When you visit your loved one at a nursing home or talk to them on the phone, you are often grateful when they communicate with you. Not every senior at a skilled nursing facility has that capacity as they struggle with the effects of cognitive decline, meaning they often cannot convey to their family details of their daily lives. The inability to communicate is a significant problem when your loved one’s experience at their nursing home involves any form of abuse.
Unfortunately, you cannot rely on the nursing home to report any type of abuse to you. Since nursing home abuse is against the law, the facility opens itself up to a fine and possibly worse disciplinary action by reporting it. While they would need to communicate this information to you under the law, families cannot count on a nursing home to do the right thing when abuse is happening in the facility. In most cases, it will be up to you to detect abuse. At the very minimum, you will need to know enough that you can get the investigation started by the appropriate authorities.
Your Loved One May Not Have the Ability to Tell You About Abuse
First, many nursing home residents may not be verbal enough to let you know what is happening fully. More than 50 percent of nursing home residents have some type of dementia or cognitive impairment, including Alzheimer’s. As these diseases progress, residents will become nonverbal. If they cannot speak, it will become less coherent.
In the future, some states may require nursing homes to install video cameras in the rooms of nonverbal residents as a way of monitoring abuse. However, that is still far off, and it will be years until that can protect nonverbal nursing home residents from certain types of abuse.
Identify Abuse so You Can Report It
In most cases, authorities will not even investigate abuse allegations at all until someone else reports it. Once the nursing home becomes aware of possible abuse, they must report it to the relevant state agency and the facility administrator within a very tight timeframe. Thus, saying something is the key to not only stopping the abuse but also ensuring that the perpetrator faces consequences.
According to the law:
“The facility must develop and implement written policies and procedures… (to ensure that) each covered individual shall report immediately, but not later than 2 hours after forming the suspicion, if the events that cause the suspicion result in serious bodily injury, or not later than 24 hours if the events that cause the suspicion do not result in serious bodily injury.” 42 CFR 483.12
In other words, you and your family are often the first lines of defense when it comes to nursing home abuse. It is largely up to you to find out what is going on and report it to the proper authorities. However, that is a challenge when your family member cannot clearly convey to you what is happening to them. With that in mind, here are some tips for how to discover nursing home abuse when your family member may be non-verbal.
Start by Learning the Legal Definition of Nursing Home Abuse
The first way to detect nursing home abuse is by knowing exactly what it is. Like everyone, you know that physical and sexual abuse are illegal. However, many other things fit the legal definition of abuse that you may not know. You should start by reviewing the legal definition of abuse.
The law groups abuse, neglect, and exploitation together in one broad prohibition.
Under the heading of abuse, federal regulations include:
- Sexual or physical abuse
- Corporal punishment
- Involuntary seclusion
Nursing home abuse also includes financial exploitation and improperly using chemical and physical restraints. You should also know that nursing home abuse occurs if anyone in the facility mistreats your loved one, including fellow residents.
If you have any doubt whether something meets the definition of abuse, consult with one of our nursing home abuse attorneys to learn more.
Listen to Your Loved One
Your family member’s disease may be in different stages of progression. Everyone knows that people in cognitive decline “have their good days,” meaning they are not always non-verbal. Your loved one may say something, and it could be about what they are currently experiencing.
If your loved one gives you any type of verbal indication that something is wrong, it is critical to listen to it and take it seriously. Even if what they are saying seems far-fetched, you should pay very careful attention to it. The little that your loved one can verbalize can be a window into their experience. You should at least note what they have said and be on the lookout for any signs that are consistent with abuse.
If they have given any verbal indication of abuse, it is important to raise it to nursing home staff. Reporting it at least lets the staff know that you are aware that something may be happening.
Pay Attention and Spot the Signs
The most critical aspect of spotting abuse of nonverbal nursing home residents is spotting the signs of abuse, especially when they cannot tell you. Some types of abuse may be more difficult to spot than others.
Even when your loved one is nonverbal, you can still spot signs of abuse. They may be increasingly agitated and seem like they are in distress. Sometimes, you may tell by their posture or the look on their face.
You may get even more clues when they are around particular staff members. The first thing to watch for is how the staff member interacts with your loved one. While not every staff member who is rude is an abuser, you should note how they speak with and physically handle the senior. If you notice a manner that is harsh or physically rough, speak with nursing home management about it because it could indicate something worse.
Signs of Physical or Emotional Abuse
Even more important, you should notice how your loved one responds when the staff member is around.
The following may signal that abuse is taking place:
- Your loved one grows very agitated and upset when a staff member is around them.
- You see signs of physical fear, such as shaking or cowering.
- They do not communicate at all when a particular staff member is around.
Signs of abuse of nonverbal residents will often go beyond that.
Other indicators of mistreatment can include:
- No longer eating or sleeping
- Withdrawal from the activities that they previously enjoyed
- Sudden weight loss or an otherwise gaunt appearance
A family would need to spot these indicators. Usually, more than one physical sign will show that your loved one is in distress.
Look for Physical Evidence
So much of spotting evidence of abuse depends on your own vigilance and perception. Unfortunately, this responsibility falls to you, but you would never know that your senior is suffering harm without your own efforts. Besides looking for psychological signs of abuse, you also need to look for physical evidence. The evidence you are looking for depends on the type of abuse.
Physical abuse is often the most apparent form of mistreatment.
Clues to the existence of physical abuse include:
- Unexplained bruises or fractures on your loved one’s body
- Marks on their body that are evidence that someone forcefully grabbed them
- Their sensitivity to touch
When you are physically close to your loved one, or are helping them change their clothing, pay extra attention to what you see. If you suspect abuse, make sure to increase your presence so you have more chances to see them up close.
Review Documents to Spot Financial Abuse
You also need to periodically review your loved one’s finances for signs of physical abuse, including reviewing every single bill from their accounts. You should also review every account statement that shows a balance. Finally, you should also do a periodic general check to ensure that nobody has stolen their identity. Catch financial abuse early to protect your loved one’s finances fully. Here, you should be proactive, even if you have no reason to suspect abuse.
Be on Guard for Signs of Nursing Home Neglect
While we spend much time talking about physical, financial, and sexual abuse, many people often overlook that nursing home neglect is also a form of abuse. It is every bit as harmful and deadly. Deaths attributed to nursing home neglect are on the rise.
In many cases, neglect is a sign that there is even something worse happening.
Here, you should look for:
- A disheveled appearance, with signs of your loved one not being washed (including things such as fingernails and hair badly in need of being cut)
- Indications of cuts and infections
- Dirty or stained clothing that staff have not recently changed
- Delays in changing them when they are soiled
Nursing home neglect is so dangerous because it can lead to dehydration, malnutrition, and infections. These are common causes of death among nursing home residents.
Always Ask Questions When You Notice Something
Sometimes, your suspicions are enough to trigger action. The next piece when you think that something is wrong is to talk to someone at the nursing home. Try to set up some time to talk to someone in management. Some nursing homes may begin to clean up their act when they know that someone is asking questions. They want to protect their own bottom line and reputation and may want to avoid fines and lawsuits. Maintaining an active and visible presence is always the first step towards learning anything about your loved one’s care.
In some cases, just letting the nursing home know that you have eyes on them can get them to self-police and clean up their own act. Of course, if you have any suspicions of abuse, it makes sense to investigate more and to file a report with the state. The laws are there to protect you. Ideally, you would raise your concerns, and there would be an investigation that reveals that there was no abuse. However, if your loved one became a victim, the authorities would take action.
Speak With a Nursing Home Abuse Attorney
If you struggle to find out what is happening, or you have a suspicion that something is going on and do not know what to do, contact an attorney. Your lawyer could help you figure out what the next steps are and could recommend a course of action for you to take. Often, you may not even know where to start.
You would also speak to an attorney because nursing home abuse is grounds for a lawsuit against the facility where the mistreatment occurred. A court can make sure the nursing home pays for any damage that they caused your family member. However, you need an attorney on your side to help you file a lawsuit because nursing homes will not pay without being made to do so.
If you are successful in your nursing home abuse lawsuit, you are your family may receive compensation for:
- Pain and suffering
- Emotional trauma
- Medical bills
- Possible punitive damages if the conduct was bad enough
- A wrongful death lawsuit, if your loved one passed away as a result of the abuse.
It is possible to detect abuse, even if your loved one cannot tell you. Many abusers break the law thinking that no one will catch them. Your vigilance can make that a misconception and help protect your family member from nursing home abuse.