Elder Abuse is defined as “a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person.” This definition has been adopted by the World Health Organization and can be found at elderabuse.org.uk.

At the heart of this definition is the “expectation of trust” which can only happen where there is some sort of relationship between the abuser and the victim. This could be a familial relationship, or the in case of nursing home abuse, a relationship between a resident of the nursing home and his/her caretakers.

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The Five Kinds of Elder Abuse

There are five common types of elder abuse that can occur in a nursing home environment. Included in this list is nursing home neglect, which was discussed in-depth here.

Physical. Physical abuse can include inflicting any type of physical injury on an elderly person, including hitting, kicking, slapping, burning, choking, restraining, false imprisonment or confinement, pushing, giving improper or excessive medication or withholding medication or treatment.
Psychological/Emotional. Emotional abuse can occur when a caregiver humiliates a nursing home resident. This can occur by yelling, mocking, making fun of, name calling, criticizing, accusing or blaming. It can also occur when a caregiver refuses to acknowledge a resident, ignores them, withdraws their affection, or otherwise gives them the “silent treatment”. This frequently occurs when a caregiver identifies something of importance to a nursing home resident, and uses that knowledge to coerce certain behavior from the resident.
Financial Abuse. This is more common than you would imagine and frequently occurs with family members or at-home caregivers. It usually involves exploiting or misappropriating the financial resources of the resident as a way of controlling the nursing home resident or for the caregivers own personal gain. This can frequently occur without the knowledge of the resident.
Sexual Abuse. This can occur when a nursing home resident is forced to take part in any type of sexual activity without their consent. This could include anything from taking part in sexual conversations to engaging in sexual acts against their will, or where they are no longer able to give consent (such as in cases of dementia or where they are physically unable to resist).
Neglect. Nursing home neglect occurs where a resident is deprived of the care and treatment they require, including assistance with personal hygiene, feeding, providing proper clothing, or even insuring that the patient is moved frequently enough. Neglect can be intentional or passive. Passive neglect frequently occurs where there is a lack of education, training, or staffing at the nursing home.

What are the Warning Signs of Elder Abuse?

In order to prevent elder abuse from happening, it is important that family members and other nursing home staff pay attention to the resident and look for warning signs which are common in these types of situations.

Physical Abuse. Physical abuse may be the easiest to detect and notice, as the warning signs are frequently visible and include bruising, scars, sprains, broken bones, etc. Signs can also include bruising from wrist restraints, and broken glasses or jewelry. However, it is also common for the abuser to leave a bruise or mark in an unexposed area of the body, such as an abdomen, thigh, or bicep.
Emotional Abuse. This is a frequently under-reported type of abuse and difficult to spot unless you are a witness to the abuse. Many older residents have difficulty communicating and conveying that anything is wrong. However, emotional abuse can often be detected by changes in behavior or personality. If you suspect a loved one is being mistreated or emotionally abused, you should consult with a lawyer about the best way to investigate any possible abuse in your jurisdiction.
Financial Exploitation. Exploiting the financial resources of an elderly patient can be difficult to spot, as it is frequently the person entrusted as power of attorney who is abusing that authority. Spotting this type of abuse requires paying close attention to the behaviors and actions of those who have access to the financial accounts of the nursing home resident.
Sexual Abuse. This is very similar to physical abuse and can be detected by certain visible signs on the body of the victim, including in the area of the breasts or genitals. Sexual abuse can also be shown by inexplicable infections, bleeding, incontinence, or torn clothing.

How Elder Abuse is Different than Neglect

Both elder abuse and elder neglect are terrible offenses in their own right. But elder abuse carries with it the added element that the actual act of abuse, or the failure to act, is intentional on the part of the caregiver. The fact that this person is or was someone with whom the victim placed their trust in makes the abuse that much more troubling.

As a result, when the abuse is intentional and brought on by a trusted caregiver, it can be that much harder to identify the abuse and do anything about it. The elderly victim may be much more reluctant to come forward about the abuse, or they may be completely incapable of discussing it as a result of their own dementia or inability to verbalize what is happening to them.

How to Identify Physical Abuse

Because your loved one may be unwilling or unable to talk to you about the abuse, either because they can’t or they are afraid of possible retaliation on the part of the abuser, you must be somewhat proactive in gathering information about what is going on.

The best and easiest way to learn more about what is happening is to simply talk to your loved one. Ask them about how they are doing and whether they feel safe. Here are some questions you can ask them:

How is the staff treating you here?
Do you feel safe when I’m not around?
Are you getting enough to eat?
Are you receiving your medication on time?
Who else do you get to see and talk to during the day?
What activities do you do when we aren’t around?
Has anyone ever hurt you while you are here?
Are you scared of any of the nursing home staff?

If you feel like your loved one is in an unsafe environment, or that they are being abuse, you need to bring it to the attention of the nursing home administrator so that they can investigate. If necessary, you could even call the local authorities and tell them what you know and what you think is happening.

If your suspicions of physical abuse are confirmed, then your loved one may need to be moved, and the persons responsible for the abuse should be investigated and kept away from your loved one and any other residents they may have abused.

How to Prevent Elder Abuse

The best way to prevent elder abuse is to pay close attention to your loved one and the way they are treated at the nursing facility. Always be aware of who is treating them and whether the resident has exhibited any significant changes in diet, behavior or emotions.

Nobody that enters a nursing facility should ever have to worry about nursing home abuse. I personally worked at a nursing facility for several years while I was in college and the staff that I came into contact with were loving and caring of all the residents.

But that doesn’t mean there are a few bad eggs out there. People who slip through the cracks and are lazy, mean, or shouldn’t be caring for the elderly in the first place.

When it comes to preventing nursing home abuse, the best defense is a strong offense. You or an advocate that you hire should be visiting with the nursing home resident on a regular basis to check in and see how they are doing. If you stop regularly visiting your loved one, or paying attention to how they are acting or the treatment they are receiving, then they are more likely to become a victim of abuse.

Finally, let’s not forget that even though our loved ones in nursing homes may not always be able to communicate with us, they are still aware of what is happening around them. They are still human beings with feelings and thoughts. So it goes without saying that you should always treat them with the dignity and respect that they deserve.

How to Report Elder Abuse

Nobody wants to discover that their friend, parent, spouse or sibling has become the victim of abuse in the place in which you have entrusted your loved one’s care.

When you first learn of possible abuse against your family member or friend, you must first speak with the nursing home administration. We don’t recommend going to anyone that is directly involved in the resident’s day-to-day care because you may not be aware of who specifically is mistreating the elderly person. Unless you have definitive and concrete proof that there is one specific individual responsible for the abuse, you must be careful not to report it to anyone that you haven’t eliminated as a suspect.

Upon reporting the abuse to the administration, you may demand that the resident be transferred to a new bed or area of the facility where they will be treated by different staff. If this is not possible, then you should determine what the standard protocol is for handling abuse cases and follow-up to make sure it is followed.

Next you should call the police as described above. Make no mistake about it, elderly abuse is a crime and those responsible should be prosecuted. Your loved one is the victim of this crime.

Depending on whether the abuse is isolated to one particular individual or is more systemic in nature (such as in cases where the nursing facility is understaffed or lacks proper training), you may want to research the possibility of transferring your loved one to a new facility. Sometimes, although not ideal, this is the best way to insure the safety of your loved one.

You may want to consider reporting the nursing facility to the North Carolina Division of Health Service Regulation. Contact information for this agency can be found in this link or you may call 1-800-624-3004.

Finally, if you want to hold the nursing home accountable for their actions (or failure to act), then it is important to contact a nursing home and elder law abuse lawyer to further investigate the facility.

For more information about nursing home neglect, click here.

If you suspect that your loved one is a victim of elder abuse and you have a question for us about what to do, you can submit it confidentially online by clicking here. You can also call the elder abuse lawyers at The Hart Law Firm at (919) 887-8582. We are happy to speak to you and answered any detailed questions you may have.

What is Nursing Home Elder Abuse?