Placing your elder family member or loved one into a nursing home was a tough decision to begin with, and the possibility of
nursing home abuse only compounds the emotional difficulty. By learning the signs of nursing home abuse and neglect you
may be able to quickly identify and respond to elder abuse. Your courage to take action now helps your loved one and could
help prevent future incidents with other elders. Rampant neglect or obvious physical abuse is rare. While the warning signs of
elder abuse can be subtle, awareness can increase your chances of early intervention. To stop nursing home abuse, you need
to know the signs.
What are the warning signs of elder abuse of nursing home neglect. There are many types of abuse including, physical abuse, emotional abuse and neglect. While the signs of elder abuse can be subtle, awareness can increase your chances of early intervention. Often times diligent attention and further investigation is needed to confirm or dispel a suspicion of neglect.
What is Physical and Emotional Elder Abuse?
The existence of any one or more of these does not necessarily mean that abuse has occurred. Instead, treat them as signs
that diligent attention or further investigation is needed.
Physical abuse includes:
Unreasonable physical constraint
Prolonged deprivation of food or water
Inappropriate use of a physical or chemical restraint or psychotropic medication
Failure to assist in personal hygiene
Failure to provide clothing and shelter
Failure to provide medical care
Failure to protect from health and safety hazards
Failure to prevent malnutrition or dehydration
Emotional abuse includes:
Verbal assaults, threats or intimidation
Subjecting an individual to fear, isolation or serious emotional distress
Withholding of emotional support
The first questions to ask when identifying nursing home abuse:
• Does your loved one have injuries or show physical signs of neglect?
• Are your loved one’s complaints insistent and frequent?
• Are objections directed at a particular nursing home staff member?
• Has your loved one displayed unusual behavior changes?
General Signs of Abuse
• Staff refuses to allow visitors to see resident, or delays in allowing visitors to see resident
• Staff does not allow visitors to be alone with resident
• Frequent arguments or tension between the caregiver and resident
• Call light is not functioning or is removed from resident’s reach
• Development or worsening of pressure sores
• Excessive weight loss
• Unusual or recurring scratches, bruises, skin tears or welts
• Bilateral bruising (bruises on opposite sides of the body)
• “Wrap around” bruises (bruises that typically encircle the arm)
• Torn, stained or bloody underclothing
• Signs of excessive drugging
• Foul smelling, uncombed or matted hair
• Patches of hair missing or bleeding scalp
• Injuries that are incompatible with explanations
• Injuries caused by biting, cutting, pinching or twisting of limbs
• Burns caused by scalding water, cigarettes or ropes
• Any injuries that reflect an outline of an object, for example a belt, cord or hand
• Complaints about painful blisters or abrasions
• Poor hygiene
• Weakness or inexplicable weight loss
• Soiled bedding
• Constant thirst or extremely dry skin
• Hazardous or unsafe living conditions
Sudden personality changes
Uncharacteristic anger, lack of interest, or anxiety
Fear of being alone
Overwhelming sadness and frequent crying
Change in alertness
Rude or humiliating comments by staff
Confused or extremely forgetful
Helpless or angry
Hesitant to talk freely
How We Can Help
Your brave decision to respond could help others. If you suspect nursing home abuse or neglect, or you yourself are being
victimized, there are alternatives to suffering in silence. When your family is ready, call for a free consultation about your legal
Causes of Nursing Home Abuse
Caregiver burnout is considered to be the primary cause of nursing home abuse and negligence. Greater risk is present in
nursing homes with:
• No abuse prevention policy in place
• Inadequate staffing levels
• Inadequate staff training
• Insufficient employee background checks
• High staff turnover rate
• A history of complaints
Some theories also suggest that certain patients are at greater risk of abuse than others. Elderly patients, those with dementia
or disruptive behaviors, highly dependent patients or those with significant need for assistance, and those who are more
socially isolated may be at higher risk for abuse.
Elder Abuse Is Illegal
No matter what the causes are for the abuse, elder abuse is illegal. In 1987, the U.S. Congress passed the Nursing Home
Reform Act (NHRA), which includes the Nursing Home Residents' Bill of Rights. It is the foundation of elder law, the legal
practice area dedicated to protecting seniors. This law was intended to protect the quality of life for residents of nursing homes
and improve the quality of care provided by their caregivers.
The following are some of the rights and freedoms specified in the Residents’ Bill of Rights, one of the primary features of the
• The right to freedom from abuse, mistreatment, and neglect
• The right to be treated with dignity
• The right to freedom from physical restraints
• The right to privacy
• The right to access personal medical records
• The right to accommodation of medical, physical, psychological,and social needs
• The right to refuse treatment
• The right to communicate freely with persons inside and outside the facility
• The right to participate in the review of one’s care plan
• The right to be fully informed in advance about any changes in care, treatment, or facility’s status
• The right to voice grievances and exercise rights without interference, coercion, discrimination or reprisal
Isolation warning signs:
Isolation of an elder is an insidious tool used by many abusers. Accomplished with the systematic exclusion of all real outside
contact, the elder victim is eventually driven to distrust friends, doctors and even close family members. Ultimately, the elder
victim becomes a pawn – manipulated into trusting only the abuser.
Family members or caregivers have isolated the elder, restricting the elder’s contact with others, including family, visitors,
doctors, clergy or friends.
Elder is not given the opportunity to speak freely or have contact with others without the caregiver being present.
What is Financial Elder Abuse?
Financial abuse is the theft or embezzlement of money or any other property from an elder. It can be as simple as taking money
from a wallet and as complex as manipulating a victim into turning over property to an abuser. This form of abuse can be
devastating because an elder victim’s life savings can disappear in the blink of an eye, leaving them unable to provide for their
needs and afraid of what an uncertain tomorrow will bring.