People living in a nursing home need nursing attention and assistance with activities of daily living by definition: that’s why they are in a nursing home to begin with. Withholding that care—neglect—can range from ignoring hygiene needs like toileting to failing to provide appropriate medications as ordered by a physician.
The staff that cares for a resident on a daily basis must pay attention to subtle changes in the resident’s condition to recognize and seek help for possible medical conditions before they worsen. These conditions can include bed sores, infections, cuts, diabetes, cognitive diseases, and mobility concerns such as inability to walk or transfer from bed to standing or sitting safely without assistance.
Too often, however, the corporate management making staffing and budgetary decisions puts corporate profit over resident safety, leading to understaffing, overstressed workers, and neglected—or even abused—nursing home residents.
What are the types of nursing home neglect?
Broadly speaking, neglect can be broken down into the following categories, although an attentive family or careful nursing home neglect lawyer will discover multiple issues of neglect in a single facility:
Personal hygiene neglect occurs when nurses or nurse aides do not provide adequate assistance with laundry, cleaning, bathing, brushing their teeth, or other forms of hygienic practices. When it comes to older people who are not able to care for themselves, hygiene can be a matter of life and death. For example, leaving them in soiled linens can lead to urinary tract infections (“UTIs”) or infected bedsores.
Basic needs neglect occurs when a nursing home neglects to provide reasonable food, water, or a safe and clean environment. This can lead to serious, even deadly, dehydration or malnutrition, skin breakdowns due to poor nutrition, falls, or serious illness.
Medical neglect occurs when a nursing home fails to provide adequate attention to a resident’s medical needs, such as failing to prevent or adequately treat medical issues like bedsores, urinary tract infections, infections, pneumonia, and the like.
Emotional or social neglect occurs when nursing home staff repeatedly ignores, abandons, or acts rudely or dismissively to a resident, often because the staff is overstressed from inadequate staffing and being overworked. Often this is seen in conjunction with abuse, poor care, or other forms of neglect, at a facility that is being run to put corporate profits over resident safety.
How will I know if my loved one is being neglected in a nursing home?
The first sign of neglect is usually too few staff and basic needs not being met: the resident not dressed or out of bed at a reasonable time, needing to go to the bathroom, unanswered call lights when family arrive and need help, soiled linens, urinary tract infections.
Often these issues are explained away as a “one time” or unusual event by staff. Do not assume that is true. While physical signs of nursing home neglect like malnutrition, dehydration, and bedsores may be more easily identifiable for a nursing home resident’s family when they visit, it is not unusual for these issues to be hidden or not disclosed to the family, as required.
If you are told you “have to” leave while a resident is changed or otherwise cared for, they may be hiding a bedsore or bruising.
The bottom line is that while you can—and in some sense, have to—trust the nursing home to care for your loved one, never assume you are being told everything, or even the truth. Verify. Ask your loved one questions, probe the staff when there are signs of problems (discussed in detail below), ask to see any issues like bedsores yourself, ensure the director of nursing or administrator is involved, get to know and recognize staff.
Critical signs of nursing home neglect
Here are some critical signs of nursing home neglect that should put you on alert that intervention is needed immediately to change a possibly deadly course of decline:
- Bedsores (also called pressure ulcers);
- poor hygiene;
- sudden, unusual, or unexpected weight loss;
- Injuries from nursing home falls;
- Changes in behavior or emotional state, such as becoming withdrawn, confused, or disoriented;
- Changes in personal hygiene or appearance efforts, such as not getting dressed, out of bed, or other changes in routine;
- Unsafe room or facility conditions, such as poor lighting, slippery floors, unsafe mobility equipment, or unsafe furniture in the nursing home resident’s room;
- Staff refusing to let family members or friends visit the resident;
- Resident being kept in an overmedicated state.
Do any of these sound familiar? Keep reading, or contact us to discuss the specifics of your story. The call is always free.
What Can I do about nursing home neglect?
Neglect can be insidious. It is possible a single aide or nurse is dropping the ball—failing to ensure proper food or fluid intake, not turning a resident who needs help, not changing depends or linins promptly, not toileting on schedule—only a few shifts in a week. That might be impossible to recognize. Hopefully it is also not enough to harm the resident.
Much more likely and potentially deadly is a systemic failure, where most aides and nurses are missing something every shift. This can be because they are too short staffed, over worked, and under paid to get to everything (or not even given the information they need to know to provide adequate care).
That does not make it right, but it means the nursing home corporation is to blame, putting its profit over resident safety.
What I have seen is that the more involved the family—the more they visit, see, report, complain, discuss, request, even pester—the better the care that resident receives. The squeaky wheel gets the grease. But no matter how attentive a family, a true system-wide understaffing will catch up to almost any resident eventually.
When visiting with a loved one living in a nursing home, watch for signs of nursing home neglect, emotional distress, sudden or unexplained decline, changes in health, repeat issues like UTIs or pneumonias. Communication between family members and nurses can play a critical role in elder resident care in an understaffed nursing home.
What if the neglect has already injured or killed a resident?
I get two types of nursing home neglect calls: (1) angry family whose loved one has not been getting good care, but the loved one is either not seriously harmed, or recovered well, and (2) shocked family whose loved one has been seriously injured or even killed by nursing home neglect.
For the first group, I’m always happy to give advice about resources to improve care, report problems, and the like. Hopefully the problem never recurs.
For the second group, there’s usually no other option than retaining a nursing home neglect lawyer to investigate. In my experience, families never get the whole story until a lawyer like me steps in to investigate. I wish it weren’t so. If nursing homes were more open and willing to admit their failures, there would be many fewer lawsuits.
Read more on nursing home lawsuits to learn how they work, what you can and should do before hiring a nursing home neglect lawyer, and questions to ask lawyers before hiring them.
You can also report a nursing home to state and federal agencies responsible for monitoring nursing homes. See my article on How To Report an Ohio Nursing Home for Abuse or Neglect for details.
How Common is Nursing Home Neglect?
What we know is that nursing home neglect—a subset of abuse—is under-researched and under-reported. According to The National Center on Elder Abuse, “Elder abuse is also underreported. The New York State Elder Abuse Prevalence Study found that for every case known to programs and agencies, 24 were unknown.” That’s truly shocking.
This groundbreaking study also estimated 260,000 (1 in 13) older adults in the state of New York had been victims of at least one form of elder abuse in the preceding year.
You can read the report here.
Who Should I Contact if I Suspect Nursing Home Neglect?
If you suspect that your loved one is the victim of nursing home neglect or you suspect that your loved one’s death at nursing home, you must act. One step is to file a complaint with the proper state agency. You can visit the Medicare.gov website to find out where you need to file a complaint by state here.
Filing a complaint against the nursing home begins the process of holding the nursing home responsible for violating regulations. According to the Medicare.gov website you should file a complaint if:
you’re concerned about the health care, treatment, or services that you or another person got or didn’t get in the nursing home. Some reasons for filing a complaint would be abuse, neglect, poor care, not enough staff, unsafe or unsanitary conditions, dietary problems, or mistreatment.
You should be aware of the importance of reporting neglect. Unfortunately, several forms of neglect can lead to serious injury, even death. The Center for Medicare and Medicaid Services also provides the following information and resources for reporting nursing home neglect:
If you have concerns about treatment of a nursing home resident, contact your local ombudsman. Contact information is provided on signs posted throughout the nursing facility, or visit http://theconsumervoice.org/ get_help on the National Consumer Voice for Quality Long-Term Care website to find one in your area.
Report any abuse of a nursing home resident to your State Medicaid Fraud Control Unit. It is the agency’s job to investigate allegations of patient abuse in nursing homes. You may also contact the U.S. Department of Health and Human Services, Office of Inspector General by email at HHSTips@oig.hhs.gov or by telephone at 1-800-HHS-TIPS (1-800-447-8477), TTY: 1-800-377-4950.
Another option is to hire a Nursing Home Neglect Attorney.
Nursing Home Neglect Attorneys
I represent families of loved ones severely injured or killed by nursing home neglect, including from dehydration and malnutrition, failure to provide adequate assistance leading to a deadly fall, extreme neglect leading to bedsores, sepsis, and death, and more. I’ve helped them form the first call to me looking for help finding answers through trial.
It is never easy. But it is important and meaningful to find answers and hold a nursing home accountable when they cause injury or death by putting profits over safety.
If you’re ready to call and discuss your story, do so now at 216-777-8856. There’s no commitment or obligation, the call is free, and I’m happy to share my experience and knowledge. I can promise you I will be candid and direct. While we are very selective about the cases we take, I always try to help by at least answering questions and explaining the law on Ohio nursing home lawsuits.
If you want to think or read more, that’s fine, too. We’ve tried to make the website as informative as possible. You can complete the contact form on any page, and we’ll reach out to you.
Or you can learn more about me here: nursing home attorney William Eadie.