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What Is One Reason That Elder Abuse Is Sometimes Difficult to Identify?

elder abuse lawyer georgiaElders in the U.S. population are the people most vulnerable to abuse. The statistics that you see are shocking. There are estimates that roughly 10 percent of seniors over the age of 60 have been victims of some kind of elder abuse, meaning that over five million people are abuse victims.

In many cases, reporting the abuse is synonymous with identifying it. Unreported abuse cases may never come to light, especially when the family is unaware that something happened. However, most cases of nursing home abuse are never known to families and even nursing home management.

What Is Nursing Home Abuse?

By way of background, there are different forms of nursing home abuse.

While many think of physical abuse as the primary type of mistreatment of seniors, other types of abuse affect seniors both physically and emotionally:

While elder abuse is unfortunately all too common, there are nowhere near as many reported cases. In fact, an overwhelming majority of elder abuse cases in the country go unreported. There are some estimates that as few as 1 in every 14 nursing home abuse cases go unreported to authorities.

Reporting abuse cases is important because the nursing home is legally required to investigate all abuse claims no matter what. The facility administrator must report to the state any abuse claim within 24 hours of receiving it. Our attorneys could advise you and your families as to when they believe that a nursing home has broken the law. We could also counsel you on how best to report an abuse allegation.

Seniors May Not Report Abuse

However, nursing homes cannot investigate abuse allegations that the victim chooses not to report. For the reasons below, most seniors will not report what has happened to them. As a result, it is incumbent upon families to look for the signs of abuse and be vigilant about investigating them on their own. Then, families should report what they find if they suspect abuse.

There is not just one reason why nursing home abuse goes unreported. In fact, abusers may act with little fear that someone will report them As a result, nursing home abuse becomes a matter of reporting instead of prevention because there is little to stop people who do not have much fear of being caught. The only hope is that increased reporting will create a situation where abusers are more afraid to act.

A Government Report Shows the Full Extent of Abuse That Goes Unidentified and Unreported

A report from the Centers for Medicare and Medicaid Services Inspector General shows the extent of the problem. One of the major reasons why so much abuse is unidentified is that nursing homes fail to report it despite their legal obligations. Nursing homes are in the best position to identify any form of abuse or neglect that happens to their patients. However, they need to identify and then report it.

The CMS Report showed that nursing homes failed to report an overwhelming majority of abuse and neglect—even when the law mandated that they inform state agencies. Specifically, the survey looked at 51 incidents of residents hospitalized for possible abuse and neglect; 42 of these cases involved head or bodily injuries. However, victims only reported eight of them to the authorities as the law requires.

Reporting to the government would have been the best way to ensure that state officials properly investigated and addressed these possible abuse-related injuries. However, the nursing homes did not follow the law, nor did the government enforce it. When nursing homes get away with breaking the law, other nursing homes will see that and not work as they should to identify and report abuse.

In this dynamic, nursing homes may not identify abuse that happens under their roof because they think they can get away with it. If they identify abuse, they must investigate it, and it could lead to fines and other punishment. They are taking the chance that the abuse will not come to light in another way.

Some Seniors Don’t Know They Are Abuse Victims

One of the primary reasons nursing home abuse goes unreported is that many seniors are unaware that it is actually happening to them. Statistics show that over 50 percent of nursing home residents have some form of dementia, limiting their ability to identify and understand an abusive situation.

Some types of abuse, such as physical abuse, are very apparent. A nursing home resident knows that they are being beaten, shaken, or otherwise physically assaulted. However, other types of mistreatment are more subtle.

For example, financial abuse is one of the most insidious and difficult to detect forms of abuse. In some cases, families do not learn that their loved one has suffered financial abuse until after their loved one passes, and they are inventorying the accounts. Financial abuse is a form of fraud, and most people do not realize that someone is in the act of defrauding them.

Seniors may completely trust the person who is taking money out of their account. Alternatively, they might not even realize that possessions are missing from their room. Thus, they cannot report abuse that they do not notice.

The same goes for sexual abuse. There are some forms of sexual abuse that victims might not even realize are abuse. For example, some types of touching or other exploitation may not be apparent abuse in the eyes of someone who is struggling with cognitive issues.

Even if a senior who is completely aware of the behavior might not realize that it rises to abuse. If the resident thinks that something is wrong with it, they might not know that it is reportable abuse in need of investigation. For example, if a nursing home staff member lingers in their room to try to see them undress, that is a form of sexual abuse. However, many people do not know that.

Nursing Home Residents Are Afraid to Identify Abuse

Many nursing home residents do know what is happening to them and are fully capable of reporting it. However, their abuse goes unidentified because fear prevents them from reporting it. They are afraid that the person whom they are reporting may retaliate against them.

The nature of an abusive relationship is that the abuser keeps the abused in fear. Even though it would be seemingly very easy to inform the appropriate people of the abuse, the reality is that it is much harder for many people to take that step.

The reality of the nursing home relationship between caregiver and resident is that the nursing home staff holds an incredible amount of power over the people whom they are supposed to help. Residents depend on the staff for every single aspect of their daily lives. Staff clean residents, change their clothes, help them to the bathroom, and sometimes feed them. The dependency gives the staff control. When there is abuse, residents understand that control, even if they have diminished cognition.

With that in mind, many residents are afraid to report abuse. They fear that the staff member may stop doing what is necessary to take care of them. At their core, abusers are about power. If they are investigated and cleared, they may eventually retaliate against the senior by not giving them the care that they need. They could do subtle things for revenge, such as not changing a soiled resident for some extra time.

The nursing home abuse does not have to be at the hands of staff. Many nursing home sexual abuse cases happen at the hands of fellow residents. Nonetheless, the fear is still the same, especially when the assaulter can inflict abuse again.

Seniors May Fear Retaliation if They Identify Abuse

Alternatively, seniors are often afraid that the abuse will get worse. Nursing home staff may “pick on” and single out the person who reported on them or one of their coworkers. Seniors may be afraid of what will happen if someone investigates their claim, but no authority takes action against the suspected abuser.

The fear may also extend to not wanting to cause an issue for their family. Identifying and reporting abuse will require family members to get involved with home administrators and possibly the authorities. Seniors may feel like they are a burden on their families and do not want to be a bother. They often do not want to upset the family dynamic by raising an issue that could anger people.

Shame and Embarrassment May Get in the Way

Other emotions may also get in the way of nursing home abuse being identified and reported. Residents may not report some types of abuse because of a strong feeling of shame. Intense shame is even more common in sexual and financial abuse cases. Even though the resident did nothing wrong in sex abuse cases, they may be feeling guilt and shame for what happened. When it comes to financial abuse, the senior could be embarrassed that someone took advantage of them.

Something else that gets in the way of identifying abuse is the fact that the nursing home resident may think that nobody will believe them. The fear of not being believed is one of the most common reasons why nursing home abuse is not detected. All the senior has to do is say something to someone, who is then obligated to report to the administrator. However, the resident may feel a report will go ignored and remain silent.

Again, without reporting, nursing home abuse is not identified. While nursing homes must advise residents of their ability to report abuse, some do not follow the law.

Many Miss the Signs of Nursing Home Abuse

Finally, nursing home abuse may go unidentified because families might not spot the signs. Unless the resident can articulate what is happening to their family, or the family sees clear signs of abuse, mistreatment is not always apparent.

Sometimes, it takes some extensive investigation to detect abuse. Other times, family members have to go by their intuition that there is something wrong going on to ask more. In any event, abuse is not always starkly apparent.

Many abuse claims come to light because it is the family that notices that their loved one is acting differently.

Signs of abuse that family members would need to spot are:

  • The senior is agitated when certain staff members are around.
  • They are unusually agitated in general.
  • There are marks on their loved one’s body.
  • Suspicious changes appear in their loved one’s financial accounts

Nursing home staff might not spot nuances in their residents’ behaviors, and family members might not notice them as well, meaning that the abuse will not be identified and reported.

Medical Conditions Could Mask Nursing Home Abuse

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Elder Abuse Lawyer, David Brauns

Further, family members may not identify abuse because other medical conditions mask it. For example, they may not notice that abuse caused a bruise because their loved one may struggle with balance and fall a lot. Seniors with dementia may become more agitated, so family members could not notice more intense agitation that is a sign of abuse.

If you suspect that your loved one is suffering from abuse, you should identify and report it. You should also place a call to a nursing home abuse attorney to learn your legal rights. Your family can receive financial compensation for what your loved one has endured. Our attorneys can assist you in knowing the law about nursing home abuse and what your legal options are.

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