Nursing Home Abuse

“Elder abuse” is a broad term that encompasses all forms of physical and emotional abuse and neglect inflicted upon seniors. “Elder abuse” also includes financial crimes (such as fraud and identity theft) that target senior citizens.

Elder abuse is a growing problem in the United States. Its full extent is unknown because elder abuse often goes unreported. We do know, however, that the problem is likely to worsen as the American population continues to age. By the year 2050, people who have attained the age of 65 will constitute 20% of the nation’s population.

While the majority of elder abuse often occurs within families, seniors who live in nursing homes and other long-term healthcare facilities are also at risk of experiencing abuse and neglect. Researchers estimate that 43% of the American population will be admitted to a nursing home at some point in their lives.

All forms of elder abuse are deplorable. Reports of abuse committed by family members and financial crimes committed by strangers are usually addressed by law enforcement and social services agencies. Abuse committed within a nursing home or by healthcare providers can often be remedied only with the help of nursing home abuse lawyers.

What is nursing home abuse?

The phrase “nursing home abuse” is often used generically to describe abuse committed within residential facilities for seniors and by employees of services that provide healthcare to an elderly population. Institutions and services that might commit elder abuse include:

  • Nursing homes (residential care facilities that provide skilled nursing care to elderly residents who suffer from disabilities, chronic illnesses, or dementia)
  • Residential care institutions (healthcare institutions that provide residential care to seniors who do not need inpatient nursing care)
  • Assisted living facilities (residential facilities that provide help to seniors with their activities of daily living, such as bathing and getting dressed)
  • Adult day health care facilities (providing supervision and assistance to seniors for part of a day)
  • Home health care and respite care services (providing employees who assist seniors within their homes in the activities of daily living)

Nursing homes and other facilities and services that provide healthcare to seniors have a sad history of abusing their patients. A 2012 survey of elderly nursing home residents in Michigan found that almost 25% of nursing home residents had experienced at least one incident of physical abuse inflicted by staff members. A study of nursing home residents in 2000 found that 44% of the residents who were interviewed reported that they had been abused.

Seniors who reside in nursing homes tend to be less independent, and therefore less able to protect themselves from abuse, than seniors who have greater mobility and more contact with the outside world. In addition, the physical and mental condition of many nursing home residents often limits their ability to complain about abuse. Since they are dependent upon nursing home staff for meals, medication, and other assistance, elderly residents may fear retaliation if they complain about being mistreated. Nursing home patients are therefore particularly vulnerable to abuse.

How are nursing home residents abused?

Seniors who are confined to residential healthcare facilities are at risk of experiencing different kinds of abuse. They include:

  • Physical abuse. Physical abuse involves the infliction of harm with the intent to cause pain, injury, or impairment. Examples of physical abuse include hitting and slapping, pushing or pulling a patient, rough handling of a patient, strapping a patient to a bed unnecessarily or using other inappropriate physical restraints, confining a patient to a small space, and deliberately causing pain while administering injections or medications.
  • Physical neglect. A caregiver’s failure or refusal to provide for a resident’s care is the most common form of physical neglect. Neglect can include failing to help residents walk or to engage in other forms of exercise, ignoring the resident’s nutritional needs, failing to change the wet clothing or bedding of incontinent patients, disregarding symptoms of medical and dental problems, and ignoring a patient’s request for assistance.
  • Sexual abuse. All forms of sexual misconduct, from unwanted touching and indecent exposure to rape, are classified as sexual abuse.
  • Emotional abuse. Verbal abuse includes threats, taunts, attempts to humiliate or harass, shouting in anger, and the use of harsh or mean language with the intent to intimidate or inflict mental anguish upon a resident. Ignoring and refusing to interact with residents is another form of emotional abuse.
  • Financial abuse. Stealing money, jewelry, medications, or other property from residents is the most common form of financial abuse committed within residential facilities. Financial abuse can also involve fraudulent billing practices.

What injuries are caused by nursing home abuse?

Seniors suffer a variety of injuries and unnecessary health problems as the result of abuse and neglect in nursing homes and other healthcare institutions.

  • Falls are the single largest cause of preventable injuries in nursing homes. About 10 to 20 percent of nursing home falls result in serious injuries, including fractures. Each year, 1,800 nursing home patients die from falling in nursing homes. About a quarter of those are the result of tripping hazards and other environmental factors. Other falls are caused by staff members using improper lifting techniques when transferring a patient (from a bed to a wheelchair, for example), or by one staff member attempting to lift a patient when protocol requires the assistance of a second staff member.
  • Bedsores result from patient neglect. Also known as pressure ulcers or decubitus ulcers, bedsores occur when a patient confined to a bed or wheelchair remains in the same sedentary position for too long. Left untreated, bedsores can become infected and lead to life-threatening conditions. Even in their early stages, bedsores cause constant suffering. More than 10 percent of nursing home patients suffer from bedsores.
  • Deep vein thrombosis and pulmonary embolisms can also result from allowing patients to sit for prolonged periods. Particularly when patients are confined to wheelchairs, the failure to move the patients’ legs may lead to life-threatening conditions and wrongful deaths.
  • Physical abuse can cause head injuries, wounds and other skin injuries, fractures, soft tissue injuries (such as neck injuries), and internal organ damage. In addition to causing pain, physical abuse can lead to depression and emotional suffering.
  • Sexual abuse can cause physical injury to genitalia in addition to the symptoms of physical abuse described above. Sexual abuse is emotionally traumatizing and may lead to severe anxiety and thoughts of suicide.
  • Malnourishment and dehydration leads to anemia, kidney injury, low blood pressure, broken bones, and other medical problems. A significant percentage of all nursing home residents do not get enough to eat or drink, despite federal laws that require nursing homes to satisfy the nutritional requirements of their patients.
  • Medication errors can delay or prevent a patient’s recovery and may cause death or serious new health problems, including excessive bleeding, delirium, and gastrointestinal problems. Medication errors include giving patients the wrong medicine, neglecting to administer medicine, or overdosing the patient. Other errors include failing to shake medications that are labelled “shake well,” creating air bubbles while mixing insulin suspensions, crushing pills that are labeled “do not crush,” failing to assure that medications are given in combination with food or water when recommended by the drug manufacturer, and administering expired medications.
  • Other errors in medical treatment are, according to a report by Medicare’s Inspector General, more prevalent in nursing homes than in hospitals. They include the failure to diagnose and treat medical conditions, the failure to monitor patients adequately, and the exposure of patients to infectious diseases by failing to follow appropriate procedures (such as disinfecting catheters).
  • Bedrail injuries have affected hundreds of nursing home patients. They occur when a patient becomes caught or trapped between bedrails or between a bedrail and a mattress. Death by strangulation is a significant risk to nursing home patients who are confined by bedrails.
  • Physical restraints are often used to prevent patients from falling, but studies show that patients are more likely to be injured by the restraints than by falls they are meant to prevent. Patients injure themselves by struggling against the restraints, while restraining patients leads to muscle weakness that increases the likelihood of falling.
  • Poor hygiene contributes to infectious diseases and other adverse health conditions. Inadequate hygiene includes the failure to change sheets or soiled clothing, to bathe patients regularly, and to keep patient’s rooms and bathrooms clean.

What causes nursing home abuse?

Abuse inflicted on patients in nursing homes and other facilities for seniors cannot be attributed to any single factor. Researchers have identified several reasons that staff members abuse or neglect seniors, including:

  • Inadequate staffing
  • Heavy workloads
  • Poor training
  • Poor supervision
  • High staff turnover
  • The failure to provide individualized care plans

Licensing of nursing staff does not always assure that nurses are adequately trained to meet the special demands of nursing homes. Unfortunately, poor wages often result in the most qualified staff members leaving for more lucrative employment, while the institution’s failure to fund training programs prevents staff members from acquiring the skills they need to assure that patients are not neglected.

All of these factors lead to frustration. Unfortunately, frustrated staff members are not always trained to deal with their feelings and may take them out on residents. They may feel particularly frustrated by aggressive or difficult residents, including those who suffer from dementia and those who otherwise require extra care or special handling. Frustration increases the risk that those patients will be abused.

Although most abuse stems from frustration and negligence rather than a sociopathic personality, the failure to conduct criminal records checks and to scrutinize references contributes to instances in which staff members are hired despite their abusive backgrounds. While state licensing agencies typically deny or revoke licenses when nurses have relevant criminal convictions, many staff members who have access to patients and their rooms (including cleaning staff) are not licensed. When they are not carefully screened during the hiring process, they have opportunities to assault or steal from patients.

What should you do if you or someone you know has been victimized by nursing home abuse?

If you are in a nursing home or other eldercare facility and feel you are being abused or neglected, or if you suspect that a close friend or relative is being harmed by abuse or neglect, you are not powerless. Here are some ways you can get help.

  • In the case of intentional physical abuse, call the police. If danger is imminent, call 911.
  • If abuse or neglect is ongoing but the patient is not in immediate danger, contact an appropriate reporting agency. Every state has an Adult Protective Services (APS) agency. You can find the telephone number of your state’s APS agency on the State Resources section of the National Center on Elder Abuse website. On weekdays, you can also call the Eldercare Locator at 1-800-677-1116 to get more information about available resources.
  • Get advice from a personal injury attorney who handles nursing home abuse cases. An attorney can help abuse victims obtain the compensation they deserve. Taking legal action also sends a message that will help protect other residents from harm. Our nursing home abuse lawyers are ready to assist you.
  • Tell other people about the abuse. Contact family members, friends, and a doctor the victim trusts. The more people who know about the abuse, the more protection the victim will receive.
  • Every state has a Long Term Care Ombudsman whose job is to act as an advocate for residents of nursing homes and other long term care facilities for the elderly.
  • The Ombudsman investigates and tries to resolve patient complaints. An Ombudsman does not act with the immediacy of an APS agency but they may help you find a long term solution to ongoing problems.
  • Cooperate with all investigations that are undertaken by government authorities and your attorney. Make written notes of abusive incidents, including dates, times, and the identities of staff members who are involved.

Look for another facility. If the problem is not one that is likely to be corrected, it is probably time for the victim to relocate to a nursing home or other facility that does a better job of caring for its patients.