It’s likely that you or someone you love will need some kind of special care, such as a nursing home, if advanced age makes daily living activities difficult. According to the Centers for Disease Control, about 1.3 million Americans reside in nursing homes, with nearly a million more in other types of residential care communities. As the baby boomer generation moves through their twilight years, numbers are only going up.
Unfortunately, the health conditions that make older people dependent on nursing home care—physical and cognitive deficits, and chronic diseases—leave them vulnerable to abuse. It’s very distressing to think that your loved one could be victimized. But there are ways to protect them. Learning about the red flags to look for, especially the more subtle psychological signs, will empower you in protecting your family member’s safety.
How Abuse Happens in Nursing Homes
Sometimes abuse is systemic, but often it’s limited to a specific caretaker. Nursing homes typically pay low wages and have high patient-to-staff ratios, which can result in overworked caretakers who are unable to cope with the stresses of their jobs. Sadly, mistreatment is sometimes the outcome. Abuse may also be inflicted by a fellow nursing home resident.
Abuse is often underreported. Victims or witnesses may be unable to tell family members or staff about the abuse, or their claims are dismissed as hallucinations or confusion. They may even fear retaliation if they report their mistreatment.
Abuse or neglect can cause the victim’s health to spiral downward, decreasing their length and quality of life. One study showed that older people who have been abused have a risk of death 300% greater than non-abused people.
Types of Abuse in Care Facilities
Abuse may be verbal or nonverbal, physical or psychological, sexual, financial, or involve neglect.
Examples of abuse include hitting, shoving, rough handling, unwanted touching and rape. Needed care, such as bathing, dental care and changing wet clothing, may be neglected.
Be alert to visible signs of mistreatment, such as:
- Dry mouth and lips, indicating dehydration
- Cuts, burns, broken bones and other injuries with no apparent cause
- Bleeding in the genital area
- Scent of urine or feces
- Lack of cleanliness in the patient’s room or clothing
Emotional Abuse of Nursing Home Residents
Some abuse is psychological, including:
- Threatening the patient with physical abuse
- Yelling or cursing at the resident
- Isolating a resident from social activities or from their family
- Shaming, accusing, or mocking the resident in front of others
- Ignoring or trivializing a resident’s concerns
- Moving the patient’s belongings, such as their cane or glasses, out of reach
- Delaying care for illness or injury
Psychological Signs Someone is Being Abused
Physical symptoms are often obvious, but an abuse victim may suffer psychological wounds that are much harder to see. That’s why it’s important to be aware of emotional changes in your relative that can indicate they’re being mistreated emotionally or physically. Some types of physical abuse, such as pushing or holding someone down, may not leave a physical mark while they’re causing psychological damage.
Look for warning signs of psychological distress due to abuse. These red flags would be symptoms that are recent and can’t be explained by any medical condition. Some of the most common signals include:
- Unusual changes in eating or sleeping habits
- Avoiding eye contact with others, especially with a specific caregiver
- Expressing feelings of depression
- Withdrawing from previously enjoyed hobbies or activities
- Sudden changes in behavior or personality, such as anxiety or aggression
- Being reluctant to speak openly
- Making statements that don’t make sense or contradict one another
- A dramatic change in weight
- Expressing feelings of helplessness
- Showing fear or deference around one particular caretaker
- Exhibiting repetitive behaviors such as hair pulling, teeth grinding or rocking
- Showing a noticeable decline in self-care skills
- Expressing thoughts of suicide or other ways of harming themselves
- Feelings of low self-esteem
Additionally, observing your loved one’s caregivers can give you important clues. You don’t want to see that staff members appear highly stressed or exhausted. A caretaker might try to keep your loved one from talking with you alone or respond evasively when asked questions. An abusive staff member might talk condescendingly to your relative, or display too much or too little concern toward them.
What to Do if You See Signs of Abuse
Talking to the supervisor, social worker, and other personnel at the facility can help to resolve many types of problems. However, if you suspect abuse is occurring, you must act quickly to protect your family member. Call the police. In addition, getting legal assistance as well can help you investigate mistreatment and hold the nursing home and any perpetrators accountable.
Finally, the most important thing you can do to protect your loved one is to be a highly visible advocate. Visit as often as possible so staff knows you’re keeping an eye on how things are going. Get to know staff members and establish positive relationships with them. Being a vigilant advocate will enhance the safety of your beloved family member and make their final years the best they can be.