Nursing home abuse is common in the United States. Older adults get hurt, are neglected, and even die in the same facilities where they should be receiving proper care.
According to the federal government, “nursing home abuse means the willful infliction of injury, unreasonable confinements, intimidation, or punishment with resulting physical harm, pain, or mental anguish.” Nursing home abuse involves harm or injury done to an older adult intended to cause pain, suffering, or impairment.
The National Council on Aging (NCOA) found that nursing home abuse:
Increases the chancesof death by 300%
Triples the chances ofhospitalization
Leads to futuremedical problems anddisabilities
Increases the risk ofdepression, anxiety,and otherpsychological issues
Nursing home abuse can be physical, mental, emotional, and sexual. The NCOA states that nursing home abuse includes:
- Physical abuse, which can be made apparent by bruises or unexplained falls
- Sexual abuse, including any sexual activity without consent
- Neglect, indicated by matted hair, dirty bedding, and so on
- Emotional abuse, such as verbal threats and harassment
- Financial exploitation, such as forged financial documents or missing personal belongings
How common is nursing
Financial nursing home abuse is a pervasive problem.S. A 2019 bipartisan Senate investigation, leading to reform efforts, found that poor resident care is “common” in about 5% of the nation’s care facilities.
According to the NCOA, approximately 5,000,000 elderly persons are abused every year.
In an Atlanta Long Term Care (LTC) Ombudsman Program study of 80 residents in 23 Georgia-based nursing homes, 44% of the respondents experienced abuse, while 48% experienced mistreatment. In addition, 38% percent of respondents witnessed fellow residents abused, while 44% had seen others being mistreated.
Overall, elder abuse affects hundreds of thousands of families annually. In 2013 alone, the National Center for Victims of Crime (NCVC) noted approximately 10,000 care facility complaints related to elder abuse.
Recent Cases ofNursing HomeAbuse
In a care facility in southern Illinois, a nurse allegedly sexually assaulted a 60-year-old resident during the pandemic. He was charged with felony aggravated criminal sexual assault and fined $200,000 by the state regulatory agency. The public health department also cited the facility for putting its residents’ safety in immediate jeopardy.
A long-term care facility in Maplewood, Minnesota, is under investigation after instances of elder abuse were recorded on a hidden camera. So far, the nursing home has fired two employees after victimizing an elderly man with Alzheimer’s.In two years or so, the facility has had nine substantiated and four inconclusive abuse complaints with the Minnesota Department of Health. Such complaints ranged from falls and unexplained injuries to medication errors.
In a lawsuit filed with the Onondaga County Supreme Court, the son of a 90-year-old woman accused the Bishop Rehabilitation and Nursing Center in Syracuse, New York, of negligence and recklessness in the care of his late mother, who had dementia.
A registered nurse working at a Southern California care facility was accused of neglecting a 69-year-old woman who died of gangrene. The nurse pleaded not guilty and remains free on $50,000 bail. If convicted, she could face up to a 10-year jail term.
Types of Nursing HomeAbuse
Elder abuse can take many forms, including:
Physical abuse occurs when older adults in a care facility experience pain, injury, illness, distress, functional impairment, or death due to the intentional use of physical force.Examples include:
- Striking with objects
According to the NCVC, 27.4% of reported complaints related to physical abuse. Sadly, physical elder abuse cases are increasing by the day. The Center for Disease Control and Prevention noted that the abuse rate among 60-year-old men increased by 75% between 2002 and 2016. The rate of abuse among women over 60 years old increased by 35% within the same timeframe. The rate is expected to rise as the elderly population grows.
Emotional or psychological abuse refers to verbal or nonverbal actions and behaviors that inflict fear, mental pain, distress, or anguish on nursing home residents. Examples include:
According to a 2020 WHO study, emotional abuse was the most prevalent form of abuse. What’s more, 33% of care facility staff members admitted to having emotionally abused residents. The NCVC found that 19.4% of the reported cases involved emotional abuse.
According to the CDC, neglect is “the refusal or failure of a caregiver to fulfill his or her obligations or duties to an older person.” Nursing home neglect can include:
- Refusing or denying food
- Failure to administer prescribed medication or treatment
- Neglecting hygiene
- Not providing adequate supervision
In 2020, 12% of caregivers admitted to neglecting residents’ needs, according to the WHO. Nearly 12% of victims (or their families) also reported cases of elder neglect. According to the NCVC, 15.3% of all elder abuse complaints are related to neglect. In another study of 2,000 residents, 95% had witnessed or experienced elder neglect.
Nursing Home Neglect
Sexual abuse is any non-consensual sexual activity. It may be a result of manipulation and deception. Examples include:
- Forced nudity
- Forced observation of pornography or masturbation
- Taking sexually explicit videos, audios, or photos
The WHO found that sexual abuse accounted for fewer than 2% of nursing home abuse cases reported by residents. Its prevalence was even less in cases reported by caregivers. However, since shame often accompanies sexual abuse, that might be the cause of lower reported cases.
Financial exploitation is the improper, unauthorized, or illegal use of an elder’s property, belongings, assets, money, or benefits. Examples include:
- Forged financial documents
- Missing property and belongings
According to the NCOA, elderly people are more likely to report financial exploitation than other forms of abuse. According to the National Adult Protective Services Association (NAPSA), 5% of older adults suffer from financial abuse. The NCVC reported that 7.9% of complaints were related to financial exploitation. And according to NCEA, approximately 60% of cases involve family members.
What causes nursing
The causes of elder abuse depend on the quality of the care facility, its policies, staff members, and operation and management. Regardless, there tend to be some common contributing factors, such as:
When there is not enough staff to care for the nursing home residents, aides can be overloaded and overworked, which can lead to patient malnourishment and dehydration in nursing home residents. The prevalence of understaffing can make it hard for employees to respond properly.
Unfortunately, understaffing in nursing homes is on the rise. A report by the U.S. Public Interest Research Group noted that 20% of U.S. nursing homes were understaffed as of December 2020.
When care facilities fail to screen their employees properly, they can endanger their residents. Aides with a history of abuse or drug addiction are more likely to abuse people in long-term care facilities.
Untrained or poorly trained staff are more likely to be abusive, especially when dealing with residents with aggressive or combative behaviors.
Risk Factors in Nursing
Any person in a care facility may suffer from elder abuse. However, some residents are at a higher risk due to the following factors:
According to an NCVC survey, 66% of elder abuse cases involve women. That figure may be attributed to the high population of women in care facilities.
Scientific studies suggest a link between lower socioeconomic status and nursing home abuse. For example, elderly persons relying on Medicaid to pay for their care in long-term care facilities may wind up at lower-quality facilities.
According to the NCEA, residents who have experienced traumatic events or abuse are more likely to be abused in the future.
Poor physical and mental health may increase the chances of elder abuse. For instance, residents with dementia or Alzheimer’s are more vulnerable to elder abuse. According to NCEA and NCOA, nearly 50% of residents with dementia experience elder neglect or abuse.
Residents with tendencies towards physical aggressiveness are at higher risk of abuse. Regardless of the cause, many staff members view combative residents’ behaviors as intentional attempts to be difficult. That makes it more likely for such residents to be abused or mistreated.
Warning Signs of NursingHome Abuse
Here are some of the signs to look out for in cases of suspected nursing home abuse.
- Broken bones
- Unexplained injuries
- Refusal of visitors
- Improper medication and treatment
- Odd behavior
- Control by the caregiver
- Fear of the caregiver
- Extreme agitation
- Panic attacks
- Suicide attempts
- Withdrawal from social interactions
- Unexplained change in behavior
- Increased nightmares
- Poor hygiene
- Unsanitary living conditions
- Lack or loss of mobility
- Malnutrition and weight loss
- Bruises around the inner thigh, breasts, or genital areas
- Sexually transmitted infections
- Unexplained vaginal or anal bleeding
- Difficulty walking or sitting down
- Torn, bloodied, or stained underclothing
- Missing items
- Sudden changes in financial situation
- Significant fund withdrawals
How can you prevent
nursing home abuse?
Nursing home abuse prevention is complex. It requires the involvement of different parties, including residents, nursing staff, and the government. There are many ways to proactively prevent abuse, including the following:
- Understand the different forms of abuse that can
occur in a care facility
- Learn nursing home policies, services, and
- Express concerns about abuse to staff members,
administrators, social workers, doctors, and nursing directors
- Inform a loved one that you believe abuse is taking
- Document evidence
- Reach out to state survey agencies or a long-term
Friends and Relatives
- Review different care facilities and choose a
- Visit long-term care facilities to ascertain their
- Visit and check in on your loved one often
- Take any complaints from your loved one seriously
- Notify relevant authorities about any abuse
Additionally, when deciding on the best care facility for your elderly loved one, consider choosing a nursing home that properly vets its staff members. Nursing home staff should communicate transparently with residents and their family members about boundaries, services and medications.
Ensure that the nursing home:
- Has written procedures and policies that prevent, prohibit, and investigate abuse
- Trains staff members on what constitutes elder abuse and steps for reporting incidents
- Screens every employee thoroughly before hiring
- Adopts policies that foster abuse disclosure in a non-victimizing manner
- Posts contact details for all relevant authorities dealing with nursing home abuse
- Maintains a sustainable staff-to-resident ratio
- Implements caregiver support interventions.
- Implements caregiver training on Alzheimer’s and dementia
- Installs quality monitoring systems
There are no fail-proof ways of preventing elder abuse, but the above strategies can serve as a starting point for seniors and their families.
Nursing Home Abuse Laws
Several national laws have been enacted in America to ensure every citizen is treated with respect and dignity, regardless of age. Elder protection laws include:
The Elder Justice Act was signed into law in 2010 as a part of the Affordable Care Act. It allocates resources and funding towards prosecuting and preventing elder abuse cases.The law also included a section outlining the creation of a database for nursing aides’ background checks, ensuring care facilities make smart recruitment decisions.This law requires:
- All nursing home aides to report suspected cases of elder abuse
- Care facilities to provide a written notice to the Secretary of Health and Human Services 60 days before any permanent closures
Elder Justice Act
This act was signed in 1965 and reauthorized in 2016. It helps define abuse among older adults and allocates resources to awareness programs like the National Center of Elder Abuse (NCEA). The act helps build resources for victims and their family members as well.
Older Americans Act
This act was signed in 1994 and reauthorized in 2013 and again in 2021. The legislature focuses on domestic abuse cases that cross state, federal, or tribal boundaries. The act allocates resources to women’s programs, including special services for women above 50 years old. The resources can help:
- Improve services for abuse victims
- Enact community response for elder abuse victims
- Cross-train (for organizations created to help abuse victims)
- Boost prosecution training programs
Violence Against Women Act
The No Fear Act protects individuals who report instances of nursing home elder abuse. The law helps guarantee equal opportunities for nursing home abuse whistleblowers concerning promotions, future employment, and raises.
No Fear Act
State Laws & Statutes
Individual states also have laws that help prevent elder abuse in care facilities. Elder protective services (EPS) or Adult Protective Services (APS) are present in all states. Some states have multiple statutes and laws; thus, the level of abuse support varies by state. Overall, the APS and EPS help ensure a base level of older adults’ protection.
In addition, long-term care ombudsman programs exist in all states. They ensure high-quality care in nursing homes to prevent neglect and injuries like bedsores or broken bones in the nursing home to prevent neglect and injuries like bedsores or broken bones in the nursing home. The programs also protect the rights of elderly persons by investigating abuse and neglect complaints and holding nursing homes responsible for their actions.
Finally, institutional abuse laws, criminal laws, and mandatory reporting laws vary by state, but exist to protect victims of abuse.
Can I sue a nursing home for abuse or neglect?
The Omnibus Budget Reconciliation Act of 1987 states that care facility residents have the “right to be free from verbal, sexual, physical, and mental abuse, corporal punishment, and involuntary seclusion.” If a facility or its staff members violates this law, they may be liable for elder abuse.
On their end, care facilities are obligated to hire caring aides and train them to provide the best care possible. They must also employ enough caregivers to cater to residents adequately.
Thus, a long-term care facility can be liable for abuse in cases of:
- Negligent hiring
- Medication errors
- Inadequate training
If a staff member harms a resident intentionally or through neglect, they may be liable for the abuse and associated damages. The same goes for any hired contractors.
How can a nursing home abuse lawyer help me?
If you believe that your loved one is experiencing elder abuse of any kind. Whether it’s physical, mental, sexual or emotional abuse, a nursing home abuse lawyer can help with the following:
- Identifying signs of abuse
- Investigating reports of abuse
- Establishing legal theories
- Quantifying damages
- Reporting damages
- Exploring options to determine the best course of action
Your loved one has a legal right to be treated well. If you believe a family member was injured due to elder abuse, maltreatment, or neglect in a nursing home, contact us for a free case evaluation.
- Emotional Abuse. According to data from the NCEA, emotional abuse is by far the most common type of abuse in the nursing home setting. ...
- Physical Abuse. ...
- Abandonment. ...
- Sexual Abuse. ...
- Financial Abuse. ...
- Neglect. ...
- Physical abuse.
- Domestic violence or abuse.
- Sexual abuse.
- Psychological or emotional abuse.
- Financial or material abuse.
- Modern slavery.
- Discriminatory abuse.
- Organisational or institutional abuse.
- Lack of basic amenities.
- Cluttered, filthy living environment.
- Unexplained or uncharacteristic changes in behavior.
- Unexplained sexually transmitted diseases.
- Unpaid bills, new credit cards, and/or increased cash withdrawals.
- bruises, black eyes, welts, lacerations, and rope marks.
- broken bones.
- open wounds, cuts, punctures, untreated injuries in various stages of healing.
- broken eyeglasses/frames, or any physical signs of being punished or restrained.
- laboratory findings of either an overdose or under dose medications.
Types of abuse include; physical, sexual, psychological, verbal, emotional and mental, financial and spiritual. Emotional and mental abuse is often subtle and in some cases victims don't recognise they are being abused.What are the four major types of abuse commonly known as? ›
There are four main categories of child abuse: physical abuse, emotional abuse, sexual abuse and neglect.What 3 types of abuse should always be reported? ›
Physical, sexual, and emotional abuse are some of the most known types of abuse: Physical abuse is when someone hurts another person's body. It includes hitting, shaking, burning, pinching, biting, choking, throwing, beating, and other actions that cause physical injury, leave marks, or cause pain.What is the most common type of abuse? ›
Neglect is the most common form of child abuse. Physical abuse may include beating, shaking, burning, and biting. The threshold for defining corporal punishment as abuse is unclear. Rib fractures are found to be the most common finding associated with physical abuse.What is one of the two most common types of abuse in care? ›
Neglect is the most common type of nursing home abuse, which includes self-neglect and abandonment. Emotional abuse is also common, but is the most difficult type of nursing home abuse to prove. These are just two of the six types of elder abuse that occur in nursing homes.What are signs of elderly abuse that we should be aware of? ›
- Seems depressed, confused, or withdrawn.
- Isolated from friends and family.
- Has unexplained bruises, burns, or scars.
- Appears dirty, underfed, dehydrated, over-or undermedicated, or not receiving needed care for medical problems.
- Has bed sores or other preventable conditions.
- Abusive style of interaction. In some families, the members have a way of relating to each other that is generally hostile and non-nurturing. ...
- Dependency. ...
- Stress. ...
- Addictions (Alcohol/Drugs/Gambling) ...
- Ageism / Lack of Knowledge.
Elder abuse can be emotional or psychological, physical, financial, social or sexual. Often more than one type of abuse can occur.What are red flags for elder abuse? ›
Some of the Red Flag warning signs of physical abuse may include inadequately explained fractures, bruises, cuts or burns. Red Flag warning signs of psychological abuse may include the isolation of an elder or actions by a caregiver that are verbally aggressive or demeaning, controlling behavior or neglect.What are the 5 signs of emotional abuse? ›
- They are Hyper-Critical or Judgmental Towards You. ...
- They Ignore Boundaries or Invade Your Privacy. ...
- They are Possessive and/or Controlling. ...
- They are Manipulative. ...
- They Often Dismiss You and Your Feelings.
- becoming clingy.
- becoming aggressive.
- being withdrawn, depressed or anxious.
- changes in eating habits.
- displaying obsessive behaviour.
- finding it hard to concentrate or take part in activities.
- missing school.
- showing signs of self-harm.
The cycle of abuse often goes through four main stages: tension, incident, reconciliation, and calm. Abusive behaviors may escalate from cycle to cycle, although this isn't always the case.What are the four factors of abuse? ›
Age; health; and physical, mental, emotional, and social development are factors that may increase a child's vulnerability to maltreatment.What is the most serious form of abuse? ›
Emotional abuse may be the most damaging form of maltreatment due to causing damage to a child's developing brain affecting their emotional and physical health as well as their social and cognitive development (Heim et al. 2013).What type of abuse is the hardest to detect? ›
Emotional or psychological abuse
Emotional abuse often coexists with other forms of abuse, and it is the most difficult to identify. Many of its potential consequences, such as learning and speech problems and delays in physical development, can also occur in children who are not being emotionally abused.
increased fear, guilt and self-blame. distrust of adults or difficulty forming relationships with others. disrupted attachments with those who are meant to keep them safe. mental health disorders such as anxiety, attachment, post-traumatic stress and depression disorders.
Stress, tiredness or lack of parenting skills or family support make the pressures of caring for a child overwhelming, and can cause abuse. Causes of child abuse can include: isolation and lack of support — no family members, friends, partners or community support to help with the demands of parenting.How many indicators of abuse are there? ›
Possible indicators of Domestic Abuse
Includes: psychological, physical, sexual, financial, emotional abuse; so called 'honour based violence; Female Genital Mutilation; forced marriage.
Some of the most common forms of abuse in adults include:
Emotional Abuse and Psychological Abuse. Neglect. Self-neglect. Financial or Material Abuse.
Physical abuse is the most visible form of abuse and may be defined as any act that results in a non-accidental trauma or physical injury. Inflicted physical injury most often represents unreasonable, severe corporal punishment or unjustifiable punishment.What are the ranking types of abuse? ›
Table 5 shows the worst combinations of four types of abuse or neglect. Where the average correlation is calculated, the first in the rank order is physical abuse, physical neglect, verbal abuse, and emotional neglect; followed by physical neglect, emotional neglect, verbal abuse and sexual abuse. ...What is the 2nd most common form of elder abuse? ›
Psychological abuse is the second most common form of elder abuse after neglect. It often consists of purposeful verbal or nonverbal infliction of emotional or mental anguish.What is patient abuse in nursing? ›
Any act or threat of physical violence, harassment, intimidation or other threatening, disruptive behavior from patients, patient's family members, external individuals, and hospital personnel. It includes physical, sexual, and psychological assaults.What type of abuse is present in all types of ill treatment? ›
It may involve causing children to feel frightened or in danger, or exploiting or corrupting children. Some level of emotional abuse is present in all types of ill treatment of a child; it can also occur independently of other forms of abuse.
Examples include humiliation or disrespect, verbal and non-verbal threats, harassment, and geographic or interpersonal isolation. Neglect is the failure to meet an older adult's basic needs. These needs include food, water, shelter, clothing, hygiene, and essential medical care.What are 5 signs of financial abuse of the elderly? ›
- Unpaid Bills And Expenses. ...
- Lack Of Trust. ...
- Forged Signatures. ...
- Unexpected Changes in Financial Situation. ...
- Change Of Names In Documents.
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.What is the fastest form of elder abuse? ›
What is elder abuse fraud? Financial abuse is reportedly the fastest-growing form of elder abuse, leaving many Americans vulnerable to theft scams, and putting businesses and other organizations on the frontlines to provide protection and help prevent fraud losses.What are two possible causes of elder abuse? ›
Community- and societal-level factors linked to elder abuse may include ageism against older people and certain cultural norms (e.g., normalization of violence). Social support and living alone reduce the likelihood of elder abuse (5).
- Current physical health problem.
- Past experience of disruptive behavior.
- Past experience of traumatic events.
- High levels of stress.
- Poor or inadequate preparation or training for caregiving responsibilities.
- Inadequate coping skills.
- Exposure to or witnessing abuse as a child.
- Social isolation.
It also includes the inappropriate use of medications and physical restraints and physical punishment of any kind. Verbal, emotional or psychological abuse, including yelling, swearing, threatening, making insulting or disrespectful comments or repeatedly ignoring the older adult.WHO is the most common perpetrator of elder abuse? ›
In almost 60% of elder abuse and neglect incidents, the perpetrator is a family member. Two thirds of perpetrators are adult children or spouses.What are the 7 components of abuse prevention? ›
483.13(b) 483.13(c) 483.13(c)(3) The facility must develop and implement policies and procedures that include the seven key components: screening, training, prevention, identification, investigation, protection and reporting/response; the facility identifies, corrects and intervenes in situations in which abuse or ...What are 4 signs of financial exploitation? ›
- Sudden changes in bank accounts or banking practices, including an unexplained withdrawal of large sums of money by a person accompanying the older adult.
- The inclusion of additional names on an older adult's bank signature card.
Elder neglect or self-neglect warning signs
Unusual weight loss, malnutrition, dehydration. Untreated physical problems, such as bed sores. Unsanitary living conditions: dirt, bugs, soiled bedding and clothes. Being left dirty or unbathed.
What Is Emotional Elder Abuse? Emotional elder abuse takes place when an older person suffers harm through insults, yelling, or verbal harassment. It is also referred to as elder psychological abuse. Emotional abuse may be one of the most common forms of elder mistreatment.
Emotional abuse includes non-physical behaviors that are meant to control, isolate, or frighten you. This may present in romantic relationships as threats, insults, constant monitoring, excessive jealousy, manipulation, humiliation, intimidation, dismissiveness, among others.What are the 4 cycles of emotional abuse? ›
The cycle of abuse is made up of four stages. These stages include the building of tension, the abuse incident, the reconciliation, and a period of calm.What are the 7 main categories of abuse? ›
- Key messages.
- Physical abuse.
- Domestic violence.
- Sexual abuse.
- Psychological or emotional abuse.
- Financial or material abuse.
- Modern slavery.
- Discriminatory abuse.
Here Are the Three Types of Abuse: Mental Abuse, Physical Abuse, and Verbal Abuse.How does abuse affect a person? ›
Maltreatment can cause victims to feel isolation, fear, and distrust, which can translate into lifelong psychological consequences that can manifest as educational difficulties, low self-esteem, depression, and trouble forming and maintaining relationships.What is the most common type of patient abuse? ›
Emotional abuse (also known as verbal or psychological abuse) occurs when someone insults a resident or uses threats to control them. It is the most common type of nursing home abuse.What is the most common form of violence found in nursing? ›
Within nursing teams, the most common type of violence is verbal abuse, which is considered less severe than physical aggression.What is the most common form of elder abuse _____? ›
Emotional abuse, defined as the infliction of mental pain, anguish, or distress on an elder person, either through verbal or nonverbal acts, is the most common form of elder abuse reported to protective agencies.What are the three main types of elder abuse? ›
- Physical Abuse.
- Sexual Abuse.
- Emotional or Psychological Abuse.
- Financial or Material Exploitation.
Abusers frequently have the following characteristics: Often blow up in anger at small incidents. He or she is often easily insulted, claiming hurt feelings when he or she is really very angry. Are excessively jealous: At the beginning of a relationship, an abuser may claim that jealousy is a sign of his or her love.
- Level One (Early Warning Signs)
- Level Two (Escalation of the Situation)
- Level Three (Further Escalation – Usually Resulting in an Emergency Response)
- Domestic Violence.
Unsafe medication practices and medication errors are a leading cause of avoidable harm in health care systems across the world.How do nurses handle violent patients? ›
Interventions for defusing aggression
Utilize verbal communication techniques that are clear and calm. Staff attitudes must be non-confrontational in use of verbiage. Avoid using abbreviations or health care terms. Use non-threatening body language when approaching the patient.