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How to Detect Signs of Nursing Home Abuse

Over 3.2 million adults are living in nursing homes and other long-term care facilities in the U.S. As many as 40 percent of all adults will enter a nursing home at some point during their lives, and as the U.S. population ages, the number of nursing home residents is expected to grow. Many of these elders are well cared for, but many may be the victims of abuse.

Elder abuse, particularly when it involves a patient in a residential care facility, can be difficult to detect and for every reported case of abuse, more than five cases may go unreported. Nursing home abuse is a serious concern and seniors who have been abused have a 300 percent greater chance of death in the 3 years following the abuse than those who aren't abused. Up to one in six nursing home residents may be the victim of abuse or neglect every year.

Though many residents are well cared for, abuse continues to be more prevalent than most people would wish to believe, and over three-fourths of the cases of nursing home abuse are perpetrated by caregivers.

A congressional report showed that an examination of nursing home records conducted over a two-year period showed that nearly one in three nursing homes were cited for violations that had the potential to cause harm, and almost 10 percent of all nursing homes had violations that caused actual harm, serious injury or placed residents in jeopardy of death.

A survey of nursing home residents showed that up to 44 percent of nursing home residents reported that they had been abused at some time in residency and nearly all of those surveyed (95%) had seen another resident neglected.

A study conducted by the U.S. General Accountability Office revealed that state regulators are likely to miss signs of abuse. The GAO found that 70 percent of state surveys missed significant deficiencies and 15 percent missed notice of actual harm or immediate jeopardy of a nursing home resident.

Due to reports like these, legislatures in all 50 states have passed anti-elder-abuse laws but nursing home abuse continues to occur.

What Nursing Home Abuse Can Involve

Physical abuse is a condition or event that causes physical harm. Physical abuse may be intentional, such as hitting or pinching, or it may be due to neglect including overuse of restraints and lack of physical care.

Sexual abuse is unwanted sexual attention or exploitation. This includes sexual attention given to a patient who is unable to express his or her wishes or who is cognitively compromised, such as the patient with dementia.

Psychological abuse is not easily identified but can include yelling, criticizing, humiliating or otherwise shaming the patient. Patients who are experiencing psychological abuse may exhibit behavioral changes.

Financial exploitation occurs when a caregiver takes advantage of access to a patient's financial matters, stealing or otherwise compromising the patient's financial status. This could include direct theft, theft from banking accounts or applying for credit in the patient's name.

Neglect is often unintentional and a result of inadequate staffing. Neglect occurs when a patient's needs are not taken care of, such as personal hygiene care or when the patient is not provided food, clothing or water. Neglect can contribute to a number of medical conditions such as bed sores, skin infections, malnutrition and dehydration.

Resident-to-resident abuse occurs when one resident is allowed to abuse another. Resident-to-resident abuse may be physical, sexual or psychological. Nursing home patients should be protected from other residents.

Signs of nursing home abuse may include:

  • Broken bones or fractures
  • Bruising, cuts or welts
  • Bed sores
  • Frequent infections
  • Signs of dehydration
  • Mood swings and emotional outbursts
  • Reclusiveness or refusal to speak
  • Refusal to eat or take medications
  • Unexplained weight loss
  • Poor physical appearance or lack of cleanliness
  • Changes in mental status
  • Caregivers that do not want patient to be left alone with others

Not all patients with these symptoms have been subject to nursing home abuse, but any sign should be cause for further investigation.

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