You may hear the terms of “nursing home neglect” and “nursing home abuse” and wonder how they’re different. It can help to picture a continuum. On the far left would be examples of top quality care at a nursing home; on the far right, it would include examples of the worst kinds of abuse.
In some people’s usage of the term, nursing home neglect would somewhere fall in between the two—still highly inappropriate but not as bad as the worst abuse. Other people use the two terms (that of neglect and abuse) as near synonyms.
From a legal perspective, a key law to consider is the 1987 Nursing Home Reform Act. This law requires all nursing homes to provide the “highest practicable” degrees of care, meaning for the residents’ physical, mental, and psychosocial well-being. Here are the basic nursing home resident rights that are protected by this law:
- The right to freedom from abuse, mistreatment, and neglect;
- The right to freedom from physical restraints;
- The right to privacy;
- The right to accommodation of medical, physical, psychological, and social needs;
- The right to participate in resident and family groups;
- The right to be treated with dignity;
- The right to exercise self-determination;
- The right to communicate freely;
- The right to participate in the review of one’s care plan, and to be fully informed in advance about any changes in care, treatment, or change of status in the facility; and
- The right to voice grievances without discrimination or reprisal.
So, how can you tell if your loved one is receiving appropriate care? How can you tell if these rights are being honored at the facility?
Red Flags of Nursing Home Neglect or Abuse
The answer is that you can monitor the situation for signs of neglect or abuse and then respond appropriately to help your loved one. In our blog post on the subject, we listed these eight signs of nursing home neglect:
- Unsanitary living conditions: This includes your loved one’s room, as well as public areas of the nursing home, such as a lobby or cafeteria. If there are places that don’t look clean or smell fresh, this is definitely a red flag.
- Personal hygiene concerns: Your loved one is entitled to personal hygiene help, from showering to washing hair and brushing teeth. If this doesn’t seem to happen often enough, then it’s appropriate to express concern.
- Nursing home staff concerns: You may notice how there seldom seems to be enough staff to provide the help that’s needed. Or, when you do see employees, they may always seem in a hurry, and there may be plenty of turnover. Think, too, about the last time you’ve seen the nursing home director. Was it when you first moved your loved one in?
- Unanswered calls for help: If your friend or family member says it’s hard to get someone to answer their phone calls or call-light requests, pay attention. Note how quickly a response occurs when you’re visiting (taking into account that residents with visitors may get more timely attention).
- Concerns about adequate nutrition: If your loved one doesn’t seem to be getting enough nutrition or is struggling with hydration issues, this is serious. Sometimes this happens because of dementia; other times, there can be swallowing issues. Still other times, depression plays a role. No matter the cause, though, nursing home staff are required to provide proper nutrition. As a related issue, they are also required to properly administer the appropriate medications at the appropriate times. Is that happening?
- Complaints from your loved one: You know your loved one, so listen to complaints from him or her and put them into context, as far as personality. But, if a complaint is out of the ordinary, then pay closer attention to what’s going on. If your loved one has issues with balance or cognitive decline, then you may need to advocate even more quickly.
- Significant changes in your loved one: If changes are obvious, whether physical, psychological, social, or emotional (or a combination of them), this can be reason for concern. Talk to the nursing home staff to see what they’ve noticed and to ask them for added attention.
- Increasing numbers of injuries: This is especially important to address if these injuries are hard to explain. If bumps and bruises are noticed, it may mean that he or she isn’t getting the assistance that’s needed. Or, in the worst case scenarios, there may be more serious neglect or abuse going on, this can include bed sores, broken bones, and head injuries, especially if family members weren’t notified about what happened, when, and what treatment was given.
Still other signs can include when your loved one seems reluctant to talk about these issues with you, perhaps fearful about retaliation, or appears nervous or evasive. Do you notice a change in demeanor when one particular staff member stops by?
Read more: Understanding the Impact of Nursing Home Abuse
How to Protect Your Loved One from Elder Abuse
If you’ve noticed one or more red flags, protecting your loved one from nursing home abuse becomes a top priority and it’s common to not know when and how to report your concerns.
How to Report Nursing Home Abuse
In situations where there doesn’t seem to be an acute emergency in progress, step one of reporting nursing home abuse typically involves sharing your concerns with the staff at the nursing home. Be respectful yet firm as you provide specific details, including what happened, when, and where. In the best case scenarios, you can work together to create a plan that provides your loved one with the necessary care and attention.
Check up on your loved one often, to monitor whether the situation has improved to an acceptable level. If you live a distance from the nursing home, call your loved one often and also seek support from friends and family members and ask that they check in occasionally. This will allow multiple people to monitor the situation and will also provide your loved one with an extended circle of visitors.
If it appears that neglectful treatment is continuing or may be reaching the degree of abuse, this may mean that the staff simply aren’t providing appropriate care. Or, it can even mean that someone at the nursing home is intending harm. If the latter situation is the case, then the nursing home needs to appropriately deal with the employees involved—and also create a plan that proactively prevents this from ever happening again.
When you have serious concerns about your friend or family member’s health or safety, contact his or her primary care physician or, if appropriate, the social worker. If the situation rises to the level of an emergency, you can call 911.
Or, perhaps you recognize that a serious situation is going on but it’s not an active crisis. In those scenarios, you can use the Eldercare Locator, a public service provided by the U.S. Administration on Aging to help people find information about reporting abuse. Simply enter your city and state, or zip code, to find resources.
If you want to contact this organization directly, information specialists are available on Monday through Friday, from 9 a.m. to 8 p.m., EST. You can use their online chat feature, call 1-800-677-1116, or email them at eldercarelocator@n4a.org
If you contact them after regular business hours, you may be provided a phone number to call. This would be an agency in your state that addresses issues that are relevant for older adults. If you leave a message, information provided says that your call would be returned the following day.
There is also a TDD/TTY service available. To access this, call your local relay service or dial 711. Then, ask to be connected to the Eldercare Locator at 1-800-677-1116. Spanish-speaking specialists are available during regular business hours, with interpretation services available in 150 languages.
The National Center on Elder Abuse (NCEA) by the Administration on Aging (AoA) is another resource. There, you can find state-specific resources; here is the information for Florida. Plus, here is a free download from our nursing home attorney team about preventing nursing home abuse.
Elder Abuse Goes Beyond Just Nursing Homes
Unfortunately, there are a lot of myths about elder and nursing home abuse. Older adults are also neglected and/or abused in a much wider range of settings: from independent living facilities to retirement communities, and from the hands of visiting or live-in caretakers. In fact, elder abuse can happen anywhere in which a vulnerable elderly person isn’t provided with adequate protection.
The umbrella term for this type of poor treatment is “elder abuse” and, as the percentage of the population of older adults grows in our country, so does the potential for this mistreatment. In 2020, 15% or so of the United States population consists of people aged 65 and up, with approximately 6% of them being 85 or older.
Out of that number, the National Center on Elder Abuse (NCEA) says, about 10% of them have suffered abuse to some degree. And, as the numbers of older adults in the United States increases, that 10% will encompass greater numbers of people.
Other Forms of Elder Abuse
Earlier in this article, we discussed warning signs of physical abuse and psychological abuse. As part of that, also check for redness or bruising in areas that might suggest the use of restraints.
Plus, there are still other forms of serious mistreatment, including financial abuse and sexual abuse. Financial abuse can be hard to detect because, unless you or another trusted person is overseeing the finances of an elderly person, monies can be siphoned off or belongings taken without your knowledge.
A caretaker can also manipulate the elderly person into believing that he or she freely gave away the money or property. If your loved one sometimes experiences confusion or has a form of dementia, it can be even easier for a dishonest person to take advantage of the situation. To add to the possibilities, sometimes the thief may believe that he or she actually deserves to take money or belongings from the older adult in exchange for the care that’s being given.
If sexual abuse occurs, your loved one may be too embarrased to share what’s happening. In some cases, confusion may once again be playing a role. Unexpected medical issues can be a red flag for this kind of abuse, especially if there is unexplained vaginal bleeding or infections. In some cases, there can be bruising. To make matters worse, some elderly patients may be experiencing more than one kind of abuse.
As soon as you have reason to believe that serious forms of mistreatment are occurring or neglect is ongoing, begin making arrangements for other living arrangements. If required, also seek advice from an experienced elder/nursing home abuse lawyer.
Contact a Nursing Home Attorney at Harrell & Harrell
When your loved one is suffering from abuse at a nursing home, it’s important to hold that nursing home accountable. To make that happen, you’ll need to have legal proof, something that isn’t easy to gather on your own. You will need to demonstrate that the nursing home did not provide your friend or family member with a duty of care. In other words, they didn’t meet the necessary standards or levels of care.
The nursing home abuse attorneys at Harrell & Harrell are highly experienced in establishing all of these necessary elements:
- The facility owed your loved one a duty of care.
- They failed to meet this standard.
- Because of this, your loved one has suffered.
Your nursing home attorney will also help you to establish the amount of compensation to seek, based on the specifics of your case. To get started, simply let us know that you’re ready for a free consultation. We’re here and ready to help.