Recognizing Nursing Home Abuse and Neglect

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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.

What Constitutes Neglect and Abuse?

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. For example, a caring aide who is poorly trained may not know how to provide proper care. Examples include:

  • 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: Abuse means causing intentional pain or harm. This includes physical, mental, verbal, psychological, and sexual abuse, and intimidation. Examples include:

  • Physical abuse from a staff member, another resident, 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.

    Reporting Neglect and Abuse

It is a violation of State and Federal law for any person, including facility staff, volunteers, visitors, family members or guardians, or another resident, to neglect or abuse a resident.

  • Anyone can and should report neglect and abuse. If you suspect neglect or abuse, or if a resident tells you they are experiencing this problem, it is important to believe the resident and REPORT THE ALLEGATION IMMEDIATELY. This will help prevent further suffering by any resident.
  • Many states have laws that require the reporting of abuse and neglect. Find out what your state requires.
  • Put your report in writing, date it, and keep a copy. Convey as much information as you can about the situation. Remember to include:
    • WHO The name of the victim, including age and address; the name of the facility and the people responsible for the victim’s care; the identity of the person who you believe abused or neglected the resident;
    • WHAT The nature and extent of harm and any physical signs of abuse or neglect; any previous incidents; what happened;
    • WHERE and WHEN the place where the incident happened and time and date of the incident.

Make Your Report To:

  • The nursing home’s administrator, director of nursing, and social worker
  • The state or local Ombudsman
  • The local police or State law enforcement
  • Adult Protective Services agency – which is part of the Department of Social Services
  • The state survey agency that licenses and certifies nursing homes (often in the Health Department)
  • A citizen advocacy group or other church or community group that visits regularly.
  • Keep trying until you get the assistance you need.

After The Report:

  • Follow up with the resident and facility to make sure the neglect or abuse has stopped.
  • Follow up with the person or agency conducting the investigation. Ask for written copies of investigative reports.
  • If the perpetrator is charged with abuse or neglect, the charge will be referred to the state licensing authority. If the guilty person is a nurse aide, the charge will be reported to the state nurse aide registry. This registry is used by nursing homes to prevent abusive aides from working with the elderly. Nursing homes are required to check the registry before hiring a person.
  • If all the safety options fail, you may have to contact the local media, the U.S. Justice Department, or seek private legal assistance.
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