What is Nursing Home Abuse and Neglect?
Nursing home abuse and elder abuse is a growing problem in America. Elder abuse is any intentional action or inaction by a caregiver that creates a serious risk of harm (even if not intended) to a vulnerable elder. Failure to provide necessary and adequate care is still a form of neglect and abuse. The following are some of the most common examples of nursing home abuse and neglect:
- Failure to provide necessary medical treatment, such as cleaning and rotating the patient.
- Failure to provide adequate access to food and water
- Physical abuse, such as hitting or slapping the elder.
- Mismanaging the elders money.
- Stealing the elders medications or belongings.
- Inappropriately restraining the elder, with physical or chemical restraints.
- Sexual abuse of the elder.
- Failure to provide a save environment from other residents. .
What are the Risk Factors for Nursing Home Abuse and Neglect?
There are approximately 1.4 million Americans currently living in one of over 15,000 nursing homes in the United States. If one includes assisted living, the number balloons to over 4 million residents. It’s estimated that one in ten nursing home residents will experience some form of abuse. The risk of elder abuse varies drastically depending on several risk factors. Below are several factors that put an elder at a much higher risk of abuse and neglect:
- Impaired Mental Health: Elders with Alzheimer’s, dementia, or other cognitive impairments are at a much greater risk of neglect.
- Age: As age increases, so does the risk of elder abuse and neglect.
- Financial Status: Money can make some elders a target for financial exploitation.
- Gender: Approximately two-thirds of nursing home abuse and neglect cases are females.
- Support Network: Frequent visits from family and friends can decrease the risk of nursing home abuse and neglect.
- Immobility: It takes more time and staff to care for an immobile patient, increasing the chance of neglect.
- Rare or complex health issues: Staff members are more likely to be untrained on the necessary care required.
- Facility: The quality of the nursing home, staff, and patient to staff ratio varies greatly from one facility to another.
Always consider the above risk factors if any family member or friend is living in a nursing home. Several of the above risk factors can be mitigated. Do a thorough online investigation of several nearby facilities before choosing a nursing home. Look for any violations or reports that have been filed against the facility. Compare the staff to patient ratios of each facility. Visit multiple nursing homes with the elder before deciding on one. Coordinate with family and friends to ensure that the elder has regular visitors. When visiting the elder, introduce yourself to the staff and build a relationship with them. If possible, assist the elder or have an outside party handle the elder’s financials.
Impact of Nursing Home Abuse
The impact of abuse has a profound effect on many different areas of life and is not a short term problem. The risk of death is 300% higher for any elder who experiences abuse or neglect. Research has also shown that victims of elder abuse develop significantly higher levels of psychological distress and lower self-esteem. Additionally, elders who experience violence are more likely to be non-compliant with treatment, experience hypertension and delayed wound healing.
What are the Warning Signs?
It is often very difficult to detect nursing home abuse or neglect. Only 1 in 24 (about 4%) nursing home abuse cases are ever detected or reported. Therefore, it is important to be aware of the warning signs that could indicate abuse or neglect is occurring. The following are possible indicators of elder abuse or neglect:
- Bedsores / Pressure Ulcers: Wounds that typically appear on the upper buttocks over the tail bone. Bedsores are usually a result of the patient being left in bed for long periods of time. It can also be an indication of malnutrition or dehydration.
- Unexplained Bruises: Bruises around the wrist and ankles can be a sign that the patient has been physically restrained. Other bruises could indicate physical violence.
- Broken Bones: Falling is a serious concern for the elderly. Under staffing leads to inadequate supervision and assistance with transfers.
- Weight Loss: Decreases in weight could be a sign of malnutrition or depression.
- Excessive Thirst: If a loved one always ask for water when you visit, it’s likely they are not being provided enough fluids throughout the day.
- Poor Hygiene: Staff should change a patient immediately if they wet or soil themselves. Feces and urine are skin irritants and will cause the skin the breakdown.
- Change in Behavior: Many patients become depressed or withdrawn if they are experiencing abuse or neglect.
- Asking for Money: Many nursing home residences have the same expenses every month. Suddenly requiring more money could indicate financial abuse.
- Items Out of Reach: Make sure the call light and phone is always within the patients reach. Some staff members place call lights out of reach to decrease their work load. Also ensure things like walking devices, glasses and dentures are within reach.
The Unseen Cost
The impact of abuse, neglect, and exploitation also has a profound fiscal cost. Elder abuse due to violence alone adds over $5 billion to the nation’s annual health expenditures. Nursing home negligence adds billions more in expenses, because injuries such as bed sores are expensive and lengthy to treat. Financial exploitation of the elderly, including fraudulent Medicare billing, adds at least another $3 billion in annual cost. Medicare (funded by tax payers) bears the expense for the majority of the cost associated with nursing home abuse. Nursing home residents, facilities, and cost of care continue to increase every year. Eliminating nursing home abuse and neglect is necessary to decrease excess healthcare spending.
It Could Happen to You or Your Loved Ones
In just a two year span, 1 in 3 nursing homes in the United States violated federal standards enacted to protect nursing home residents. During the same time period, 1 in 10 nursing homes received citations for causing elderly residents serious injury or death. A recent study investigated nursing home abuse and neglect rates by interviewing 2,000 nursing home residents. An alarming 44% of those interviewed reported physical abuse directed towards themselves or other residents. Even more startling, 95% of those interviewed reported neglect at the nursing home they resided in. In the year prior to the study, over 50% of the nursing home staff admitted to mistreating (physical violence, mental abuse, neglect) older patients. Two thirds of the incidents involved neglect.
Another survey of certified nursing assistants (CNA) found that 17% had pushed, grabbed, or shoved a nursing home resident. 51% reported they had yelled at a resident and 23% had insulted or sworn at a resident. Both studies rely on self reporting; actual abuse rates are likely much higher.
Nursing home abuse isn’t isolated to just certain parts of the country or cheap facilities. Nursing home abuse and neglect happens everywhere, including Kansas City, Missouri and Kansas City, Kansas. Our nursing home abuse attorneys are frequently surprised by the reports of neglect and abuse from residents of expensive and highly rated nursing homes. It only takes one bad employee for abuse or neglect to occur at a nursing home.
How to Choose the Right Nursing Home in the Kansas City Area?
There are approximately 100 nursing homes in the greater Kansas City area and choosing the right one can be overwhelming. Start the selection process by utilizing websites such as Medicare.gov to compare nursing homes. The website will sort nursing homes based on distance from your desired location. Overall rating, health inspections, staffing, and quality measures are provided to compare each nursing home. The website will also alert you to high risk facilities as determined by a state or Federal inspection team. An example of a high risk facility in Kansas City, Missouri is Glennon Place Nursing Center, which received 1 out of 5 stars for health inspections, quality measures, and overall rating.
After eliminating the high risk nursing homes, make a list of acceptable nursing homes. Go over the list you’ve created and explain the research you’ve preformed to the elder, this can greatly decrease their anxiety. Then take a day or two to visit the physical location of several potential nursing homes. Make sure to have the elder accompany you. If possible, try to meet and interact with the current residents of the facility to assess their satisfaction with the facility. After visiting each facility, take time to discuss the positives and negatives with the elder. Take notes of what they did or didn’t like and go back over the notes with the elder after visiting all facilities. Discuss the options and select a facility that both you and the elder are comfortable with.
No matter what facility you select, make sure to follow-up with the elder frequently! Regardless of the history or rating of a facility, elder abuse and neglect is still a possibility. The staff, management, and residents of a facility can change at anytime, for better or worse. Learn the names of the staff members that frequently take care of your loved one. Ask the elder which staff members are their favorite, least favorite, and new. Many elders feel guilty reporting their care givers for abuse or neglect. Frequent conversations about the quality of care will enable you to detect non-verbal signs fo abuse.
Scientific Articles on Nursing Home Abuse
Providers only identify 1 in every 24 cases of elder abuse. Older adults are often reluctant to report abuse because they fear they will be removed from their homes or separated from their caregivers. Providers need to be aggressively reporting suspected elder abuse with the same tenacity they report child abuse. Greater training is needed in emergency room departments to detect elder abuse.
259 elderly victims of physical abuse were evaluated. 42% of the elderly victims experienced facial injuries. Certain elderly groups were more susceptible to various types and methods of violence. Married men aged 70-79 years old were more likely to be victims of community violence at night, suffering facial injuries. Single women aged 60-69 years old were more likely to be victims of domestic violence during the day, suffering trauma to areas other than the face.
The main causes of abuse identified by older victims themselves were mutual dependency between victim and perpetrator, power and control imbalances, loneliness and a marginalized social position of older persons. Effects of abuse included negative feelings, physical and psychological distress, a change of personal norms and values, changed perspectives on money and low self-efficacy. Coping strategies mentioned by victims included seeking informal or professional help and using self-help strategies.
September 2015: Elder Abuse and Help-Seeking Behavior in Elderly Chinese.
40 elder abuse survivors underwent in-depth interviews. Most of the elder abuse survivors interviewed denied that their own experience was abusive. Social isolation, cultural barriers, self-blame, and lack of knowledge were major barriers to help seeking.
197 older adults without dementia were interviewed. 44% of those interviewed reported that they had been victims of domestic abuse. Psychological abuse was the most common type of abuse reported.
26 articles on elder abuse spanning 20 years were reviewed. Psychological abuse and financial exploitation were the most common types of maltreatment. Rates of abuse were more common in developed countries.
49 studies on elder abuse were reviewed. The highest risk factors for abuse were family disharmony, poor or conflicting relationships, and low levels of social support. The study highlights the importance of the socio-cultural aspects of abuse.
The causes of patient neglect were found to frequently relate to high workloads, burnout, and the relationship between carers and patients. Patients and their family members were found to be more likely to report neglect than the healthcare staff.
The major findings of the study include that adult children often (1) overestimate their parents’ ability to manage their finances; (2) prefer to mange their parents’ finances informally, as opposed to using legal options like power of attorney; and (3) tend to think of their parents’ assets as “almost theirs.”
2039 adults over 60 years old in rural communities were surveyed. 36% of those surveyed reported elder mistreatment. Risk factors identified for elder abuse included depression, being widowed/divorced/single/separated, having a physical disability, having a labor intensive job, depending solely on self-made income, and living alone. Depression was the main risk factor associated with mistreatment.
Significant differences in views of elder abuse were observed among African-American, Caucasian American, and Korean-American elderly women. Korean-American women were much less likely to perceive a given situation as abusive than the other groups. All three groups showed vast differences on their source of help in case of elder abuse.
Nursing Home Abuse Lawsuit
The Hollis Law Firm is located in the greater Kansas City area and handles lawsuits nationwide. Contact the Hollis Law Firm today if you suspect a loved one has been the victim of nursing home abuse. One of our nursing home attorneys will review your case and the best path forward. All case evaluations are free, confidential, and carry no risk or obligation. Get in touch with our team today by completing a contact form online or by calling (800) 701-3672.
Content created by C. Brett Vaughn RN, BSN, JD