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The Department of Health and Human Services defines abuse as "[t]he willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain or mental anguish."
About 5 million seniors a year suffer some kind of mistreatment or neglect. In nursing homes and long-term care facilities, abuse typically occurs when nurses, certified nursing assistants, staffers, managers and administrators leave residents unsupervised and without adequate physical, mental or medical attention. Sometimes, staffers, fellow residents or strangers harm residents intentionally.
Nearly half of the reported incidents involve the neglect and abuse of residents by facility employees, while about 25 percent are resident-to-resident harm. Another 26 percent comes from unknown assailants.
When people think of nursing home abuse, they might think of bed sores from neglect, but there are many different kinds of abuse. Typically, it falls into six categories defined by the National Outbreak Reporting System (NORS): physical, sexual, emotional or psychological, gross neglect, financial and resident to resident abuse. There are also additional types detailed by the National Center on Elder Abuse (NCEA).
The third-most prevalent type of abuse is psychological or emotional, and it accounts for 21 percent of all reports tracked by NORS. This occurs when verbal or nonverbal acts cause anguish, pain or distress through intimidation, humiliation or harassment. Separating elders from family and friends or forcing them into social isolation are also examples of this type of abuse.
Physical abuse remains the most prevalent type of abuse in long-term care facilities. According to NORS, 29 percent of all abuse complaints in 2010 were physical. This involves the use of physical force that results in bodily injury or pain.
Sexual abuse makes up only 7 percent of cases but carries a lot of devastation with it. This type of mistreatment involves non-consensual sexual contact of any kind. Disabled seniors and people with Alzheimer's or dementia are vulnerable because they can be incapable of expressing non-consent. Preying on those conditions is also considered abuse.
Gross neglect makes up 14 percent of abuse cases. It happens when those responsible for the care of a senior refuse or fail to fulfill their professional and legal obligations. Examples include failure to feed, clothe, shelter, clean and keep elders safe – even from other residents or abusive employees.
Like sexual abuse, financial exploitation is one of the more rare forms of abuse. This typically happens when a nursing home employee or another facility resident illegally uses a resident's funds, property or assets. Examples include: cashing checks without permission, forging signatures, stealing belongings or money, bullying or deceiving a senior into signing financial documents.
Even rarer is when a professional outside the elder care facility takes advantage of a resident. This can involve improper or illegal use of a power-of-attorney privilege or of a guardianship.
This type of abuse makes up 22 percent of all abuse. It encompasses all types of abuse just mention, but occurs when other residents prey on weaker residents because of lack of supervision by staff.
|Signs of financial abuse include:|
|Unauthorized charges on an elder's ATM or credit card.|
|Discovery of forged signatures|
|Sudden changes in legal documents such as a will|
|Additional names on an elder's bank card|
|Unpaid bills despite adequate funds being available|
|Withdrawal of large sums of money|
According to the National Center on Elder Abuse (NCEA), recognizing and halting neglect is the first step to preventing abuse. In addition to looking for the signs listed above, several risk factors make a senior vulnerable. These risks are put into three big categories: facility, resident and relationship.
The No. 1 cause of abuse in nursing homes is poor staffing. High turnover, poor training and an overworked staff leads to greater risks for residents. When picking a nursing home, talk to the staff and look into a facility’s credentials to help determine whether a facility is adequately staffed.
Sadly, the more dependent a resident is on the staff, the more likely they are to be abused. Mental or physical impairment makes seniors an easier target for mistreatment or neglect.
Another important factor in preventing abuse is making sure to visit a family member in the nursing home as often as possible. It's also possible for family members to become too involved and actually interfere in the caregiving process.
Ideally, nursing homes should take these risks into account and be more proactive in preventing mistreatment of their residents. However, sometimes it is up to the family member to be vigilant and watch for the signs.
If you suspect nursing home abuse and the senior is in immediate danger, call 911. Otherwise, you can call the Long Term Care Ombudsman. Each state has its own ombudsman who will investigate claims specific to nursing homes or long-term care facilities. When you make a call, make sure you have the elder's contact information and details about any possible mistreatment.
|Largest U.S. Nursing Home Chains|
|HCR Manor Care||38,412||279|
|Life Care Centers of America||30,983||231|
|Genesis HealthCare Corp||25,409||206|
|Sun Healthcare Group||20,736||200|
|Extendicare Health Services||16,849||168|
|Evangelical Lutheran Good Samaritan Society||12,067||175|
|The Ensign Group||10,065||94|
Bonnie Nidiver and her son, Scott, filed a lawsuit against Cypress Healthcare Center in Butte County Superior Court after Bonnie's husband, Eugene, died from poor care in the home. Eugene went into the facility for help healing from a broken pelvis and wrist. Ten weeks later, he was dying in hospice. Before surgery, he was fit and active.
According to the Nidivers’s complaint, Cypress staff kept Eugene drugged on antidepressants, sedatives and narcotics. With no one to supervise him, he fell from his wheel chair twice – and the second fall broke his hip. Bonnie visited the nursing home daily and alerted the staff, but no one seemed to pay attention to her.
The Nidivers's story is not uncommon. Families across the country continue to file lawsuits against long-term care facilities that injured their loved ones.