD)
• Social withdrawal 
• Loss of self-esteem 
• Severe anxiety and depression 
• Emotional numbness 
• Suicidal thoughts or attempts
• Trust issues

When a resident is sexually assaulted or abused in a nursing home, these long-term impacts can greatly impact their ability to live a quality life or return to a better health status. 

What to Do If You Suspect Elder Abuse

Whether you can confirm that abuse or neglect is happening or you just have your suspicions, taking immediate action is the best way to protect your loved one. 

Report to Authorities

If you know or suspect a nursing home resident is being abused, you’ll want to ensure that they’re safe. For example, if a person has broken bones, they must go to the hospital. After that, it’s time to report the abuse or neglect: 

• Notify the nursing home administration, especially if the complaint involves inadequate training
• File a report with your local law enforcement agency 
• Report healthcare fraud to health and human services for further investigation
• Contact your state’s Adult Protective Services
• Report the nursing home to your state’s nursing home regulatory agency 
• Notify the state’s long-term care ombudsman 
• Consider emergency placement if your loved one is still in danger 
• Document all the reports you’ve made and regularly follow up

Document Your Observations

Family members who suspect the abuse or neglect need to keep detailed records of the abuse. This will help support your claim when you take legal action. Things to include in your records are: 

• Dates and times of incidents 
• A written description of the events 
• Names of witnesses or other involved parties 
• Copies of the resident’s medical records 
• Photos of the injuries
• Names of staff who were present 
• Any other communication you’ve had with nursing home staff 

Victim or Their Family Members Should Seek Legal Advice

Seeking legal advice from an elder law attorney can help on your quest to hold those who abused you or your loved one accountable. These professionals can help you: 

• Understand your legal rights and options 
• Navigate through the reporting process 
• Collect any evidence to support your claim 
• File all legal documentation
• Make sure your rights are protected throughout the process 
• Seek compensation for damages
• Prevent future abuse or neglect from happening by holding those responsible accountable

Secure Expert Legal Counsel! 

Nursing home abuse is terrible, but being able to spot the warning signs is how you can help your loved one. Whether it’s physical, sexual, emotional abuse, neglect, or financial exploitation, taking action the minute you see red flags and suspect the abuse is key to keeping your loved one safe and seeking justice. 

The experienced nursing home abuse attorneys at the Nursing Home Law Center are well-versed in elder law and can help you hold the nursing home and caregiver responsible for their actions. We’ll fight for you and your loved one’s rights to ensure they can live with proper healthcare, enjoyment, and dignity. 

We offer compassionate legal representation, 24/7 assistance, and a free, confidential consultation. Contact us by filling out our online form or calling (800)-926-7565.

References: [1] WHO