Federal law provides that all residents in nursing homes are entitled to receive quality care and live in an environment that improves or maintains the quality of their physical and mental health. This entitlement includes freedom from neglect and abuse. But what is the difference between “abuse” and “neglect?”

Neglect is the failure to care for a person in a manner, which would avoid harm and pain, or the
failure to react to a situation which may be harmful. Neglect may or may not be intentional and includes:
§ Incorrect body positioning — which leads to limb contractures and skin breakdown;
§ Lack of toileting or changing of disposable briefs – which causes incontinence and results in residents sitting in urine and feces, increased falls and agitation, indignity and skin breakdown;
§ Lack of assistance eating and drinking — which leads to malnutrition and dehydration;
§ Lack of assistance with walking – which leads to lack of mobility;
§ Lack of bathing – which leads to indignity, and poor hygiene;
§ Poor hand washing techniques — which leads to infection;
§ Lack of assistance with participating in activities of interest – which leads to withdrawal and isolation.
§ Ignoring call bells or cries for help.

Abuse means causing intentional pain or harm. This includes physical, mental, verbal, psychological, and sexual abuse, corporal punishment, unreasonable seclusion, and intimidation. Examples include:
§ Physical abuse from a staff member or an intruder or visitor from outside the facility — including hitting, pinching, shoving, force-feeding, scratching, slapping, and spitting;
§ Psychological or emotional abuse — including berating, ignoring, ridiculing, or cursing a resident, threats of punishment or deprivation;
§ Sexual abuse – including improper touching or coercion to perform sexual acts;
§ Substandard care which often results in one or more of the following conditions — immobilization, incontinence, dehydration, pressure sores, and depression;
§ Rough handling during care giving, medicine administration, or moving a resident.

My take: An elderly person should never be subjected to abuse or neglect. Report all acts of abuse and neglect to local police, representatives of the Department of Social Services, as well as the agency in your state responsible for the oversight of nursing homes.

Dan Frith
Dan Frith

Dan Frith has over 25 years of experience representing individuals and families in cases of medical malpractice throughout Virginia. He has been named "Best Medical Malpractice Attorney" by Roanoker Magazine and is a member of the Million Dollar Advocates Forum. To speak with Dan, contact him by email at