Nursing Home Abuse and Neglect Law: Basics

How to identify the signs of elder abuse in a nursing home or other care facility, and what to do about it.

According to the Centers for Disease Control and Prevention (CDC), more than 500,000 older adults over the age of 60 are abused or neglected each year. These numbers likely reflect just a portion of the real problem, since many cases of abuse and neglect go unreported each year. Of course, elder abuse can occur in nursing homes and in other treatment settings, and in this article we'll focus on identifying elder abuse in the care facility setting, and on an abused or neglected resident's legal options.

What is Elder Abuse?

The Administration on Aging, a division of the Department of Health and Human Services, defines elder abuse as, "any knowing, intentional, or negligent act by a caregiver or any other person that causes harm or a serious risk of harm to a vulnerable adult."

The CDC identifies six types of maltreatment that occur among people age 60 and older. These include:

  • physical abuse
  • sexual abuse
  • emotional abuse
  • neglect
  • financial abuse, and
  • abandonment.

Slapping, pushing, and hitting all constitute physical abuse. The improper use of physical or medicinal restraints also falls into the category of physical abuse. But as you can see from this list, elder abuse isn't limited to the physical.

What is Elder Neglect?

Defining "neglect" has been much more difficult, primarily because of the numerous forms that neglect can take, and how much the facts vary from one situation to the next. (Note that "neglect" is not the same as "negligence.")

Generally speaking, though, neglect is defined as any failure by a caregiver -- whether it is hired staff or even a family member -- to fulfill the obligations related to the older person’s care.

Because an elderly person’s needs are so wide-ranging, the forms of neglect can be just as varied. Typically they include any denial of needs related to shelter, food, clothing, hygiene and medical care.

What Are the Signs of Elder Abuse and Neglect?

Every situation is different, but here are a few things to look for:

  • Physical abuse: unexplained injuries such as bruises or broken bones; burns; frequent use of medical providers.
  • Emotional abuse: fearful behavior; anxiety; severe and unexplained changes in moods or personality; fear of interacting with nursing home staff or care givers; refusal to see family members or close friends; withdrawal from social support system; hesitation to talk openly.
  • Sexual abuse: development of sexually transmitted diseases; genital or anal pain, injury or bleeding.
  • Neglect: malnourishment; lack of basic necessities such as food, water, poor hygiene, shelter; bedsores or skin ulcers; medical needs not attended to; unpaid bills.
  • Abandonment: unsanitary or unclean living conditions; soiled bedding or clothing; lack of proper medical treatment.
  • Financial exploitation: discrepancies between the person’s standard of living and available assets; unexplained depletion of assets; unexplained financial transactions; missing personal property items; sudden and unexplained changes in living arrangements, such as a new location or new roommate.
  • Self-neglect: this results where the elder person refuses care, and the symptoms can take on one or any combination of the other symptoms described above.

Who is Legally Liable for Nursing Home Abuse and Neglect?

When abuse or neglect occurs in the nursing home setting, the facility can be held liable if any of the following played a part in causing harm to a resident or patient:

  • negligent hiring
  • understaffing
  • inadequate training
  • breach of statutory or regulatory obligations, and
  • medication errors.

Remember that the facility is also "vicariously liable" for the bad acts of its employees, including most actions taken in the course and scope of the worker's job responsibilities.

As part of a resident’s care, nursing homes often hire contractors or otherwise outsource various tasks to third parties. Those third parties may also be liable for abuse or neglect of a resident. For example, if another resident -- or a guest visiting the nursing home -- injures a resident, the private security firm providing security to the nursing home may be liable for negligence, and therefore on the financial hook for damages.

What Should I Do If I Suspect Elder Abuse Or Neglect?

If you are a victim, or if you suspect that someone you know is a victim of elder abuse or neglect, you should immediately call the police or Adult Protective Services. You do not need to prove abuse in order to make a report. To get started, go to the National Center on Elder Abuse "Reporting Abuse" resource page.

If you are concerned about potential problems at a nursing home or assisted living facility resident, your state’s long-term care ombudsman can also serve as a resource. To find your local ombudsman’s office, call the U.S. Administration on Aging at 800.677.1116 or go to www.eldercare.gov.

Here are some additional resources that may provide assistance:

How Can the Authorities Help?

The circumstances of each individual situation will dictate the appropriate response. If a nursing home/elder abuse victim is in imminent physical danger, or is at immediate health risk, the local police or responding paramedics may remove the victim from the scene and to a safe location (including a different care facility. If a crime has been committed, the police will conduct an investigation and refer the complaint to the judicial system.

If the threat of harm or abuse is less imminent, procedures vary from state to state. Generally, however, the state’s office of Adult Protective Services will be charged with investigating the complaint and assessing the danger. APS will then enlist partner social services to address the health and safety concerns for the victim.

In any situation where an instance of elder abuse is suspected, it may make sense to consult with a lawyer who has experience handling these kinds of cases. The lawyer can identify the appropriate response in a non-emergency situation, and will ensure that the elder person's well-being and legal rights are protected.

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