How to Spot Abuse, Neglect, or Mistreatment in Nursing Homes

Outside view of a nursing home building

The decision to enter a nursing home is not an easy one, and many people worry that their loved ones may be mistreated. You can reduce the risks of mistreatment by carefully screening potential nursing homes, but there are never any guarantees. If you are concerned that your loved one may be experiencing nursing home abuse, neglect, or mistreatment, here is what you should know.

Nursing Home Residents’ Bill of Rights

The Nursing Home Reform Act of 1987 (NHRA) sets basic standards that all nursing homes in the United States must follow, such as providing nursing services and dietary services. It also provides a Bill of Rights for all residents. Protections guaranteed under this Bill of Rights include, but are not limited to:

  • Freedom from discrimination
  • Access to proper medical care
  • Notification of a designated family member or legal representative when certain things occur, such as a medical emergency or a major change in treatment needs
  • Privacy
  • Visitors
  • Social services
  • Leaves of absence when medically appropriate
  • Involvement of friends and family
  • Freedom from abuse or neglect

What Is Nursing Home Abuse?

Nursing home abuse is a broad category that encompasses all types of physical, emotional, or financial abuse, as well as neglect. Every case is different. But in general, a situation may be considered abuse if it results in physical pain, mental anguish, or injury.

Signs of Different Types of Nursing Home Abuse

Each type of nursing home abuse may show specific signs. Note that in cases of emotional or physical abuse, some of the signs may mirror those of mental decline or physical frailty. It’s important to remain actively involved in your loved one’s life to help determine what is actually going on. Also, keep in mind that it is entirely possible for someone to be in mental or physical decline while also being abused. Always take potential signs of nursing home abuse seriously, rather than being too quick to explain them away.

Signs of Physical Abuse

  • Bruises, scars, welts, broken bones, or sprains, especially if they occur more than once
  • Broken eyeglasses, hearing aids, or other medical devices
  • Torn underwear, unexplained genital or rectal bleeding, or sexually transmitted diseases
  • Refusing to seek medical care for injuries
  • Unwillingness to talk about how injuries occurred or giving highly implausible explanations

Signs of Emotional Abuse

  • Sudden mood changes
  • Lethargy
  • Fearful reactions to one or more members of staff
  • Isolation and withdrawal from family and friends
  • Childlike behaviors such as thumb sucking or bedwetting that can’t be explained medically

Signs of Financial Abuse

  • Unusual financial transactions such as large ATM withdrawals
  • Changes in overall financial situation
  • Any sudden changes in wills, property titles, power of attorney, life insurance beneficiaries, or other legal documents
  • Missing cash
  • Duplicate healthcare bills or bills for services not rendered

Signs of Neglect

  • Inappropriate clothing for weather conditions
  • Poor hygiene
  • Bedsores
  • Being left alone in public
  • Unusual weight loss without a medical cause
  • Lack of basic services such as heat or running water

Things to Look for Overall

In addition to checking your loved one for specific signs of abuse or neglect, it’s well worth regularly taking a look around the entire facility. Here are some things to look for:

  • Resident satisfaction. Do most people living in the nursing home seem reasonably content? Do they seem engaged, and do they socialize with each other and with staff? Are residents clean and appropriately dressed?
  • Mealtime. Are residents served fresh, nutritionally balanced, tasty meals? Are dining areas clean and well-appointed? Are staff members assisting those who need help feeding themselves? Is the atmosphere pleasant?
  • Daily activities. Are there plenty of things to do throughout the day? Are residents encouraged (but not forced) to participate? Are staff members actively involved and available to assist? Are offsite field trips offered for those who are able to participate? If so, are they adequately supervised and managed?
  • Resident choices. Are residents allowed to make choices about their daily living, such as when to go to bed, get up, eat, and bathe? Are visitors welcome, and are they allowed to visit privately, such as in the resident’s room? Are personal items allowed in resident bedrooms? Are all religious and cultural needs met?
  • Safety. Are there grab bars and call buttons in the bathrooms, good lighting in stairwells, well-marked exits, and safety locks on windows? What about backup generators? Are special safety protocols in place for residents with dementia?
  • Staff. Is there enough staff for the number of residents, and are staff members trained in handling a variety of emergencies? Are staff members friendly, helpful, and engaged with residents throughout the day? Do they welcome visitors and allow them to look around? Do they do their best to create a home-like environment rather than an institutional feel? Do they give the impression that they have residents’ best interests at heart?

It's still possible for an individual resident to be abused or neglected even in a seemingly welcoming and well-run nursing home. However, if you see things that show poor management overall, take it as a red flag, even if you haven’t seen specific signs that your loved one is being abused or neglected.

What to Do if You Suspect Nursing Home Abuse

If you suspect that your loved one is being abused or neglected, you will naturally be upset. But it’s important to stay calm. Talk to your loved one and his or her close friends at the facility. Ask questions and document their responses. With their permission, take photos or videos of any injuries. Note any issues you discovered while walking through the facility, with pictures if possible.

If the situation is an emergency, don’t hesitate to call 9-1-1. Otherwise, take your documentation to an experienced attorney, who will review your options with you. Nursing home abuse is illegal, but most homes have strong legal representation to limit their liability. You’ll need an equally strong attorney to protect your loved one’s rights.

At Cooney & Conway, we have the experience and compassion to guide you through this painful situation. To get started, fill out our free case evaluation today.