Signs of Nursing Home Abuse

Most elderly people in nursing homes are unable to take care of their daily living needs without assistance, which is why their families have placed them in surroundings where that assistance is supposedly at hand.

While many, of not most, nursing homes are caring and conscientious, there are some where that assistance is negligently absent. And further, there are times when conscious or deliberate harm is done to elderly people. It can be physical or emotional harm, or both, but in either case it's personal injury and therefore potentially a legal matter.
If you have a loved one in a nursing home, it's important to be able to recognize signs of nursing home abuse or mistreatment. Here are some things to watch out for.

New wounds or scars on the skin
These could be from a fall, or from overly tight restraint, or from rough handling by the staff. As we age, our skin thins out and becomes delicate, easily bruising or tearing. Our elderly loved ones need gentle handling to avoid injury.

From Falls
Perhaps your loved one needs assistance sitting upright. There's a safe and appropriate way to do this, but sometimes it's forgotten, so the person could fall from the chair, or get up and wander around, sustaining a fall.

Our eyesight deteriorates as we age, but perhaps the glasses have been lost or broken.
The floors should be kept free of debris or obstacles, but perhaps someone left liquid or clutter where it could cause a fall.

From Overly tight restraint
Restraints are used to prevent falls, and to prevent a person with Alzheimer's, for instance, from wandering off the premises and becoming lost or hurt on the street. There's a correct way to use a restraint, but if it's put on too tightly, it can cause bruising, or break the skin.

From Rough handling
Sometimes nursing home staff are overworked and become too tired, or too impatient. That's a possible explanation for rough handling, but not a justification of it. A tight grip on an elderly person's arm can cause bruising and pain and even in more extreme cases a broken bone. But perhaps the elderly person is unable to speak well enough to object, or perhaps they feel intimidated.

Pressure sores
Some elderly people have difficulty turning themselves while in bed, or are entirely unable to do it because of having had a stroke, for instance. The staff is required to turn them at least every two hours and if this isn't done, the continual pressure on one place wears down the skin, causing an open sore known as a decubitus ulcer.

This is usually on a hip or near the coccyx. If it isn't treated immediately, it will enlarge and deepen and potentially become infected. It can even enter the bone tissue. These sores are preventable by good care.

Depression or anxiety
When you visit your loved one in the nursing home, you can gauge their mood each time, and if they appear to be more depressed, you can ask them what's troubling them. If their speech is intact you may learn at once what the problem is and be able to rectify it.
But if their speech is impaired, they may not be able to tell you. If their mood seems to be lower at each visit it may be time to discuss it with nursing home staff, and find out if any emotional abuse is happening. Sometimes there's even sexual abuse.

Weight loss
Many elderly people lose weight rather than gaining it, as a function of advancing age. But if you notice that your loved one starts losing weight more than you would expect, it could be that for some reason they've lost their appetite (see Depression or anxiety), or that food is being withheld. Why would food be withheld? Either from laziness and neglect, or as an inappropriate punishment. In either case, you'd be wise to check into what's happening.

Dehydration
Some harm doesn't give you obvious external signs. For instance, if a person is mildly or even moderately dehydrated, you might not notice it on a visit (although the nursing staff should notice it).

As we age, we tend to lose our sense of thirst, so your loved one might be thirsty but not reach for the nearby water. For that reason, nursing home staff is expected to offer drinking water at least every two hours. But you might notice extra dry lips, or eagerness for water to drink when you offer it, and if so, you could pay extra attention to that on each visit, or perhaps mention it to the staff. Severe dehydration is life-threatening and calls for quick action.