What is Nursing Home Abuse? A Complete Guide

Elder abuse and nursing home abuse affect as many as 1 in 10 elders, more than 40 million people over the age of 65. Older people have a much higher risk of injury that other generations and have greater difficulty recovering from physical injuries and physical and emotional trauma, so the intentional harming of an elder can have long-standing, even life-threatening consequences. Nearly 1 in 3 nursing homes in the US have been issued at least one citation for abuse from Adult Protective Services (APS), though abuse often goes unreported.

For something to be considered abuse, it must cause physical, emotional, or financial harm to the person, even they can’t remember or give a full account of the abuse. A person with dementia, for example, may feel the effects of the trauma but not be able to recall what occurred or process a traumatic event. They may lash out in fear or anger at an innocent person because they have a strong emotional response but don’t remember exactly what happened or who hurt them.

I encourage families of people in nursing homes to pay particular attention both to the things their loved one says and to any unexplained damage to their body or clothing. Many people can’t, but I also encourage people to visit at unexpected times and to bring any and every concern to the facility’s staff. You should also document through photos and notes every instance of abuse or suspected abuse. Even our best intentions can’t necessarily prevent elder abuse, but we together we can hold abusers responsible.

The 4 Types of Nursing Home Abuse

Physical Abuse

Any forceful or physical act against a patient that causes physical injury or pain, including the threat of such action.

Examples:

• Hitting
• Shoving
• Burning
• Pushing
• Scratching
• Painful grabbing, pulling, or holding
• Improperly restraining or tying down
• Taking away mobility aids
• Trying to force a person to walk, stand, or move in ways that are unsafe for them
• Threats of physical violence

Symptoms:

• Bedsores
• Bruises
• Cuts
• Welts
• Broken bones
• Malnourishment
• Dehydration
• Increased anxiety
• Depression
• Increased aggression or anger
• Fear of staff members
• Unexplained stories or dreams about abuse
• Unchanged soiled clothes or bedding

Emotional Abuse

Any intentional act or threat that causes trauma or emotional distress.

Examples:

• Verbal attacks
• Victim blaming
• Yelling
• Threatening
• Intimidation
• Degradation
• Humiliation
• Isolation from family members or friends

Symptoms:

• Depression
• Increased anxiety
• Loss of appetite or malnourishment
• Poor hygiene
• Agitation
• Antisocial or nonverbal behavior
• Fear of staff members
• Unexplained stories or dreams about abuse
• Sudden aggression or anger
• Increased anxiety

Sexual Abuse

Any non-consensual sexual conduct between a caregiver and a patient, or the threat of such action.

Examples:

• Unwanted physical contact
• Unwanted exposure of a patient’s body
• Coercing or forcing a patient to remove their clothing
• Being forced to view any sexually explicit images or acts
• Threats of unwanted contact, exposure, or sexual degradation or humiliation

Symptoms:

• Torn or ripped clothing
• Bruising or other injuries to the genitalia, arms, or legs
• Depression
• Aggression or anger
• Fear of staff members
• Unexplained emotional or behavior changes
• Unexplained stories or dreams about abuse

Symptoms of emotional and physical abuse can also indicate sexual abuse.

Financial Abuse

Any exchange of money from the patient to a caregiver through theft or coercion.

Examples:

• Using a person’s credit cards or bank accounts without their consent
• Forging the patient’s signature on a check or financial statement
• Stealing cash or checks
• Stealing financial documents
• Stealing property, vehicles, jewelry, medication, or home items
• Convincing a person to pay for a service or bill multiple times
• Forcing or coercing a person to sign a will or transfer power of attorney
• Forcing or coercing a person to sign over a property or vehicle
• Forcing or coercing a person to agree to unfair rental agreements

Symptoms:

• Unusual activity on credit cards and back accounts
• Transference of any property or financial assets
• Missing cash, checks, credit cards, or financial documents
• Increased agitation or worry
• Depression
• Fear of a certain person
• An unlikely or unusually close bond with a staff member

Negligence

Neglect is any substandard care for a nursing home resident. Negligence is nursing home abuse when the patient has been harmed, either physically or emotionally. An isolated act of negligence that did not harm anyone isn’t necessarily nursing home abuse, but these signs may indicate that abuse is occurring and should be investigated and documented.

Signs of Neglect:

• Not calling a doctor or nurse when needed
• Not returning family members’ phone calls
• Noticeably dirty or dusty facility
• Bugs or mold in facility
• Not changing a patient’s clothes or bedding regularly
• Not cleaning a resident daily
• Not treating a patient’s injuries or illnesses
• Not washing a patient’s clothes regularly
• Not providing enough food and water
• Poor food quality
• Unsanitary food prep areas
• Leaving a resident with limited mobility alone for hours at a time

If a person is unable to care for themselves in any of the above ways or habitually fails to do so, this is called self-negligence. For example, people with memory issues may be physically capable of feeding themselves, but may not remember to do so or recognize when they’re hungry. While self-neglect is a serious form of elder abuse and intervention is necessary, it is not considered Nursing Home Abuse and is not something one can file legal claims regarding.

Why Does Nursing Home Abuse Occur?

• Chronic understaffing
• Inadequate training
• Lack of supervision
• Burnout
• Inadequate funding
• Unchecked frustration and anger
• Seeking a sense of power on control
• Greed

Reporting Nursing Home Abuse

If you believe your loved one is being abuse in a nursing home, follow these steps.

1. Call or go to the nursing home and request to speak to the director or highest-ranking manager available. Explain your evidence of abuse and demand that the person or people suspected to be involved are removed from the patient’s caregiving team. Do not hand over your evidence. Instead, provide copies.
2. Call 911. Police or paramedics can and should remove a person from an abusive environment or person if called. A police report is also critical documentation for a legal case.
3. Call the toll-free hotline or file an online report with Adult Protective Services (APS) of Georgia.
4. Call an experienced Nursing Home Abuse attorney like me, Tracey Dellacona.

Statute of Limitations

The statute of limitations on Nursing Home Abuse is 2 years, except for when:

• The abused person was murdered
• Medical malpractice was involved
• A government entity is at fault
• The abuse was ongoing

If your loved one was abused in a situation like the one above, or if you didn’t realize an injury was the result of abuse until later, please call me. I offer free consultations to all my potential clients so I can hear the details of your unique situation and give you the best legal counsel for your family. Call my office today to set up your free consultation.