Nursing home abuse or neglect is defined generally as any action or failure to act that causes unreasonable suffering, misery, or harm to the patient. It can include assault of a patient, but can also include withholding necessary food, medical attention, or physical care from the patient. It is important that families stay involved in the lives of their loved ones once they have been placed in a nursing home. This is the best way to prevent or recognize abuse. Below are five main categories of abuse and their warning signs.

1. Neglect – Neglect can be intentional or unintentional on the part of the nursing home facility. Neglect happens when a patient's needs are not being met. This includes not providing appropriate food, water, medical, and personal care for the patient. This can be an intentional choice on the part of the staff or it can happen be unintentional and due to the lack of adequate staffing in a nursing home facility.

It is important to know the warning signs for neglect. A neglected patient may be dehydrated or malnourished. Bed sores and other skin conditions can be signs of neglect. A decline in personal hygiene can be a sign of personal care being neglected. Weight loss is also a sign consistent with neglect. If any of these signs are present, your loved one may be the victim of neglect.

2. Psychological Abuse – Psychological abuse in nursing homes is one type that can be very hard to identify, because it can be subtle and hard to notice. Elders feel extreme sadness, fear, and anxiety. This type of abuse occurs when there is excessive yelling, humiliating, criticizing, or shaming the patient. It might also involve threatening and intimidation of the elderly patient. Many times, psychological abuse is accompanied by other forms of abuse.

Elderly people who experience psychological abuse will often become timid and withdrawn. Depression is a sign of psychological abuse. Some victims of psychological abuse will become more angry, agitated, and aggressive. Changes in behavior are common in patients who experience this type of abuse. Due to depression, there may be sudden weight loss and loss of appetite. These patients may even refuse to eat or take medications. Since this is a difficult form of abuse to identify, it is important to be aware of these warning signs and notice any changes in your loved one's behavior.

3. Physical Abuse – Physical abuse in nursing homes is abuse that involves physical harm of the elderly resident. It involves intentionally inflicting physical harm, such as hitting, kicking, or pinching. Physical abuse can also come from the overuse of restraints or bed injuries or from physical neglect.

Physical abuse would seem to be easier to identify, but that is not always the case. Some signs of physical abuse are hidden by clothing, or false stories of falls or stumbles. Bruises and abrasions, as well as falls, fractures, or head injuries can be signs of physical abuse. Injuries requiring emergency treatment or resulting in broken bones should be red flags to the family. Often staff in charge of an abused resident will refuse to leave when the family is present. This may be a warning sign that something negative is going on with the resident. Be present and observant when visiting a loved one in a nursing home to help ensure proper treatment and care.

4. Sexual Abuse – Sexual abuse is another form of abuse that takes place in nursing homes. This type of abuse involves any unwanted sexual attention or sexual exploitation. This can happen with any patient and is especially hard to detect in patients who are cognitively impaired or have memory loss, such as patients with dementia.

Sexual abuse can be harder to identify, but there are some warning signs. Pelvic injury or bruising in the genital and inner thigh area can be warning signs of elder sexual abuse. Newly contracted STDs is a major red flag. Sexual abuse may cause the elderly person to have unexplained difficulty standing or walking. There may also be changes in behavior or mood, including unusual sexual behavior. Be aware and take action if you see any of these warning signs in a loved one.

5. Financial Abuse – This type of abuse takes place when the caregiver takes advantage of access to the elderly person's financial matters, and steals or compromises the victim's finances. This can be stealing from the person or accounts, applying for credit, or incorrectly billing for services paid by Medicare or Medicaid.

If your loved one is in a nursing home facility, watch for these warning signs of financial abuse: 1) A caregiver demanding money or taking money or possessions as gifts from an elderly patient. 2) Unknown charges to credit cards or sudden mismanagement of personal finances. 3) Forcing a patient to sign financial documents or forging the person's name on documents.

Be sure to help your loved one keep track of their finances and to know their rights.

If any of these types of abuse are suspected, it is important to ask questions of the facility and to investigate. It may also be necessary to remove your loved one from the facility. Many of these crimes go unreported. It is important to report the crime to proper authorities and to find an attorney that can help take the appropriate legal action to protect your loved one and others who could be victims of abuse.

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