Nursing Home Abuse or Neglect

More than a million people in the United States wake up every day in nursing homes. Many of these individuals are helpless, vulnerable and completely dependent upon nursing home staff to meet most or all of their needs. After all, nursing homes are supposed to be in the business of providing skilled nursing care to elderly and disabled residents.

Unfortunately, the quality of care in the nursing home industry has increasingly declined over the past decade. A number of recent studies indicate that residents in nursing homes suffer abuse and neglect more and more frequently at the hands of nursing home corporations. In many cases residents have died or have been severely abused as a result of neglect.


According to the National Center on Elder Abuse (NCEA), elder abuse is a growing problem. Concerned people can spot the warning signs of a possible abuse problem and make a call for help if an elder is in need of assistance. Not all elder abuse is physical abuse, some is psychological or financial/fraud.

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 such acts of violence as striking (with or without an object), hitting, beating, pushing, shoving, shaking, slapping, kicking, pinching and burning. In addition, inappropriate use of drugs and physical restraints, force-feeding and physical punishment of any kind also are examples of physical abuse. Signs and symptoms:

  • 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 contact with any person incapable of giving consent is considered sexual abuse. It 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:

  • 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 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:

  • 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 report 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 may be evident in the following ways:

  • 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 report of being mistreated.

Most important is to be alert. The suffering is often in silence. If you notice changes in personality or behavior, you should start to question what is going on.

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