Abuse in Nursing Homes
Nursing homes are profit-driven businesses and during tough economic times good business practice and quality control can suffer in favor of short-sighted profits, quotas, and corner cutting. Businesses in trouble do not generally announce this, rather, they simply cover their tracks as best as they can. Cutbacks in hours and wages have a great impact on employee attitudes, which can easily translate to mistreatment, neglect, and even abuse in nursing homes.
The elderly are the most vulnerable and the least likely to complain, so unfortunately they are often the targets. Our responsibility does not end once we have found a suitable nursing home and helped our loved ones relocate as comfortably as possible. They are now in the hands of strangers, so we must still keep a vigilant eye and maintain a constant lookout for anything that looks askew.
A recent investigation concluded that employment checks do not always provide adequate protection against elder mistreatment. For instance, the Centers for Medicare and Medicaid Services prohibit nursing homes from hiring persons with a prior history of committing abuse in a nursing home setting, but those who have been convicted of other forms of abuse like child abuse may still be hired.
Some states require a criminal background check, while others do not. Even so, these checks usually do not uncover convictions in another state. Furthermore, in some states, non-caregiving staff such as maintenance workers and others without a direct patient care role do not undergo criminal checks even though they may have direct access to patients and patient areas
While the incidence of sexual abuse appears to be low, it is more likely to occur in a nursing home than in a community setting. A small survey of sexual abuse incidents among the elderly revealed that 40 out of 42 cases occurred in nursing home facilities. Sexual abuse made up 4.6% of all cases of nursing home abuse and 5.6% of other long-term care facility abuse in 2001. A case series of 20 cases revealed that 75% of the abused persons were non-ambulatory and all suffered from cognitive and neurological disorders. Perpetrators are usually gerophiles who seek out elderly victims or are male residents of the facility. The sexual aggressor may also be a patient’s own family member.
Recognize the Warning Flags - Know What to Look For
Look for signs of physical nursing home abuse and neglect. Physical abuse can range from relatively mild to very extreme and can include assault, battery, and rape. Physical restraint, either by mechanical means or via the administration of drugs not authorized by a doctor, is abuse.
✓ bandages, bruising or bleeding
✓ open wounds, bed sores or cuts
✓ ligature marks around throat, mouth, wrists or ankles
✓ burns and abrasions
✓ sudden changes in weight
✓ soiling, poor hygiene, urine and feces odor
✓ additional or more serious infections
✓ hair loss
✓ torn, stained, or bloody clothing or bedding
✓ overall cleanliness of living quarters, and cleaning materials not put away
Emotional abuse is more difficult to spot, but this can be even more devastating. This includes: insults, humiliation, threats, and frightening the patient. Neglect can consist of withholding nourishment, water, medication, provision of personal hygiene, clean linen and preparing the bed daily.
✓ look for listlessness or unresponsiveness
✓ infantile or other strange behaviors
✓ physical or emotional withdrawal
✓ disappearance of personal items
✓ sudden and unusual financial transactions
✓ depression, or an unwillingness to open up and talk
If you notice any signs of abuse or neglect you need to alert authorities immediately. You are also urged to contact a nursing home abuse lawyer to discuss your legal options.
Confronting Elder Mistreatment in Long-Term Care
Nursing Homes: More Can Be Done to Protect Residents from Abuse. U.S. General Accounting Office (GAO-02-312), Washington, DC, March 2002
Teaster PB, Roberto KA, Duke J, et al. Sexual abuse of older adults: Preliminary findings of case in Virginia. J of Elder Abuse and Neglect 2000; 12:1-6
FY 2001 Long-Term Care Ombudsman Report. Washington, DC; Administration on Aging, Department of Health and Human Services 2003. Available at: http://www.aoa.gov/lycombudsman.org Accessed on February 19, 2004
Burgess AW, Dowdell EB, Prentky RA. Sexual abuse of nursing home residents. J Psychosoc Nurs Ment Health Serv 2000; 38(8):26-35.