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Signs of Nursing Home Abuse and Neglect

According to the Center for Disease Control and Prevention, there were over 16,000 nursing homes in the United States in 2004. Over 1.5 million people called those facilities home that year and that population is expected to keep growing.

Unfortunately, some residents will also experience some form of abuse or neglect during their time in a nursing home. For those who have loved ones in any type of long-term care facility, it is important to be mindful and watch for signs of abuse.

Physical Abuse

The National Center on Elder Abuse (NCEA) defines physical abuse as any “use of physical force that may result in bodily injury, physical pain, or impairment.” This can include hitting, shaking, use of restraints, slapping and other forms of physical contact. Bruising or other unexplained injuries are often signs of physical abuse, along with a caretaker’s refusal to allow visitors or a sudden change in the elder person’s behavior.

Physical abuse can also include forms of neglect, such as dehydration, malnutrition and untreated health problems. The NCEA notes that providing the elderly person with unsafe, hazardous, unsanitary or unclean living conditions can constitute neglect as well.

Bed sores, also referred to as pressure ulcers or decubitis ulcers, are one of the strongest signs of neglect and are completely preventable. Typically, bed sores form on areas where the bone comes into close contact with the skin on the heels, elbows, shoulders and back of the head. They can, however, appear any place on the skin subjected to prolonged pressure. The Centers for Disease Control and Prevention note that bed sores are categorized in stages by the depth and severity of the wound:

  • Stage 1: The skin is reddened but not an open wound and will not disappear when pressure is relieved
  • Stage 2: Some skin loss associated with the wound and may appear as a blister or shallow crater
  • Stage 3: A full thickness of skin is lost, exposing the subcutaneous tissues and appearing to form a deep crater
  • Stage 4: A full thickness of skin and subcutaneous tissues are lost, exposing muscle or bone

In 2004, the CDC estimated that 11 percent of all nursing home residents suffered from some type of pressure sore, with stage two being the most common.

Sexual and Emotional Abuse

According to the National Committee for the Prevention of Elder Abuse (NCPEA) sexual abuse can be any non-consensual physical contact. This can include rape, forced nudity and other degrees of sexual assault. Incidences of sexual abuse are difficult to identify because often the elderly person is unwilling or unable to communicate the extent of the contact. The NCPEA notes there are many physical indicators of sexual abuse:

  • Genital pain or bleeding
  • Bruises on external genitalia or inner thighs
  • Difficulty walking or sitting
  • Torn, stained, or bloody underclothing
  • Sexually transmitted diseases

As with physical abuse, behavior changes can also be indicative of sexual abuse.

Financial Abuse

A survey conducted by the NCEA in 2000, found that financial exploitation comprised 13 percent of the abuse allegations investigated by law enforcement. But according to the National Institute of Justice, financial abuse of the elderly is vastly underreported. At the White House Conference on Aging in 2005, it was noted that nearly one in every six elderly people will be the victim of financial exploitation and abuse, though only one in every 100 cases is reported.

The NCEA notes that any of the following may be evidence of financial exploitation:

  • Sudden changes in bank account or banking practice
  • The inclusion of additional names on an elder’s bank signature card
  • Unauthorized withdrawal of the elder’s funds using the elder’s ATM card
  • Abrupt changes in a will or other financial documents
  • Unexplained disappearance of funds or valuable possessions
  • Bills unpaid despite the availability of adequate financial resources
  • Discovery of an elder’s signature being forged for financial transactions or for the titles of his/her possessions
  • Sudden appearance of previously uninvolved relatives claiming their rights to an elder’s affairs and possessions
  • Unexplained sudden transfer of assets to a family member or someone outside the family

Working With an Attorney

If you suspect a loved one is experiencing any form of elder abuse, it is important to discuss your case with an experienced elder abuse attorney.

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