What Are the Different Kinds of Abuse and Neglect That Can Take Place in Nursing Homes?

Families need to know the legal obligations that nursing homes must follow when they care for your loved one. There is one general rule that nursing homes must follow when it comes to the treatment of their residents, and it is quite broad. Specifically, it says:

“The resident has the right to be free from abuse, neglect, misappropriation of resident property, and exploitation.”

Nursing home abuse can include many behaviors. Specifically, there are six primary types of nursing home abuse, even though this list is not exclusive.

They are:

Families can and do sue nursing homes for abuse and neglect. If your loved one suffered injuries, they should speak with a nursing home injury attorney about pursuing a claim for financial compensation to make the nursing home pay for what they did. Below, you can read more about each type of nursing home abuse.

Physical Abuse

Many people mistakenly think that physical abuse is just the nursing home staff hitting residents. However, it goes beyond that. Any type of activity that uses force against a resident can be considered abuse for purposes of a nursing home lawsuit. Even if the staff is not actively striking a resident, they can be unnecessarily rough, and that can constitute abuse. The nursing home is even responsible for physical abuse committed by other residents.

Here are some obvious examples of physical abuse of nursing home residents:

Not only are these forms of abuse, but even threatening a resident with these types of harm is illegal abuse. While statistics about physical abuse in nursing homes are hard to come by, there is universal agreement that there were more abuse complaints in recent years. What is even more frightening is that many incidents of physical abuse go unreported. Either the families do not spot the injuries, or they do not follow up and file a complaint. The problem may be even greater than realized because of the unreported incidents.

Physical Abuse Is Easier to Spot

In a way, physical abuse is the easiest type of abuse to identify. Even though your loved one may not tell you what is going on, you will notice signs of the abuse in the form of unexplained bruises and other marks and injuries.

You may even notice that your loved one shows signs of fear when a certain staff member is nearby. Families should ask questions if anything seems wrong. Even if there is no abuse, you have an obligation to your loved one to act to protect them. When it comes to abuse, the rule of thumb is that “if you see something, say something.” Otherwise, the abuse will continue, and the abuser may get away with their actions and harm others.

Always Report Physical Abuse

While the senior or their family may worry about retaliation if they file a complaint, reporting abuse is the only way to get the abuse to stop. If not, the abuser will just simply continue to mistreat the resident. At some point, they will cause serious injury.

Note that physical abuse does not always involve making contact with a resident. It can also involve illegal restraints. Some nursing homes will restrain their residents using physical restraints. Facilities cannot simply restrain their residents to keep them supervised and in one place. While restraints are not automatically illegal, nursing homes must use the least restrictive restraints. At the same time, drugging a patient to keep them compliant is also an illegal form of physical abuse.

Emotional Abuse

While many think of abuse as causing physical harm, the truth is that the legal definition expands to include other types of wrongful conduct by nursing home staff. Families should never underestimate the devastating effects of emotional abuse in nursing homes. While a large proportion of nursing home staff members are caring individuals who are really trying to do the best that they can, some nursing homes hire people who either do not know how to interact with the elderly, or they have a personality that leads them to emotionally abuse others.

Stressed Staff Members Can Resort to Emotional Abuse

Sometimes, even well-meaning staff members can come unhinged under the pressure of an understaffed nursing home, especially when they have little to no training. Eventually, they lash out at the people whom they are supposed to help. This, too, is emotional abuse.

Emotional abuse is every bit as illegal as physical abuse, and it can leave its own scars. Seniors are very vulnerable to this type of mistreatment, even if it seems like some might have a diminished capacity to comprehend what is going on around them.

Examples of Emotional Abuse

Nursing home staff members have a tremendous amount of power over the people whom they care for every day. When they are in control of practically every aspect of a senior’s life, they may take on an attitude that allows them to treat and talk to people with contempt. While rudeness may not be illegal, emotional abuse is.

Here are some examples of emotional abuse in a nursing home setting:

• Staff members in a nursing home-recorded video of residents and posted it on their social media, including mocking commentary with the video.
• Staff may regularly shout at a resident and berate them.
• Many staff members single out a resident and blame them when they find something wrong. Constant blaming or false accusations can be emotional abuse.
• Stressed out or incompetent staff may resort to humiliation or threats of violence or punishment when they cannot or will not do their own jobs properly.

These are just a few examples of emotional abuse. The truth is that any type of behavior from the staff that invokes fear or causes emotional distress in residents may be illegal, depending on the circumstances. The nursing home staff does not even have to intend abuse to make the facility liable in a lawsuit.

The Effects of Emotional Abuse

Seniors are especially vulnerable to emotional abuse. Many elderly people are already in a fragile emotional state, whether it is due to confusion or just advancing age. Thus, they suffer greatly when staff subjects them to mental abuse.

Some effects are:

• Stopping eating or drinking, which can lead to malnutrition and dehydration
• Insomnia
• Weakening of the immune system leading to increased risk of illness or infection
• Depression and withdrawal
• Personality changes

Family members can be on the lookout for signs of emotional abuse. Often, when they realize what is going on, the abusive staff members have already harmed and injured their loved one.

Financial Abuse

Seniors are especially at risk of suffering from financial abuse. They are vulnerable and may be suffering from reduced intellectual capacity due to dementia or related conditions. Even seniors who do not live in nursing homes are a common target of scam artists who want to enrich themselves at the expense of the elderly.

In a nursing home setting, the risk of financial abuse is even higher. Seniors in nursing homes are dependent on the staff for every single part of their daily lives. Moreover, they may have insufficient human contact that leaves them unguarded when someone takes an interest in them. The combination of the control that nursing home staff have over them along with their wealth makes seniors an easier mark for a con artist or anyone else who wants to exert financial pressure.

While nursing home residents are at risk of financial exploitation by their family members, facility staff may also be perpetrators. You may be surprised to know that financial exploitation is actually the second most common form of elder abuse. Just because a senior is in a nursing home does not mean that they are protected. Not only can their family members still try to pressure them financially, but nursing home staff also play a large role in their lives.

The Different Forms of Financial Abuse

Even though federal nursing home regulations prohibit financial abuse, it is still too common. In many ways, nursing home staff can financially exploit their residents for whom they are supposed to provide care.

The form of financial abuse that most people are aware of is when someone with influence over a senior pressures them to change their will to give that person money or property. Oftentimes, this comes at the expense of family members who are counting on an inheritance. Nursing home workers often try to gain a resident’s trust. Then, they construct an alternate reality for the senior, which can include lies about family members. Eventually, the staffer is in a position of control over the resident where they can manipulate and persuade them to disinherit loved ones.

Financial abuse does not even have to involve a will. Staff might trick seniors into signing over some assets with a simple form. Some accounts have no ties to a will. For example, a retirement savings account has beneficiaries. These accounts get distributed outside the probate process. All an unscrupulous nursing home employee would need to do is to convince the resident to change beneficiaries, and they can help themselves to part or all of the retirement account.

Financial Abuse Can Include Stealing from a Resident’s Rooms

Financial abuse in nursing homes extends well beyond manipulation. Nursing home residents have their possessions in their rooms. Sometimes, this could include valuable jewelry or other heirlooms. Many nursing home residents report that their valuables disappear from their rooms. A skilled nursing facility owes an obligation to its residents to protect their possessions. Instead, some staff members end up stealing right from the residents’ rooms.

Not only do staff members sometimes remove possessions, but they can also take credit cards and wallets. When residents leave their wallets by their bedsides, staff members could use their credit cards while they sleep. Some residents report having their cash stolen from their wallets.

Additional Examples of Financial Abuse

Financial abuse does not have to be actual stealing from wallets either.

Here are some additional examples of financial abuse of nursing home residents:

• Threatening a senior with discharge due to a bill and frightening them into transferring their assets
• Failing to appropriately safeguard a resident’s possessions
• Identity theft using a resident’s personal identifying information to open new accounts
• Misusing the power to shop on behalf of a resident
• Abusing any type of financial power of attorney

Signs of Financial Abuse

Not only are nursing homes prohibited from financially exploiting residents, but they also have an obligation to report suspected crimes against their residents to authorities. There are numerous warning signs of financial abuse that family members and other nursing home staff should spot.

Here are some signs that should be an alert that there is financial abuse:

• You may detect a higher level of anxiety about money.
• The bank or investment account balance is much lower than usual.
• You start receiving bills that you do not recognize.
• Changes in a senior’s financial behavior
• Mysterious charges in their account with the nursing home

Sexual Abuse

Sexual abuse in nursing homes is, unfortunately, a common problem.

A CNN investigation revealed how widespread the problem is.

• The study reported that there has been an average of 1,000 complaints of sexual abuse filed each year in the past two decades.
• Over 1,000 nursing homes have faced disciplinary action for failing to properly handle sexual abuse allegations.
• Many of these allegations have resulted in fines for a nursing home’s failure to protect its residents from sexual abuse and exploitation.

Nursing Homes Must Protect Their Residents from Sexual Assault

Nursing homes have a legal obligation to protect their residents from assault, no matter who is committing the abuse. They need to have policies and procedures to not only prevent assault but also to handle allegations that arise. Here, ignorance is not a defense when a nursing home fails to keep its residents safe. Facilities must make active efforts to prevent sexual assault, even in the absence of known risks.

Further, nursing homes have an obligation to check the backgrounds of the people that they hire. However, they do not always follow these rules and may end up hiring sexual abusers and deviants. These perpetrators often specifically seek jobs at nursing homes so they can target the residents.

In fact, nursing homes are often sites for sexual abuse because a majority of nursing home residents are women. Predators think that they can get away with sexual abuse because many residents lack the capacity to report the abuse. Even if the seniors say something, the facility staff might not believe them.

Examples of Sexual Abuse

Sexual abuse can include many incidents of conduct that are not rape.

Here are some examples:

• Any type of unwanted sexual touching of a resident is sexual abuse.
• Some nursing home staffers take and distribute nude pictures of seniors.
• Sexual conduct, such as harassment or someone exposing themselves to a resident, can be abuse.

Note that, just like every other form of abuse, the laws do not just apply to nursing home staff. The resident has the right to be free from sexual abuse from anyone. In fact, one of the most common forms of sexual abuse is when another resident commits the act. This type of abuse is even more prevalent than sexual exploitation at the hands of staff.

Nursing homes must also prevent these acts, and they can be held legally accountable for any abuse that occurs to their residents. If your loved one suffers an attack by another resident, you would file a lawsuit against the nursing home for failing to prevent the attack.

When Other Residents Commit Sexual Assaults

While we describe the prohibition on patient dumping below, nursing homes actually may need to remove residents who pose a danger to others in the facility. If a nursing home admits a sexually aggressive resident, they are responsible for that person’s behavior. This means that they need to have a plan in place to monitor the resident, so they do not become registered sexual predators. Some seniors who suffer from dementia have less of an ability to comprehend what they are doing, and it is up to the nursing home to prevent resident-on-resident sexual assault.

Sexual abuse is one of the most difficult forms of abuse for families to spot. Many of the signs of sexual abuse will manifest themselves on the vaginal or genital areas, and families do not often check these. Abuse may become apparent from behavioral changes in the resident, such as agitation, depression, anxiety, or withdrawal. However, sexual abuse is not the first thing that families would suspect. This is why so many incidents go unreported.

Nursing Homes Cannot Ignore Allegations of Sexual Abuse

Many residents are afraid to say something or feel guilty and ashamed. Even if the resident described the sexual exploitation, many will automatically discount their allegations and not believe them because the senior may suffer from dementia and confusion. Legally, nursing homes cannot ignore or brush off any allegation of sexual abuse. Just like physical abuse, they must report the allegations for an immediate investigation.

Sexual abuse has very real effects on the victim. Often, there will be physical injuries or sexually transmitted diseases that result from the assault. Even if there are no physical signs, the victim can be traumatized. One study found that roughly half of female nursing home residents who suffer sexual abuse in a facility will die within a year.

Neglect

While you may think that nursing home abuse requires the active mistreatment of a senior, the nursing home providing inadequate care for residents is also a form of abuse. In fact, neglect is the type of nursing home abuse that is often likely to lead to serious injury or death. It is a common reason why people contact attorneys to sue nursing homes.

Federal and state nursing home laws lay out numerous obligations that nursing homes have concerning resident care. Practically every detail of the resident’s daily life is subject to these laws. However, the truth is that a substantial number of nursing homes do not follow the rules. Many fail to care for their residents to the point where it could be considered neglect.

Inadequate Staffing Often Leads to Neglect

Neglect can be present with both activities of daily life, such as hygiene, and with medical care. Both are equally illegal and can endanger the resident’s life. The problem is that some nursing homes try to inflate their profits at the expense of their residents’ health and safety by cutting back on staff. Even if the nursing home workers are attentive and trying to do their jobs, there may simply not be enough of them to properly care for the seniors.

Most states do not require a minimum number of nurses, and in reality, many nursing homes, especially those that belong to larger chains, deliberately understaff their facilities. As a result, many residents suffer injuries each year.

Neglect Can Cause Bedsores

One common result of neglect that affects large numbers of nursing home residents is pressure ulcers. Otherwise known as bedsores, this is a completely avoidable condition that results from nursing home staff not doing their job and paying attention to seniors. Many residents are at risk of bedsores because they are not mobile and are in one place for an extended time. Nursing home staff have an obligation to frequently change their position, so the residents do not experience a skin breakdown that comes from constant pressure on one area.

Not only are bedsores the result of neglect, but a lack of care and abandonment also cause pressure ulcers to get worse. Bedsores are completely treatable with the proper level of care. However, some seniors have bedsores that are allowed to fester to the point where they develop septic shock. Some studies show that as many as 28 percent of nursing home residents develop pressure ulcers.

Neglect Increases Risks of Dehydration and Infections

A lack of qualified nurses and inadequate training create situations where residents do not get proper attention every day. Another common way that this harms seniors is through dehydration and malnutrition. Both of these leave a resident even more vulnerable to other dangerous conditions. For example, dehydration weakens a senior’s skin, leaving them even more vulnerable to bedsores. In general, when nursing home residents do not receive the proper nourishment, their overall health declines, and they will get sick.

In addition, neglect also increases the chance that residents will develop an infection. A lack of hygiene caused by inattention will lead to a buildup of harmful bacteria.

Nursing home neglect can cause entirely preventable infections, including:

• Urinary tract infections caused by a failure to change and clean residents or properly tend to their catheter
• Aspiration pneumonia when a resident’s feeding tube is not sanitized
• Pressure ulcers, as described above
• Bacterial gastroenteritis which causes severe diarrhea

Finally, neglect can also mean inadequate supervision for seniors. A general lack of watching and care increases the risk of injuries in falls.

Not only is leaving a resident unkempt and untended to a demeaning humiliation for a senior who deserves better, but it is also against regulations. Neglect is a common reason why families sue nursing homes.

Patient Dumping

Many seniors are at the mercy of the nursing home that they choose to trust for their daily care. These residents simply cannot pack up and move elsewhere. Instead, they are completely dependent on the skilled nursing facility since they cannot care for themselves.

Nursing homes have a legal obligation to hold a resident’s bed for them when they are at the hospital. Unless the senior dies or their family informs the nursing home that their relative is moving somewhere else, the facility may not give away the bed to someone else. Simply stated, the law entitles the resident to get their bed back when they get released from the hospital.

Nursing Homes Cannot Discharge Residents at Will

Once a resident moves into a facility, federal law sharply limits the circumstances under which a facility can discharge them. In other words, once a nursing home accepts a resident, they have a legal obligation to care for them and keep them in the facility. While there are some legitimate reasons for needing to move a resident somewhere else, profit is not one of them.

However, in practice, some nursing homes think that they can maximize their revenue by moving patients out of the facility. Not only is this illegal, but facilities might do so in dangerous ways that can kill an evicted resident. There have been numerous horror stories of nursing home residents who were loaded into a car or van and moved to a short-term motel with a few days’ supply of medication and were later found dead. Facilities might take others somewhere and literally dump them on the sidewalk.

Nursing homes do not even need to throw a resident out on the street to be guilty of patient dumping. Some facilities use this tactic in a more subtle and sneaky way. They will simply transfer a resident to a hospital and then refuse to readmit them to the home upon discharge. This conduct is also illegal.

Profit Motive Is No Excuse for Patient Dumping

In some cases, nursing homes are simply dissatisfied with the rate of Medicaid reimbursement that they are receiving. They may feel that it is not worth their while to keep and care for the senior although they accepted the resident in the first place. In other cases, the skilled nursing facility may have a resident paying their own way, and they can make more money if they clear the bed by getting rid of someone on Medicaid. Many nursing homes are notorious for caring first about their bottom line, and their profit margins are lower for patients receiving some form of government assistance.

Circumstances That Allow for Discharge

Under no circumstances may a nursing home simply move a resident out of the facility. As mentioned above, any decision to make a resident leave must fall into one of the allowable exceptions under federal law.

Here are a few of them:

• The resident’s condition has improved to the point where they do not need the nursing home’s care anymore.
• The senior is a danger to other residents in the facility, often after they have been physically aggressive or have sexually abused other seniors.
• The resident cannot afford their own care and will not apply for Medicaid.
• The senior is a danger to other residents’ health.
• The facility can no longer meet the resident’s healthcare needs.

Even if one of the above exceptions applies, the nursing home still cannot just evict the resident. They must work with families, giving them 30 days notice of a pending discharge. Further, nursing homes cannot release residents to a dangerous situation that jeopardizes their health or safety. Nursing homes must make provisions for the senior’s continued care after a discharge.

Patient dumping is a form of nursing home abuse that gives you ground for a lawsuit if it happened to your loved one, and they suffered harm. This could entitle your family to financial compensation.

How to Find the Best Nursing Home Abuse Lawyer Near You

You can find a nursing home abuse attorney who will help you hold the nursing home that injured your loved one accountable for what they did.

Here are a few things that you can do to obtain legal representation.

• Word of mouth is one of the best ways to find an attorney as friends or coworkers can relate their personal experience with the lawyer.
• There are attorney directories that provide guides with lawyers by specialty.
• When it comes to nursing home abuse lawsuits, you want to make sure that the lawyer has specific experience filing lawsuits against nursing homes because they can be complicated cases with medical testimony.
• Always make sure to read the attorney’s reviews online, especially on sites like Google, Avvo, and Yelp.
• Take the time to interview several attorneys so you can get a comparison of how they would handle your case and how they relate to you.

If you even suspect that your loved one suffered abuse, it is critical to report your suspicions to the nursing home immediately. Federal law requires skilled nursing facilities to report any abuse allegations to the home administrator and their state within 24 hours for an investigation. Then, you should contact an experienced abuse attorney to discuss a possible lawsuit against the nursing home.