Signs of Nursing Home Elder Care Abuse and Neglect and What To Do About It
It is troubling to think that the topic of elder care abuse and neglect in nursing homes is one we have to discuss, but, unfortunately, it is an issue that can adversely affect the older, and more vulnerable, people in our lives. Due to the nature of nursing homes, sometimes signs of abuse, or cries for help, are dismissed as indicators of old age or dementia. It is important to be cognizant of elder care signs of abuse and neglect to ensure the best care of our loved ones in their later years.
The first thing to be aware of are the types of nursing home abuse that can occur. According to the National Center on Elder Abuse (NCEA), each type of abuse causes different types of symptoms that can indicate abuse:
Physical abuse is defined as the use of physical force that may result in bodily injury, physical pain, or impairment. Physical abuse may include, but is not limited to, acts of violence such as striking (with or without an object), hitting, beating, pushing, shoving, shaking, slapping, kicking, pinching, and burning. Also, inappropriate use of drugs and physical restraints, force-feeding, and physical punishment of any kind are also examples of physical abuse.
Signs and symptoms of physical abuse include, but are not limited to:
- bruises, black eyes, welts, lacerations, and rope marks;
- bone fractures, broken bones, and skull fractures;
- open wounds, cuts, punctures, untreated injuries in various stages of healing;
- sprains, dislocations, and internal injuries/bleeding;
- broken eyeglasses/frames, physical signs of being subjected to punishment, and signs of being restrained;
- laboratory findings of medication overdose or under utilization of prescribed drugs;
- an elder’s report of being hit, slapped, kicked, or mistreated;
- an elder’s sudden change in behavior; and
- the caregiver’s refusal to allow visitors to see an elder alone.
Sexual abuse is defined as non-consensual sexual contact of any kind with an elderly person. Sexual contact with any person incapable of giving consent is also considered sexual abuse. This includes, but is not limited to, unwanted touching, all types of sexual assault or battery, such as rape, sodomy, coerced nudity, and sexually explicit photographing.
Signs and symptoms of sexual abuse include, but are not limited to:
- bruises around the breasts or genital area;
- unexplained venereal disease or genital infections;
- unexplained vaginal or anal bleeding;
- torn, stained, or bloody underclothing; and
- an elder’s report of being sexually assaulted or raped.
It is troubling to think that the topic of elder care abuse and neglect in nursing homes is one we have to discuss, but, unfortunately, it is an issue that can adversely affect the older, and more vulnerable, people in our lives. Due to the nature of nursing homes, sometimes signs of abuse, or cries for help, are dismissed as indicators of old age or dementia. It is important to be cognizant of elder care signs of abuse and neglect to ensure the best care of our loved ones in their later years.The first thing to be aware of are the types of nursing home abuse that can occur. According to the National Center on Elder Abuse (NCEA), each type of abuse causes different types of symptoms that can indicate abuse: Physical Abuse
Physical abuse is defined as the use of physical force that may result in bodily injury, physical pain, or impairment. Physical abuse may include, but is not limited to, acts of violence such as striking (with or without an object), hitting, beating, pushing, shoving, shaking, slapping, kicking, pinching, and burning. Also, inappropriate use of drugs and physical restraints, force-feeding, and physical punishment of any kind are also examples of physical abuse.
Signs and symptoms of physical abuse include, but are not limited to:
- bruises, black eyes, welts, lacerations, and rope marks;
- bone fractures, broken bones, and skull fractures;
- open wounds, cuts, punctures, untreated injuries in various stages of healing;
- sprains, dislocations, and internal injuries/bleeding;
- broken eyeglasses/frames, physical signs of being subjected to punishment, and signs of being restrained;
- laboratory findings of medication overdose or under utilization of prescribed drugs;
- an elder’s report of being hit, slapped, kicked, or mistreated;
- an elder’s sudden change in behavior; and
- the caregiver’s refusal to allow visitors to see an elder alone.
Sexual Abuse
Sexual abuse is defined as non-consensual sexual contact of any kind with an elderly person. Sexual contact with any person incapable of giving consent is also considered sexual abuse. This includes, but is not limited to, unwanted touching, all types of sexual assault or battery, such as rape, sodomy, coerced nudity, and sexually explicit photographing.
Signs and symptoms of sexual abuse include, but are not limited to:
- bruises around the breasts or genital area;
- unexplained venereal disease or genital infections;
- unexplained vaginal or anal bleeding;
- torn, stained, or bloody underclothing; and
- an elder’s report of being sexually assaulted or raped.
Emotional or Psychological Abuse
Emotional or psychological abuse is defined as the infliction of anguish, pain, or distress through verbal or nonverbal acts. Emotional/psychological abuse includes, but is not limited to, verbal assaults, insults, threats, intimidation, humiliation, and harassment. In addition, treating an older person like an infant; isolating an elderly person from his/her family, friends, or regular activities; giving an older person the “silent treatment”; and enforced social isolation are examples of emotional/psychological abuse.
Signs and symptoms of emotional/psychological abuse include, but are not limited to:
- being emotionally upset or agitated;
- being extremely withdrawn and non-communicative or non-responsive;
- unusual behavior usually attributed to dementia (e.g., sucking, biting, rocking); and
- an elder’s personal account of being verbally or emotionally mistreated.
Neglect is defined as the refusal or failure to fulfill any part of a person’s obligations or duties to an elder. Neglect may also include failure of a person who has fiduciary responsibilities to provide care for an elder (e.g., pay for necessary home care services) or the failure on the part of an in-home service provider to provide necessary care.
Neglect typically means the refusal or failure to provide an elderly person with such life necessities as food, water, clothing, shelter, personal hygiene, medicine, comfort, personal safety, and other essentials included in an implied or agreed-upon responsibility to an elder.
Signs and symptoms of neglect include, but are not limited to:
- dehydration, malnutrition, untreated bed sores, and poor personal hygiene;
- unattended or untreated health problems;
- hazardous or unsafe living condition/arrangements (e.g., improper wiring, no heat, or no running water);
- unsanitary and unclean living conditions (e.g. dirt, fleas, lice on person, soiled bedding, fecal/urine smell, inadequate clothing); and
- an elder’s personal report of being mistreated.
Abandonment is defined as the desertion of an elderly person by an individual who has assumed responsibility for providing care for an elder, or by a person with physical custody of an elder.
Signs and symptoms of abandonment include, but are not limited to:
- the desertion of an elder at a hospital, a nursing facility, or other similar institution;
- the desertion of an elder at a shopping center or other public location; and
- an elder’s personal report of being abandoned.
Financial or material exploitation is defined as the illegal or improper use of an elder’s funds, property, or assets. Examples include, but are not limited to, cashing an elderly person’s checks without authorization or permission; forging an older person’s signature; misusing or stealing an older person’s money or possessions; coercing or deceiving an older person into signing any document (e.g., contracts or will); and the improper use of conservatorship, guardianship, or power of attorney.
Signs and symptoms of financial or material exploitation include, but are not limited to:
- sudden changes in bank accounts or banking practice, including an unexplained withdrawal of large sums of money by a person accompanying the elder;
- the inclusion of additional names on an elder’s bank signature card;
- unauthorized withdrawal of the elder’s funds using the elder’s ATM card;
- abrupt changes in a will or other financial documents;
- unexplained disappearance of funds or valuable possessions;
- substandard care being provided or bills unpaid despite the availability of adequate financial resources;
- discovery of an elder’s signature being forged for financial transactions or for the titles of his/her possessions;
- sudden appearance of previously uninvolved relatives claiming their rights to an elder’s affairs and possessions;
- unexplained and/or sudden transfer of assets to a family member or someone outside the family;
- the provision of services that are not necessary; and
- an elder’s personal report of financial exploitation.
Self-neglect is characterized as the behavior of an elderly person that threatens his/her health or personal safety. Self-neglect generally manifests itself in an older person as a refusal or failure to provide himself/herself with adequate food, water, clothing, shelter, personal hygiene, medication (when indicated), and safety precautions.
The definition of self-neglect excludes a situation in which a mentally competent older person, who understands the consequences of his/her decisions, makes a conscious and voluntary decision to engage in acts that threaten his/her health or safety as a matter of personal choice.
Signs and symptoms of self-neglect include, but are not limited to:
- dehydration, malnutrition, untreated or improperly attended medical conditions, and/or poor personal hygiene;
- hazardous or unsafe living conditions/arrangements (e.g., improper wiring, no indoor plumbing, no heat, no running water);
- unsanitary or unclean living quarters (e.g., animal/insect infestation, no functioning toilet, fecal/urine smell);
- inappropriate and/or inadequate clothing, lack of the necessary medical aids (e.g., eyeglasses, hearing aids, dentures); and
- grossly inadequate housing or homelessness.
If you do discover that an elderly person has experienced abuse or neglect under a nursing home’s care, there are some specific things you need to do:
- Verify the elderly person’s story. Your first step should be to see if the elderly person is telling the truth. Get clear about what your relative or friend is saying by going over the problem with them. If you can, check with other residents of the nursing home who seem to be coherent. Also, gather medical records, or take photos, of recent injuries or prescriptions.
- Consider removing the elderly person to another facility. If you are worried about the safety of a nursing home resident, assist them in leaving the nursing home immediately.
- Inform the authorities. Inform the police or district attorney. In some states, such as California, you are required to report elder abuse when you learn it has occurred. If the district attorney determines that the evidence that you present rises to the level of criminal behavior, the state will file charges against the nursing home.
- File a complaint with the appropriate agencies. File a complaint about the nursing home to your state’s department of social services, adult protective services, or elder protective services.
- Consider hiring an attorney. You should retain a civil attorney experienced in one or more of the following areas: nursing home law, elder abuse, personal injury, or consumer fraud. In certain situations, it is possible to join with other persons who have suffered damages as a part of a class action lawsuit.
If you or someone you know has suffered abuse or neglect while at a nursing home, the law offices of Martin Harding & Mazzotti, LLP can help. Call us at 1-800-LAW-1010 or click here to learn more.