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How to Recognize Nursing Home Abuse and Neglect

Article provided by Aiken & Scoptur, S.C. Please visit our Web site at Aiken & Scoptur, S.C.

As our population ages, we are becoming more and more dependent on skilled nursing facilities to take care of our elderly population. We hope we make a wise choice, but nursing homes aren't always what they appear to be when we "take the tour."

Facilities that care for the elderly strive to appear safe and clean, even when they are not. Under the Nursing Home Reform Act (NHRA) of 1987, federal law requires that nursing homes maintain quality standards to protect residents and adopt uniform standards for proper long-term care. Still, nursing homes across the country receive citations for neglect and abuse ever year. That's why it's important to keep an eye out for warning signs.

Types of Nursing Home Abuse and Neglect

What are some types of abuse you need to look for?

  • Physical abuse: physical abuse by staff or resident-on-resident abuse
  • Emotional abuse: isolation, overmedication, threats, and harassment.
  • Sexual abuse: rape by staff and residents
  • Neglect: dehydration, malnutrition, falls, broken bones, pressure sores

What Should We Look For?

Nursing home residents may be reluctant to report incidents of abuse and neglect, mostly because they are afraid or confused. Even if they do understand what's going on, they may not be aware of the legal protections they have.

Physical abuse and neglect are typically the most apparent nursing home injuries. You need to be on the lookout for unusual bruising, unexplained falls and broken bones, unusual weight loss, and open areas of the skin. Many elderly residents lack the ability to turn themselves and relieve pressure to their calves, heels, and buttocks. You need to be aware that pressure sores can develop and check for signs when you visit. Once they start, pressure sores often don't get proper treatment and they can become dangerous and extremely painful very quickly.

Falls are another problem. Many nursing homes lack appropriate staffing to assist with transferring and walking residents. The owners often try to cut corners with the budget in order to be more profitable, so the first place they cut is staffing. Because of that, residents don't get the assistance they need and this can result in falls and broken hips. Make sure you know what type of assistance is required and what type is actually being given.

Sexual abuse is uncommon but not unheard of. Signs include bruises or open skin around the breasts or genital area; underwear that is bloody, torn, or stained; or a sexually transmitted disease. Residents with Alzheimer's disease are unusually susceptible to sexual abuse, as they are confused and unable to really understand what is happening.

Neglect. In addition to falls and pressure sores discussed above, malnutrition and dehydration can cause significant problems and actually lead to the development of pressure sores. Keep an eye out for unusual or unexplained weight loss. If your loved one loses more than 5% to 10% of their body weight in a short period (3 to 6 months), that could be a sign of malnutrition.

Ask what is spent for food per resident per day. You might be in for a surprise. Some facilities pay less for an entire day's worth of food per resident than you would pay for one value meal at McDonald's. That's hardly enough nutrition for a resident.

Dehydration can also lead to decreased mental status, poor skin condition, and kidney failure.

Don't hesitate to look at the nursing home chart to make sure your loved one is getting all the food, nutrition, and supplements they need.

What You Can Do

Be an advocate, ask questions and check out the facility. It keeps records as to each facility, including how many times a facility has been cited and for what. If you suspect abuse or neglect, contact your state's health and human services department and file a complaint. Someone from the agency will come out and inspect the facility. Talk to an attorney. Oftentimes, that is the only way that nursing homes can be held accountable for abuse and neglect.

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