Nursing Home Abuse: How to Spot It

As America’s citizens grow older, concerns over nursing home abuse are on the rise. Infirm and frail seniors are more vulnerable to bullying, mistreatment, and even exploitation. It’s tough at times, however, to know the difference between abuse and normal challenges surrounding the care of older citizens with mental or physical conditions.

What is Nursing Home Abuse?

Federal nursing home regulations define nursing home abuse as the occurrence of any of the following incidents that result in physical harm, pain, or mental anguish:

  • Infliction of injury
  • Unreasonable confinement or restraint
  • Intimidation
  • Deprivation of care or service
  • Punishment

The above events can be caused directly by a caregiver or other patient, or indirectly by management failing to provide the goods and services needed to avoid physical harm, pain or mental anguish.

Initially, the signs of nursing home abuse may appear to be symptoms of dementia or evidence of the senior’s frailty. It is true that the signs of nursing home abuse do mirror symptoms of mental decline. However, that is only more reason to be alert and protect your loved one from any inappropriate action.

There are a number of forms of abuse that could be present in a nursing home. Here are a few of the most common, and things to be on the lookout for if you suspect it may be happening to your loved one.

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Physical or Sexual Abuse

Physical abuse is usually the most evident form of nursing home abuse. Physical abuse can take the form of hitting, pushing or heavy gripping that causes pain, bruising or injury. Sexual abuse, or contact with a senior without their consent, is another form of physical abuse. In addition, unnecessary restraints, confinement to a certain area by removing a wheelchair or walker, and inappropriate use of drugs are considered physical abuse.

Signs of physical abuse you should look for include:

  • Bruising, welts, scars and other unexplained signs of injury
  • Broken bones
  • Over-medication or sedation
  • Signs of restraint on wrists or ankles
  • Vaginal or anal bleeding
  • Torn or stained underclothing
  • Change in weight
  • Dehydration
  • Bedsores
  • Unexplained emotional changes

Emotional Abuse

a victim of nursing home abuse
Emotional abuse occurs when someone speaks to or treats a senior in ways that cause emotional pain or distress. This can include intimidation, yelling, or humiliation. Other forms of emotional abuse include ignoring the elderly person, isolating them from friends and activities, or menacing them.

Signs of emotional abuse are harder to spot than physical abuse. Emotional abuse may be a concern if you see:

  • The senior exhibits fear or alarm around a caregiver
  • Your loved one blames themselves for minor or irrelevant problems
  • The senior exhibits false signs of dementia such as depression, mumbling, or rocking back and forth


Neglect is the failure to care for a senior properly. Neglect can stem from incompetent caregivers, lack of resources or denial as to the level of care the elderly person needs. If neglect results in serious injury or potential harm, it is abuse. The abuse caused by neglect makes up a large percentage of nursing home abuse that is reported.

If you suspect nursing home abuse caused by neglect, look for the following signs:

  • Weight loss, signs of malnutrition, or dehydration
  • Bedsores
  • Unsanitary living conditions such as soiled bedding or closing, dirt, or bugs
  • Inappropriate clothing for the season

Financial Abuse

Financial abuse is the unlawful use of an elderly person’s funds or property. A dishonest caregiver or employee might steal checks or money from the senior, commit identity theft or steal other personal property. In addition, financial abuse can occur through health care fraud or abuse, including billing for services not given to the patient, over-billing or double billing and insurance fraud.

The senior’s family should stay very involved in their finances and be on the lookout for any of the following signs that might indicate financial abuse:

  • Frequent unexplained withdrawals from bank accounts
  • Recurring reports by the senior of lost property
  • Duplicate billings or other discrepancies in the medical bills
  • Evident problems with the care facility, including poorly trained or inadequate staff, resident crowding, and management ignoring your questions about care

What to Do if You Suspect Nursing Home Abuse

If you observe repeated signs of nursing home abuse and suspect a senior is the victim of abuse, take action on their behalf. Taking a wait and see attitude is not appropriate if the elderly person is likely suffering. They have the right to be protected. Notify the authorities if you suspect an immediate danger to any of the nursing home residents. Consult with a lawyer who specializes in elder law to see if your suspicions are founded. They have the experience to advise whether you have a case against the facility and what further action is recommended.

The information contained herein is intended for informational purposes only and should not be construed as legal advice. Seek competent legal counsel for advice on any legal matter.

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