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The older population in the United States is growing at a faster rate than the younger population. Many of the older adults are considered frail and vulnerable, they may be unable to take care of their own daily needs, and they often depend on others for help. This leaves them vulnerable to being abused or taken advantage of by someone in a caregiving role – whether that person is a family member, friend, or other caregiver. A National elder abuse incidence study found that over half a million older adults in the U.S. were experiencing abuse; it is estimated that for every reported incident of abuse, 5 additional incidents go unreported.

The Centers for Disease Control and Prevention (CDC) found that elder abuse, including exploitation, is experienced by approximately 10 percent of adults over the age of 60 who live at home. They do report that this statistic is likely underestimated because many victims are unable to or afraid of disclosing the abuse. While these particular numbers are about elder abuse in any setting, we will focus on abuse and neglect in a healthcare setting.

Nursing Home Abuse and Neglect: Definitions

The Department of Health and Human Services defines elder abuse as any knowing, intentional, or negligent act by a caregiver or other person that causes harm or risk of harm to a vulnerable adult. All 50 states in the U.S. have passed some form of elder abuse prevention laws, recognizing older adults as a vulnerable population in need of added measures of legal protection.

Abuse can take many forms, but the most common forms of elder abuse typically fall into one (or more) of the following categories:

• Physical abuse: inflicting physical pain or injury; slapping, bruising, or physically or chemically restraining an older adult;
• Sexual abuse: sexual contact of any kind without consent;
• Financial abuse: illegally taking, concealing, or misusing funds, property, or assets of a elderly person for someone else’s benefit;
• Emotional abuse: inflicting mental pain, anguish, or distress through verbal and non-verbal methods (belittling, intimidating, threatening, etc);
• Neglect: failure to provide food, shelter, protection, or health care to a vulnerable elder;
• Abandonment: desertion of a vulnerable adult by someone who has responsibility to care for that person.

What Are the Warning Signs of Abuse or Neglect In a Nursing Home?

Naturally each situation is going to be unique, but some signs that ones can look for that might point to abuse or neglect of their elderly family member can include:

• Physical: unexplained bruises or burns, broken bones, or frequently needing to see a medical provider.
• Sexual: development of an STD; genital or anal pain, bleeding, or injury.
• Financial: unexplained loss of assets; unexplained financial transactions; missing personal items; sudden or unexplained changes in living arrangements.
• Emotional: severe and unexplained changes in behaviors and mood; anxiety; withdrawal from family and friends; hesitation to speak openly; fear of nursing home staff.
• Neglect: lack of basic necessities such as food, clothing, medical care, etc.; malnourishment and/or dehydration; bedsores or skin ulcers; medical needs not being attended to; unpaid bills.
• Abandonment: Unsanitary or unclean living conditions; soiled bedding/clothing; lack of proper medical treatment.
• Self-neglect: when an older adult refuses care, and symptoms can be one or a combination of the above-mentioned symptoms.

Who Do I Report Nursing Home Issues To?

If you suspect that someone you love is a victim of nursing home neglect or abuse, it is important to call either the police or Adult Protective Services. You are not required to prove the abuse – in this case, if you suspect there is abuse and report it to the authorities, they have a duty to investigate. The National Center on Elder Abuse has some excellent resources available to assist you in finding local help. By law, responders are not allowed to release your name as the one who brought up the concern of abuse or made the report; this is especially important when abusers have threatened the safety of our loved ones if they tell about the abuse.

Who Is Legally Liable When Abuse Happens In a Nursing Home?

Questions of liability are, of course, hard to determine without knowing specifics of each unique situation. But in general, the person causing the abuse would be liable first of all. Then, beyond that person, the nursing home facility can be held liable if the neglect or abuse can be proven to be caused by:

• Negligent hiring
• Being understaffed
• Inadequate training
• Medication errors
• Not following regulations and statutes that apply to them

A nursing home facility is considered “vicariously liable” for the actions of its employees when they’re acting in the nature and scope of their employment responsibilities. In facilities that hire contractors to carry out certain jobs, the third party contractor could also be held liable for the abuse or neglect, depending on the specifics of the situation.

What Can Be Done To Prevent Elder Abuse Before It Starts?

A lot of the protective factors that would help prevent elder abuse on a personal level have to do with relationship and communication. Checking in often with our older loved ones, being present in their lives, and listening to them; helping them feel a sense of community and care are all things that can help prevent or put an early stop to abuse.

On an institutional level, it is important to ensure there are effective monitoring systems; solid policies and procedures regarding patient care; regular training on elder abuse and neglect for all nursing home employees; regular visits by family members, volunteers, and social workers; and education on durable power of attorney and how it is to be used.

If Abuse Happened, How Can I Make It Better?

No one wants to think that their loved one suffered abuse or neglect while they are supposed to be cared for in a nursing home. Sadly, however, the unthinkable does happen. How do you deal with the fallout from abuse and neglect in a nursing home setting and help repair what was done?

After alerting the proper authorities, and having them investigate, take care of whatever arrangements are necessary so your loved one is safe. At this point, it is time to decide what the legal options are for your loved one. Consulting with an experienced Elder Abuse Attorney (a Personal Injury Attorney who specializes in cases of elder abuse and neglect) can help you and your loved one find out what legal rights you have and if there are damages you can be compensated for.

Compensation after abuse certainly doesn’t undo the abuse or the effects of it – but it can help with the expenses of treating the effects of the abuse and may also help your loved one be able to change facilities if necessary. Another benefit of bringing a claim against those responsible for the abuse is that it brings the experience to light and brings it to an end, preventing damages to others. An experienced attorney can help you determine what options you have and can also help with questions of liability.