Common Types of Abuse and Neglect in Nursing Homes

Use these links to jump to different sections:

• Who Is Most Likely To Be Abused in a Nursing Home? 
• Types of Nursing Home Abuse 
• What Are the Steps in Reporting Abuse? 
• Questions for a Nursing Home Abuse Attorney 

An individual may be placed in a nursing home facility when: 

• They become unable to care for themselves properly 
• Their family members can’t provide the care they need 

From medical care and community life to assisting with daily activities, nursing homes provide valuable services and can promote the well-being of older persons in many ways. 

However, nursing home residents are also a vulnerable population and can become victims of abuse.  

The federal Nursing Home Reform Act of 1987 and state laws protect nursing home residents from abuse and neglect. Despite legal protections, abuse cases involving older adults occur every year. 

There are different forms of abuse in long-term care facilities. According to the National Center on Elder Abuse (NCEA), psychological and physical abuse are the most reported types of abuse. 

If you have a loved one who lives in an assisted living facility, it’s important to be aware of warning signs of mistreatment and to take legal action when necessary.  

This article will explain the most common types of elder abuse and neglect in nursing homes and when to report mistreatment. 

Who Is Most Likely To Be Abused in a Nursing Home? 

Many factors make nursing home residents more vulnerable to abuse.  

“Anytime you have a portion of the population at a nursing home that either requires a very high level of care or has a very high acuity level because of immobility or the inability to get out of their bed, feed themselves, or drink from a glass of water on their own—those people are always very vulnerable because they require a lot of hands-on assistance,” says Indiana personal injury attorney Ashley N. Hadler.  

Additionally, “populations that suffer from any type of memory loss or other cognitive problem that would call into question their ability to recall or report events” are also highly vulnerable. 

Some risk factors are characteristics of the resident. Other factors are features of the nursing home facility and management: 

• Having a physical disability 
• Having a cognitive impairment  
• Alzheimer’s and dementia 
• Understaffing 
• Lack of caretaker training and supervision 

Nursing home abuse can be perpetrated by nursing home staff members, such as nurses and other caregivers, or by other residents. 

Types of Nursing Home Abuse 

In Hadler’s practice, “the most prevalent type of injury would be something associated with falls or development and deterioration of bedsores,” she says.  

“Malnutrition and dehydration are, unfortunately, things we see becoming very common. The reason for that, we believe, is because of staffing shortages that predated the Covid-19 pandemic and now, since the pandemic, have been exacerbated by difficulties finding staff or, sometimes, decisions at the corporate level to understaff facilities or not pay a reasonable rate to keep and hire new employees to staff the nursing home.” 

The most common types of abuse in nursing homes include: 

• Physical abuse 
• Psychological or emotional abuse 
• Sexual abuse 
• Financial abuse 
• Neglect and abandonment 

Let’s look at these forms of abuse in more detail and signs to look for if such abuse is occurring. 

Physical Abuse 

Physical elder abuse is when someone uses physical force against an older person, resulting in physical harm or personal injury.  

Physical abuse includes actions such as hitting, shoving, and kicking as well as retraining or locking someone up against their will. 

Physical abuse can lead to serious injuries, including broken bones, bleeding, burns, and sprains.  

The following behaviors could be signs physical abuse is happening: 

• Reoccurring injuries 
• Frequent hospitalizations 
• Delayed reporting of injuries or no reporting at all  
• Vague explanations for what happened or none at all 

Psychological or Emotional Abuse 

According to the National Center on Elder Abuse (NCEA), psychological abuse is the most commonly reported type of abuse in nursing homes.  

Psychological abuse is when someone intentionally says or does something to cause another person distress, fear, or anguish.  

Many behaviors can be involved in psychological or emotional abuse: 

• Isolating residents from other residents, family members, or staff 
• Threatening or taunting residents 
• Punishing residents by taking away social interaction or personal belongings 
• Screaming at residents 
• Insulting residents 

Psychological abuse can result in physical harm and deteriorate the resident’s mental health and well-being.  

If you begin to notice a change in the resident’s mood, if they become  

Sexual Abuse  

Sexual abuse is a general term that may involve any unwanted sexual contact or action against someone else, and can include:  

• Sexual assault 
• Groping 
• Fondling 
• Rape 

Signs of sexual abuse can include: 

• Bruising, bleeding, or other injuries around the genitals  
• Stains and tears in underwear or other clothing 
• Sexually transmitted diseases  
• Difficulty walking or moving 
• Distress and anxiety 

Financial Abuse  

Financial exploitation occurs when an elder’s assets are illegally or improperly used. 

Assets may include: 

• Money and bank accounts 
• Personal property 

Financial abuse not only covers obvious wrongdoing like theft of an elder’s money or property. It also includes:  

• Illegally accessing an elder’s bank accounts or funds  
• Forcing the elder to give money account access 
• Coercing an elder into changing their will or other estate plan documents 

If you notice:  

• Money or other property has gone missing 
• There are strange withdrawals from checking or savings accounts 
• Unaccounted purchases or transactions on credit or debit cards 

Consider investigating whether some form of financial exploitation is taking place. 

Neglect and Abandonment 

Neglect is a type of abuse that occurs when a caregiver fails to give adequate care.  

Types of nursing home neglect include: 

• Not giving residents their medication 
• Giving residents the wrong medication 
• Not giving residents needed physical therapy or stimulation 
• Not giving residents enough food or drink 
• Not cleaning residents who need assistance with personal hygiene 
• malnutrition, weight loss, and other health problems 

Signs of neglect include: 

• Muscle atrophy 
• Bedsores 
• Drastic weight loss 
• Dehydration 
• Poor hygiene  
• Poor dental health 

Abandonment is a type of neglect that occurs when the person responsible for giving care leaves the elder and doesn’t arrange for others to care for the elder.  

Abandonment leaves the elder without any assistance and can result in severe harm or death if abandonment persists. 

What Are the Steps in Reporting Abuse? 

If you suspect a loved one or someone you know is the victim of nursing home abuse, don’t hesitate to take action to stop the abuse.  

You can contact law enforcement if you’re aware of an immediate danger to a nursing home resident. 

You can also contact your state’s adult protective services or long-term care ombudsman program to report abuse and get an investigation. 

In some situations, you may want to pursue compensation for injuries and harm caused by nursing home abuse.  

In this case, contact a nursing home abuse attorney in your area about filing a civil lawsuit against the responsible parties. Depending on the facts of your situation, you may be able to bring several legal claims against a nursing home. 

An experienced nursing home abuse attorney will know the law and be able to talk you through your options for taking legal action. They will also be able to formulate the best legal strategy for your case and guide you through the litigation process. 

When it comes to any legal action, the “[importance of getting] an attorney involved who can communicate with the facility, gather all of the necessary information, help to evaluate the claim, and ultimately pursue the claim to recover that compensation,” says Hadler.  

Questions for a Nursing Home Abuse Attorney 

If you or a family member is a resident of a nursing home and you suspect there has been some form of abuse, consider speaking with a nursing home abuse lawyer. 

Many lawyers provide free consultations for potential clients. These meetings let you get legal advice and decide if the attorney or law firm meets your needs. 

To get the most out of a consultation, ask informed questions such as: 

• What are your attorney’s fees and billing options? 
• Who is responsible for nursing home abuse? 
• What legal action is available? 
• What is the process of reporting nursing home abuse? 
• Is a settlement possible? 

Once you have met with a lawyer and gotten your questions answered, you can begin an attorney-client relationship. 

Look for a nursing home attorney in the Super Lawyers directory for legal help as a nursing home resident.