There comes a time when a family is faced with the decision to admit an elderly parent, grandparent, or loved one into a nursing home or other long-term care facility. No one ever wants that, but sometimes it is necessary and unavoidable. When an elderly loved one needs medical care or has daily needs that a family member cannot provide, a nursing home is often the only option. Approximately 1.5 million American families have had to make this choice.
Sadly, many residents of nursing homes are subject to abuse and neglect. If your loved one resides in a nursing home or long-term care facility, it is important that you know how prevalent nursing home abuse and neglect are and what signs you should look for if you suspect your loved one is being abused or neglected. You can prevent the abuse or neglect of your loved one by knowing what to look for and what to do if you suspect it. If your loved one has suffered any harm as a result of abuse or neglect by a staff member at a nursing home, they may be able to sue the nursing home and any of its employees for the harm they caused.
How Many People Reside in Nursing Homes or Other Long-Term Care Facilities?
Caring for the elderly is a growing concern. Every year, more and more elderly Americans rely on some sort of residential care facility. According to 2020 insurance industry data:
- There are roughly 15,600 nursing homes operating in the United States;
- There are approximately 330 nursing homes in Kansas;
- There are approximately 520 nursing homes in Missouri;
- According to a Centers for Medicare & Medicaid Services (CMS) quality rating poll, Missouri nursing homes rank as the 8th worst in the nation in terms of resident satisfaction;
- There are about 4,300 facilities that provide hospice care;
- There are 28,900 residential care communities;
- Approximately 3.2 million Americans live in a nursing home or other long-term care facility;
- Approximately 70% of nursing home residents are women;
- About 72% of those women are widowed or unmarried;
- Half of all nursing home residents are at least 85 years old;
- Nearly 8% of residents are age 95 or older;
- It is projected that, by 2030, 75% of all Americans who are 65 years of age and older will rely on nursing home care;
- The average stay in a nursing home is 835 days;
- Approximately 10% of older adults residing in a nursing home will stay longer than 5 years;
- About 53% of people admitted to nursing homes die within 6 months of admission;
- Approximately 65% of nursing home residents die within 1 year of admission.
There are many reasons why it may be necessary to choose a nursing home for a loved one. Here are some of the most common reasons why people move into a nursing home:
- They require more care. Approximately 78% of assisted living residents leave the facility because they require more care. Living in a nursing home has been especially difficult during the Covid-19 pandemic. In 2020, more than 107,000 nursing home residents and 1,340 nursing home staff died from Covid-19. This means that 40% of all Covid-19 deaths in the United States occurred in nursing homes.
- Elderly persons living alone are no longer able to care of themselves. As a person gets older, the body gets weaker and they become less mobile. Elderly persons who once were capable of caring for themselves eventually become unable to perform necessary activities of daily living (ADLs). These include:
- Functional mobility
- Personal hygiene
- The family care provider cannot meet their needs. If you are reading this article, then the family care provider for your loved one has probably been you! And you probably know that caring for an elderly person who needs special medical care or constant monitoring is difficult and draining. There comes a point at which continuing to care for an elderly loved at home is not beneficial for them and may not be healthy or even possible for you. Your loved one may require special care and attention that you simply cannot provide.
- Relatives and caretakers live far away. When a person reaches the stage in their life when they are not able to care for themselves and require more intensive care, and their family and friends live far away, there may be no alternative than to opt for nursing home care. Approximately 14% of people who live in an assisted living facility will leave to be closer to family members. Most people can only afford to visit their family members in nursing homes about 6 times per month.
In-home care is unaffordable or impractical. Although nursing home costs are high (around $7,700 per month) and many nursing home residents would rather live in their own homes, many nursing home residents with special medical needs cannot afford the even higher costs of in-home care.
What is Nursing Home Abuse and Neglect?
Despite the purpose of licensed nursing facilities to care for its residents, nursing homes are a common place for abuse and neglect of the elderly. Elder abuse and neglect can take many forms. For example:
- Physical Abuse. Although there are nursing care providers who tend to their residents with compassion and integrity, some nursing home residents will physically abuse or mistreat a helpless resident. Physical abuse can occur by a staff member intentionally hitting, slapping, or kicking a resident or by being aggressive when handling or moving a patient. Staff often physically abuse residents with dementia or other mental disabilities to retaliate for aggressive behavior.
- Sexual abuse. A staff member may have nonconsensual sexual intercourse with a resident or may grope or fondle a resident when attending to them. The staff member may threaten or intimidate the resident, who may be unable or unwilling to tell someone what is happening. Physical and sexual abuse also may be perpetrated by other residents.
- Mental or psychological abuse. Staff members may insult or make fun of residents as a way of expressing frustration with the resident or simply ignore a resident as a form of emotional abuse.
- Financial abuse. It is not uncommon for staff members to steal property from a resident’s room. A staff member also might manipulate a resident into providing for them financially or giving access to their financial information or accounts. Financial abuse also may occur by overcharging residents for necessary items they require.
- Neglect. Staff members may not physically abuse a resident but may, instead, neglect a resident’s specific needs, such as:
- Medical (providing essential medical care; administering medicine; applying bandages; monitoring electronic devices or medical equipment)
- Physical (providing adequate food and water, failure of which can result in serious malnutrition and dehydration; moving an immobile resident, failure of which can result in bed sores)
- Social (including a resident in events, trips, or activities with other residents)
- Psychological (avoiding isolation; interacting with others, touching others, visiting or communicating with family members; being treated with respect and concern; responding to requests or pleas for help)
- Personal hygiene (bathing; changing dirty or soiled clothes or bed linens regularly; grooming).
How Common Is Nursing Home Abuse and Neglect?
Nursing homes are a common place for abuse and neglect of the elderly. Any form of neglect may be performed intentionally or negligently. The National Center on Elder Abuse (NCEA) reports that approximately 95% of nursing home residents have been neglected or witnessed neglect of another resident. According to a 2020 World Health Organization (WHO) study, 12% of nursing home staff members have self-reported that they have neglected the needs of their nursing home residents. However, far too many cases of abuse and neglect go unreported.
What Are the Signs of Nursing Home Abuse and Neglect?
More often than not, a nursing home resident who is abused or neglected must rely on family, friends, and loved ones to identify and report their condition. Here are some warning signals that may indicate possible abuse or neglect of your loved one in a nursing home.
- Unexplained injuries, broken bones, cuts, scrapes, or bruises
- Immobility, not leaving the room or changing positions in bed
- Bed sores
- Expressions of fear or withdrawal in the presence of individual staff members
- Dramatic weight loss
- Poor hygiene
- Malodorous or unsanitary conditions
Some red flags indicating dehydration or malnourishment in a loved one could include:
- Disoriented Behavior
- Extreme irritability
- Changes in urine output or color
- Severely dry skin or mouth
- Hair loss
- Excessive fatigue
- Sunken cheeks
All of these symptoms and signals can lead to serious health conditions or even death.
What Factors Contribute to the Cause of Nursing Home Abuse and Neglect?
Just as the various forms of abuse and neglect in nursing homes are common, so too are the reasons why staff members may abuse or neglect a resident. Here are the most common reasons for nursing home abuse and neglect:
- Insufficient staff. Nursing home administrators, doctors, nurses, and staff often are overworked with extended hours and must perform in a stressful environment. Approximately 20% of all nursing homes are understaffed. This can lead to stress, fatigue, frustration, and an inability or unwillingness to provide the proper standard of care to all residents. Many staff who self-report committing abuse state that they were emotionally exhausted.
- Negligent hiring. Because of severe understaffing, nursing home administrators may ignore or overlook their duty to effectively screen potential employees, run proper criminal background checks, and confirm required licenses and certifications before hiring.
- Improper training and supervision. Time restraints and understaffing often leads to a lack of proper training for nursing home employees. This results in inadequate care and mistakes.
A recent article published in the European Journal of Public Health reported on the most common risk factors for elder abuse and neglect in European and American nursing homes. The report indicated that the main risk factors for nursing home abuse and neglect are:
- Being female
- In the study, women comprised 77.3% of the victims who reported physical, psychological, and financial abuse.
- Having a cognitive impairment or disability
- As much as 18.5% of the residents who were abused by staff had some form of dementia.
- Being older than 74 years of age
- The study revealed a close association between elder abuse and the victim’s degree of dependency, specifically requiring assistance with ADLs. This dependency increases with age and declining health.
Can a Nursing Home or its Staff be Liable for Abuse or Neglect?
If you or a loved one has been the victim of nursing home abuse or neglect, you may be able file a claim against the nursing home and any staff member who committed the abuse or neglect.
Every health care provider, including nursing homes, have a duty to provide a proper standard of care to patients and residents. When a nursing home or staff member fails to act with the necessary standard of care and causes harm to the resident, they breach their duty of care, and a cause of action is available. There are a host of federal regulations that require specific standards of care. For example, specific federal regulations require that nursing homes:
- “[E]nsure that the patient is offered sufficient fluid intake to maintain proper hydration and health.”
- Provide residents at least three meals a day that are “palatable, attractive and at a safe and appetizing temperature.”
Failure to abide by these or any other similar standards leave nursing homes open to criminal and civil liability.
What Should I Do if I Suspect My Loved One Has Been a Victim of Nursing Home Abuse or Neglect?
If you have a loved one who resides in a nursing home and suspect that they are being abused or neglected in any way, you should contact local law enforcement if it is an emergency and your loved one is in immediate risk. The trouble, however, is that abuse and neglect is often perpetrated in secret and symptoms and signs may only appear gradually. Sometimes abuse and neglect can be difficult to prove.
If you suspect your loved one is being mistreated, there are several things you should do:
- Document. Document your observations and suspicions. Keep a record of any suspicious treatment. Keep copies of any treatment plans, medical records, medicine administered, and meals. Also document your loved one’s condition over time—how they look, feel, and react.
- Take pictures. Take pictures of any new injuries, bruises, cuts, scrapes, or marks on your loved one’s body.
- Make a report. Depending on the situation, report your suspicions to an appropriate authority. If you suspect a specific employee is committing the abuse or neglect, you might discuss the issue with a supervisor or administrator of the nursing home. If you think the mistreatment is more systemic within the policies and practices of the nursing home, report the situation to law enforcement, a social worker, or your state’s nursing home or long-term care Ombudsman, which is responsible for advocating for the health, safety, welfare, and legal rights of nursing homes residents.
- Retain a nursing home abuse and neglect attorney. Proving nursing home abuse or neglect is difficult. It requires specific evidence that is not always easy to obtain. However, a nursing home abuse and neglect attorney can help and is critical to raising a successful negligence claim.