>>> Areas of Practice

• What is Nursing Home Abuse?
• Physical Abuse
• Sexual Abuse
• Verbal Abuse
• Mental or Emotional Abuse
• Financial Abuse
• Neglect
• How can Nursing Home Abuse be recognized?
• Signs of Physical Abuse
• Signs of Sexual Abuse
• Signs of Verbal Abuse
• Signs of Mental or Emotional Abuse
• Signs of Financial Abuse
• Signs of Neglect
• How can Nursing Home Abuse be prevented?
• Seeking help

What is Nursing Home Abuse?

Nursing Home abuse is elder abuse that occurs in a nursing home. It can consist of Physical Abuse including Sexual Abuse, Verbal Abuse, Mental or Emotional Abuse, Financial Abuse, and/or Neglect.

Physical Abuse

Physical abuse is the performing or causing of a wrongful and harmful physical contact with another person, in this context, an elderly resident of a nursing home. It can also be the deliberate deprivation of necessary items such as food, water or medicine so that the resident is physically harmed.

Physical abuse can occur from one resident to another, but in the vast majority of cases it happens at the hands of staff members of nursing homes.

Some of the examples of behavior that would constitute physical abuse are:

• Hitting, slapping, pinching, kicking, pushing
• Corporal punishment
• Assault
• Wrongful restraints, either physical or chemical
• Sexual abuse (see below)

Sexual Abuse

Sexual abuse is the wrongful contact or other behavior with the genitals, breasts, or anus of a resident. “Wrongful” means that the resident did not give knowing and voluntary consent to the contact or behavior. Some examples of sexual abuse are:

• Sexual assault or battery
• Rape
• Exposing of a resident’s private body parts
• Photographing or videotaping a resident’s private body parts
• Coercing a resident to perform unwanted sexual acts
• Otherwise sexually harassing a resident

Verbal Abuse

Verbal abuse is the use of disparaging or derogatory language to, or about, a resident of a nursing home. Verbal abuse can exist whether language is written or oral, and even if delivered to someone other than the resident if within his or her hearing. Some examples of verbal abuse are:

• Insults
• Obscenities
• Ridicule
• Belittling
• Embarrassing

Mental or Emotional Abuse

Mental or emotional abuse is improper verbal or non-verbal behavior that causes a nursing home resident to become mentally or emotionally upset, agitated, depressed, withdrawn, disoriented or confused. Some examples of behavior that could constitute mental or emotional abuse are:

• Hollering
• Swearing
• Ignoring
• Isolating
• Intimidating
• Threatening

Financial Abuse

Financial abuse is the unconsented-to or illegal use or taking of nursing home resident’s money, property or other assets. Some examples of behavior that constitutes financial abuse are:

• Theft of a resident’s money or property
• Forging a resident’s name to a financial document
• Cashing a resident’s check without authorization
• Selling unneeded or overpriced goods or services to a resident
• Deceiving or forcing a resident to sign a will, contract or other document
• Improperly using a conservatorship against a resident
• Improperly using a power of attorney against a resident

Neglect

Neglect is wrongful inattention to a nursing home resident that causes the resident detriment or harm. The inattention is wrongful when the neglectful person has a duty to tend to the resident, as is the case when an elder person is the resident of a nursing home. Some examples of neglect as a form of nursing home abuse are:

• Failure to provide adequate food or water
• Failure to assist the resident to eat, if necessary
• Failure to administer needed medication
• Failure to prevent bedsores
• Failure to assist with toilet functions as necessary
• Failure to assist with hygiene
• Failure to prevent infections
• Failure to provide necessary clothing
• Failure to keep the resident’s person, clothing, bed, or room clean and sanitary
• Failure to see that the resident enjoys common areas and social activities

How can Nursing Home Abuse be recognized?

Signs of Physical Abuse

There are a number of signs that indicate the possible occurrence of physical abuse. Some of them are:

• The resident has a broken bone, dislocated joint or sprain
• The resident has scratches, cuts, lacerations, punctures or burns
• The resident has marks or burns from ropes or belts used as restraints
• The resident has discolorations such as bruises, black eyes, welts, pinch marks
• The resident has broken eyeglass lenses or frames
• The resident does not want to be left alone with a caregiver
• A caregiver will not allow a visitor to see the resident alone
• The resident exhibits drowsiness, drooling, or vacant stares (possible over-medication)
• The resident becomes frequently and inexplicably ill
• The resident complains of abusive behavior

Signs of Sexual Abuse

There are many signs that sexual abuse might have taken place. Some of them are:

• The resident has acquired marks on the breasts
• The resident has acquired genital infections or venereal disease
• The resident has vaginal or anal bleeding
• The resident has torn, stained, or bloody underclothing and/or linens
• The resident complains of abusive behavior

Signs of Verbal Abuse

Following are some signs that a nursing home resident may be suffering from verbal abuse:

• Staff members are heard making rude, derogatory or obscene comments to a resident
• Staff members are heard insulting, ridiculing, embarrassing or humiliating a resident
• The resident has become inexplicably sensitive or fearful
• The resident complains of being verbally abused
• Other residents complain of verbal abuse

Signs of Mental or Emotional Abuse

There are many ways a person might be alerted to possible mental or emotional abuse. Some are:

• The resident has become fearful, agitated or hesitant
• The resident has become withdrawn or depressed
• The resident shows unexpected or unusual changes in behavior
• The resident exhibits unnatural behavior such a sucking, biting or rocking
• The resident has become disoriented or confused
• The resident wants to be isolated from family and friends
• The resident has become unwilling to communicate
• The resident begins insulting, threatening or ignoring family members or friends
• The resident complains of abusive behavior

Signs of Financial Abuse

There are many ways one can be alerted to possible financial abuse. Some of the signs are:

• Some of the resident’s money or property is missing
• Property of the resident has been inexplicably sold or transferred
• An additional name has been put on the resident’s bankcard
• There are sudden large withdrawals from the resident’s bank account
• There are sudden changes in the resident’s banking practices
• The resident has abruptly changed his or her will or other financial document
• The resident has acquired unnecessary items or property
• The resident is being provided with unnecessary services
• The resident complains of being victimized financially

Signs of Neglect

There are many signs that a nursing home resident has been neglected. Some are:

• The resident’s body shows unnatural swelling
• The resident has bedsores
• The resident has infections
• The resident is dirty
• The resident has an unkempt appearance
• The resident has dirty fingernails or teeth
• The resident has a foul or unhealthy odor
• The resident shows an unexplained weight loss
• The resident has untreated injuries
• The resident exhibits a sudden change in behavior
• The resident’s clothing, bed or room is dirty or unsanitary
• The nursing home itself looks and/or smells dirty or unsanitary
• The resident complains of being neglected

How can Nursing Home Abuse be prevented?

Most nursing home abuse is committed by staff members of nursing homes. This happens when staff members are not screened properly prior to hiring, when there is an inadequate number of staff members employed to take care of the number of residents, when staff members do not receive proper schooling or training, and when working conditions for staff members are poor.

There are many things you can do to help prevent nursing home abuse to one of your loved ones. The first thing to be concerned with is your choice of a nursing home. This is probably the single most important thing one can do toward the prevention of nursing home abuse. See Choosing a Nursing Home for information on how best go about this task.

Another very important point to be aware of is visitation. It has been proven that nursing home residents who receive the most visits get the best care. So planned and frequent visits will go a long way toward making sure your loved one is properly cared for.

Other ways you can help prevent nursing home abuse are by visiting homes and observing the facility and the people – both the employees and the residents. And talking to people at the nursing home is also very important. Talk to the nursing home’s Administrative Director, Director of Nursing, and other staff members. Talk to residents and family members of residents. Following are some of the things you will want to make sure of:

• The nursing home is clean and sanitary, both to the eye and nose
• The residents seem happy or at least contented
• The staff members have a pleasant manner
• There are an adequate number of nurses and certified nurses’ assistants (CNAs)

The nursing home properly screens prospective employees for:

• Criminal history
• Substance abuse
• Proper work ethics
• Ability to manage their stress or anger
• Proper attitudes toward caring for the elderly

The nursing home offers staff members job training in:

• Caregiver skills
• Problem-solving
• Conflict-resolution
• Stress-reduction techniques
• Handling difficult resident-care matters
• Cultural issues affecting residents and staff
• Mandatory reporting of abuse

The nursing home’s policies ensure that staff members receive:

• Adequate communication with the Administration
• An adequate salary
• Recognition and respect for the difficulty of their jobs
• The opportunity to further their positions
• The opportunity for further education in their field

Seeking help

If you suspect that a loved one has been the victim of nursing home abuse and you would like more information on possible actions to take to prevent future occurrences and remedy past ones, please call (800) 777-9877 toll free.

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