Five Common Types of Nursing Home Abuse: Warning Signs and Legal Action

From medical care and community life to assistance with daily activities, long-term care facilities provide valuable services and can promote the well-being of older adults in many ways. 

However, nursing home residents are also a highly vulnerable population. Despite legal protections under the federal Nursing Home Reform Act of 1987 and state laws, many abuse cases involving nursing home residents occur every year.

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, says Ashley N. Hadler, a personal injury and nursing home abuse attorney at Garau Germano law firm in Indianapolis.

“Any portion of a nursing home population that requires a lot of hands-on assistance will be more vulnerable,” says Hadler. That includes individuals who:

• Require a very high level of care;
• Have a very high acuity level because of immobility;
• Are unable to get out of their bed, feed themselves, or drink from a glass of water on their own; or
• Suffer from any type of memory loss or other cognitive problem that would call into question their ability to recall or report events.

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

Five Types of Nursing Home Abuse: Spotting the Warning Signs 

Hadler says that in her practice, “the most prevalent type of injury would be something associated with falls or development and deterioration of bedsores.”

She adds that “malnutrition and dehydration are also, 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, since the pandemic, have been exacerbated by difficulties in 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: 

1. Physical abuse; 
2. Emotional abuse; 
3. Sexual abuse; 
4. Financial abuse; and 
5. Neglect or abandonment. 

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

1. Physical Abuse 

Physical elder abuse occurs when someone uses physical force against an older person, resulting in physical harm or personal injury.  Physical abuse includes actions such as hitting, shoving, or 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 that physical abuse is happening: 

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

2. 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.  

Psychological abuse can result in physical harm and deteriorate the resident’s mental health and well-being. Many behaviors can be involved in psychological or emotional abuse: 

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

You may notice sudden mood swings, depression, or heightened fear and anxiety if emotional abuse is occurring.

3. Sexual Abuse  

Sexual abuse is a general term that may involve any unwanted sexual contact or action against someone else, including sexual assault or rape, groping, or fondling. 

Signs of sexual abuse include:  

• Bruising, bleeding, or other injuries around the genitals;  
• Stains and tears in underwear or other clothing; 
• Testing positive for sexually transmitted diseases;  
• Difficulty walking or moving; or
• Distress and anxiety. 

4. Financial Abuse  

Financial exploitation occurs when an elder’s assets are illegally or improperly used. Assets may include money and bank accounts or items of 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; or 
• Coercing an elder into changing their will or other estate plan documents. 

Consider investigating whether some form of financial exploitation is taking place if you notice that:  

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

5. 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; 

Signs of neglect include: 

• Bedsores; 
• Muscle atrophy; 
• Drastic weight loss; 
• Dehydration; 
• Poor hygiene;  
• Deteriorating dental health; 
• Malnutrition-related health problems. 

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 that 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, Hadler emphasizes 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.” 

Find an Experienced 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 about your legal and reporting options. Many lawyers provide free consultations for potential clients and work on a contingency fee basis, meaning there are no upfront legal costs to get legal advice.

To begin your search, visit the Super Lawyers directory to locate an experienced nursing home attorney in your area. For more information about this area of law, see our overview of nursing home law and related content.