Nursing Home Abuse

elder abuse

“The elderly in skilled nursing facilities are among the most vulnerable members of our society. They are dependent on the … nursing facility operator for their food, medicine, medical care, dental care, and a bed; a roof over their heads; for assistance with virtually every daily activity.”

National Institutes of Health (NIH)

This article will teach you the following about Nursing Home Abuse;

  • The Warning Signs Of Nursing Home Abuse
  • What To Do About It If You See It
  • How To Report Elder Abuse And Neglect In A Nursing Home – Who To Call First
  • …and much, much more.

Relatives Are “First Responders” When It Comes To Nursing Home Abuse

nursing home family member

To begin with, if you have a family member or loved one who is in a nursing home, you need to be hyper-vigilant when it comes to their care. This is because, though they are not in your care, you are the first line of defense against any abuse or neglect they may suffer in the home. You are the “first responder” for your family members.

What Are Some Of The Warning Signs Of Nursing Home Abuse?

If you are visiting someone in a nursing home, you may notice some tell-tale signs of neglect or abuse that you don’t need to be a doctor or a nurse to figure out.

Some of the signs of nursing home abuse and neglect may be changes in behavior, mood or body language, signs of dehydration and malnutrition, sudden loss of weight, bruising, broken bones, bedsores, bad hygiene, to name a few. Try and pay close attention to anything out of the ordinary.  

Elder Abuse Isn’t Always Physical

In contrast to physical abuse, your loved one may have fallen prey to financial and psychological abuse as well. Financial abuse could be the result of a staff member extracting banking information from your relative or the unauthorized use of a credit card the relative may have had with them when they were admitted to the home. Furthermore, people suffering from dementia are especially susceptible to this kind of abuse, due to their diminished cognitive ability.

nursing home resident

Psychological abuse could take the form of intimidation through threats of violence, yelling, the use of profanity towards the resident and more.. It could be something as simple as ignoring a patient’s basic needs like not taking them to the bathroom, or as devious as the withholding of food or water in order to extort a favor from the resident.

Pay close attention to your intuition, it may be trying to tell you something!  

Above all else, always keep in mind that people who are being abused may be too afraid to say anything, even to a family member. This is because they may fear retaliation. Just remember, after you leave the visit, they have to stay.

Common nursing home injuries include:

  • Bedrail injuries.
  • Bedsores.
  • Broken bones.
  • Concussions.
  • Falls.
  • Infections.
  • Spinal injuries.

What Should You Do If You Suspect Nursing Home Abuse Or Neglect Of A Family Member?

First of all, you can start off by interviewing the family member or resident you are visiting.

nursing home medication

When you are alone with your loved one, ask them how they’re being treated. If they are capable of having a coherent conversation, don’t be afraid to go into detail and ask pointed questions like; Did somebody hurt you? What did they do to you? How often do they; Help you change positions? Give you water? Feed you? Take you to the bathroom? Change your bedding? Change your clothes? Give you your medication?

It’s important to observe body language when you are asking these questions. By doing this, you could observe non-verbal answers to your questions that may otherwise have been overlooked..

Alzheimers Patient In A Nursing Home – Interviewing Someone Suffering From Dementia

nursing home dementia

If your family member or loved one has been diagnosed with Alzheimers Disease by a physician, it will be more difficult to interview them about abuse. People’s first reaction to allegations of abuse by someone with dementia is often disbelief. Predators who prey on the elderly know this all too well!

Do not take any allegations of abuse lightly. Even a person with dementia can be aware they have been abused. The other side of it is, the abuse may have been imagined also. Your job is to find out which is accurate: it happened or it was imagined. There are ways of finding out the truth. If your relative complains of sexual abuse, check their genital area for any unusual bruising. Even if you don’t see any, this does not mean it didn’t happen! If your loved one says somebody slapped them or threatened them, this may be a little more difficult to prove also.

Do your best to find any visible evidence to corroborate complaints of abuse.

When There is No Visual Proof Of The Abuse – Install A Hidden Camera

This can be costly, but in the end, it could save a life. And also, if you intend to bring the nursing home to court at a later date, video evidence is a game-changer. Capturing the abusers in the act, on videotape, is a huge help in any criminal or civil case. People lie- videotape doesn’t!

Hidden Camera Footage

Reassure Your Family Member That You Will Take Measures To Protect Them From Further Abuse

You must always keep in mind that your relative may be fearful to speak out about abuse, especially if the staff has used any sort of intimidation tactics with them in the past. There is always the fear that you will complain about the abuse to the staff, and then after you leave, the abuse will escalate.

You need to reassure your family member or the person you are visiting that you will not just run to the staff and complain, that you will take calculated measures to protect them.   

And of course, if you see something that is in need of immediate attention, you have several options; you can call the staff or call 911, or both. If you feel your loved one needs emergency care, you can call an ambulance to have them taken to the hospital right from the nursing home. Please keep in mind, a nursing home is not a hospital.

Sometimes, if the staff is negligent, or intentionally caused harm to your loved one, they may pretend they didn’t notice the injury.

How Can You Gather Proof Of Elder Abuse In A Nursing Home?

If your family member has indicated to you that abuse is going on, or you see something that just doesn’t look right, or even if you have that gut feeling something is wrong but not life-threatening, take out your phone and discreetly take pictures.

You have to keep in mind, the majority of the staff at a nursing home will not admit to any wrongdoing, so you need to collect the proof yourself.

record with cellphone

If your family member indicates, in any way, that they’ve been abused or neglected, use your cell phone to record your conversation with them. Their statements may be needed later on, and may no longer be obtainable after you leave.

Remember- the most important pieces of evidence you can collect right now are images, videos, and voice recordings. While it is against the law in New York to record people talking in a conversation you are not a party to, it is within the law to record a conversation you are a part of.

In other words, if you want to find out about an injury and you ask a staff member how it happened, you are allowed to tape their answer without their consent or knowledge. Other states may have different laws, but in NYS, this is the law.

Examine, Observe And Record

If your family member complains of sores on their back or legs, you need to discreetly “examine” them. By this I mean wait until you are alone, and ask them to show you what they are talking about. You may need to assist them in rolling over onto their side or stomach and help with partially removing their clothes, so you can get a good look at them.

Whatever it takes, try to take videos and pictures with your phone. For example, bedsores, which are a common occurrence in nursing homes, are often the result of negligence. They can manifest when nursing home staff doesn’t assist your loved one in turning over or changing position, which should happen every two hours or so throughout the day.  If you see any signs of bedsores, you must photograph them!

Pharmaceutical Restraints

nursing home pharmaceutical restraints

Some nursing homes have gotten into legal trouble in the past for using narcotics to “quiet people down”. “Pharmaceutical restraints” or “Chemical Restraints” are terms used to describe this form of abuse.. One case involved staff using the Antipsychotic drug Seroquel to make patients docile, so the staff would have less work to do.. The pharmaceutical company that manufactured Seroquel, AstraZeneca, was fined 68.5 million dollars for off-label marketing of the drug.

Keep Your Emotions In Check

Try and keep in mind that you may hear things that surprise and shock you. You may hear things that you think are made up. Try and keep your wits about you. Your loved one’s safety depends on you keeping a level head. Furthermore, you should keep your emotions in check while you’re in the nursing home because the first and foremost thing you can do if the person is not in immediate danger, is to gather evidence. This will be next to impossible if you are hysterical.

Whatever agency you decide to go to later, or be it a nursing home abuse attorney, the more proof you have to substantiate your claims, the better.

Speak To Other Residents At The Nursing Home

If at all possible, after you are done gathering facts and proof from your loved one, see if you can speak to any of the patients in nearby beds. Remember, you don’t want to get anybody in trouble after you leave, so be discreet. Never ask questions related to abuse or neglect to residents in front of staff members!

Interview Staff Members

After speaking with your relative and any other resident that you can, it’s time to move outwards, to the bigger fish- the ones who may have committed the offenses: the staff.

Wait for an opportune moment when you can speak with the staff member who is caring for your loved one, while they are alone. Covertly set your phone on record and approach them.

Try and keep in mind you are not lodging a complaint or accusing anyone of anything: you’re just a concerned relative offering to help.   

What Types Of Questions Should You Ask?

Well, to begin with, if they don’t already know you, introduce yourself to the staff member as the relative of “so and so”, and thank them for the good care they are taking of your loved one.

Then mention words to the effect, “I see it’s really busy around here. Seems like you could use some more help.”.

This simple statement can elicit a spontaneous remark that could be extremely valuable later on. If the staff says they are understaffed, ask how many more people they should have.

Also, ask what it’s like at night. Are there fewer staff working at night? Is it enough to handle the number of patients you have? How will that affect my mom?

Answers to care-related questions may be extremely important in the future.

And while you may not get answers to all your questions, you may get answers to some, and something is better than nothing!

Your Demeanor And Actions Will Determine Your Success

Always keep in mind, you’re not lodging a complaint, you’re gathering evidence of possible abuse. If you start pointing fingers at people, you’re less likely to get the information you want. The information that can protect your loved one.

And never, under any circumstances, reveal to any staff member that you are taking pictures or recording anything, no matter how sympathetic they may seem. People talk!

If you’re paying attention, you might find another staff member who is doing their job diligently. Try to pull them aside and ask what’s going on. You may get lucky and find someone who is fed up and wants to vent.

It’s also possible that they might make a spontaneous remark about some abuse or neglect they’ve seen. As far as gathering evidence is concerned, a statement like this may be priceless.

There are some good workers in these homes who may be afraid to speak out. Maybe they’ve tried in the past but weren’t listened to, or their jobs were threatened. These people may welcome your heartfelt questions.

And if by chance you manage to get a like-minded staff member to speak with you, try and catch some video of their face. Make sure you get them to say their name on the recording also.

The reason for this is twofold- one, you may not remember it, and two, they may deny ever having spoken with you. Should you need it later, the video will have a huge impact on the person or persons viewing it, and it lends more credibility to your allegations.

Start Off Small And Work Your Way Up

Always try and start out by talking with the lowest ranking staff members who are involved with the care of your relative. This is because if you try asking questions to a supervisor and get shut down, nobody else will speak with you! And guess what? The janitor knows everything! He probably witnesses abuse or neglect, and staff probably confides in him on a regular basis. You see someone sweeping the floor or mopping, give them a big thanks for their work, and buy them coffee…before you think you need them. You never know.  

Next, you may want to ask to speak with the supervisor on duty and ask them what’s going on. If you ask as a concerned relative /caregiver and inquire as to what you can do to help, you may get them to say something about the facility you wouldn’t normally hear from a supervisor.

Ask the supervisor if it’s ok to see your relative’s medical records. In some cases, you may not be entitled to them, but if you have power of attorney or are the spouse, you are entitled to see them. If the supervisor refuses to give them to you, this is a red flag. Don’t acknowledge this in any way though. Just say, “Oh well, I guess that’s the way it’s done. I’m new at this.”. Sometimes being smart means playing stupid.

There’s Another Alternative, If This All Seems Too Much For You

This one may not apply to everyone, but if you have the resources, you may want to hire a private investigator to go in and covertly gather information for you.

If You Observed Abuse In The Nursing Home, What Should You Do After You Leave?

In conclusion, you have several choices; you can call a skilled nursing home abuse attorney who specializes in this kind of matter, and set up a free consultation, or you could call Adult Protective Services (APS) and ask them how to proceed. If the nursing home is in a small town in Upstate NY, calling APS could be like calling up the good ole boys’ network. Probably better off sticking with an attorney far removed from the local scene.

Here are some more websites that may further assist you;

To find Nursing home Ratings By Medicare, click here.

Click on the highlighted link if you are a Nursing Home Abuse Attorney interested in search engine optimization.

Here are some more websites that may further assist you;

Nursing Home Comparison

Elder Abuse Fact Sheet by WHO

Identifying Elder Abuse