How to Report Abuse in Nursing Homes?

Elderly woman in nursing home

Abuse of the elderly is a prevalent problem across nursing homes, hospitals, and long-term care facilities. Unfortunately, it often goes unreported, especially if the victims themselves are not aware of any issues.

Many patients in nursing homes have physical disabilities or cognitive impairments that prevent them from realizing when they are abused. Thus, it is often up to staff members or family members to recognize the issue and report it.

If you become aware of an elderly person who is experiencing nursing home abuse, you must notify the proper authorities as soon as possible. Doing so can help someone in a difficult situation and potentially even save their life.

Recent studies have found that there is a significant risk of abuse in facilities designed specifically for the elderly. One study found that for every reported case of elderly abuse, there are about 24 unreported cases.

Incidences of neglect are even higher, with only 1 in every 58 cases reported. In addition, the COVID-19 pandemic has led to higher rates of elderly abuse, according to the WHO.

As a family member or friend of an elderly person who resides in a nursing home, you must be alert for any signs of injuries or abuse. If you believe that someone you care about is being abused, you should report the abuse immediately, using the resources we discuss below.

Options to Report Nursing Home Abuse

There are a number of ways to report suspected elder abuse. Hotlines and other local resources exist to address home abuse cases. A few options include:

  • Calling a nursing home abuse hotline
  • Reaching out to an ombudsman
  • Calling your state or local Adult Protective Services office
  • Working with health care providers to report abuse

Each of these options will be discussed in further detail below.

Options to Report Nursing Home Abuse Infographic

Nursing Home Abuse Hotlines

Two main sources exist to report elder abuse in nursing homes. These include the National Center on Elder Abuse (NCEA) and the Eldercare Locator.

Both the NCEA and the Eldercare Locator are programs run by the U.S. Administration on Aging, a division of the U.S. Department of Health and Human Services.

The NCEA is a national resource center dedicated to preventing elder mistreatment. The website of the NCEA gives contact information for reporting nursing home abuse in each state. It also provides information on state agencies devoted to the elderly as well as laws and regulations.

The Eldercare Locator provides similar resources, including details of local support groups for protecting the elderly.

Either of these websites can contribute a wealth of information for family members or friends seeking to ensure that their loved one gets the appropriate care that they need in a safe environment.


A long-term care ombudsman works as an advocate for residents in nursing homes and other licensed residential settings. Their services are authorized by the Federal Older Americans Act, and there is one designated for every state.

The ombudsman provides information on how to find an appropriate long-term care facility and how to get quality care. They are trained to resolve problems in the long-term care industry and to protect the rights of the elderly.

An ombudsman can assist you with filing complaints, but they will keep matters confidential unless you give them express permission to share them. This program is run by the Administration of Aging (AoA) and the Administration for Community Living (ACL). In addition to the state ombudsman, local ombudsmen are also appointed.

Long-term care ombudsmen are responsible for the below functions:

  • Addressing residents’ complaints of abuse or neglect
  • Addressing violations of rights or dignity
  • Acknowledging any residents’ concerns about quality of care or quality of life
  • Reconciling issues related to poor quality of care
  • Educating older people about their rights
  • Offering information on making changes to find high-quality care

If you need to speak with your local long-term care ombudsman, you can find their contact information through the National Consumer Voice website.

National Adult Protective Services Association

The National Adult Protective Services Association (NAPSA) works to help older adults and adults with disabilities who need assistance. They investigate cases of abuse, neglect, or exploitation alongside physicians, nurses, and law enforcement officers.

Every state has an Adult Protective Services (APS) agency, and their services vary across jurisdictions. While their primary focus is on ensuring that the people under their care are not exposed to abuse, they can also assist with developing a health care plan that serves individual needs.

If a report alleging abuse is made to the state or local Adult Protective Services agency, a few steps will occur. The APS screener will review the report to determine whether the actions meet the definition of abuse, neglect, or exploitation as defined by statutory requirements.

If the report meets the criteria, a representative from the Adult Protective Services agency will initiate face-to-face contact with the adult needing assistance. During the face-to-face meeting, the worker will determine what services are required to ensure that the individual’s needs are met to maintain their well-being and independence.

You may reach out to your state’s local APS agency by finding their contact information through the NAPSA database. Most states have a 24-hour hotline available to take confidential reports. If you don’t need assistance immediately, other non-urgent phone numbers are provided.

Local Law Enforcement

If an elderly person in a nursing home or long-term care facility has been seriously hurt or died as a result of any type of abuse in a nursing home, local law enforcement should be contacted immediately.

Officers can come to the incident site and perform an investigation to determine whether a crime has been committed. If they believe a crime has occurred, the officer may file charges against the perpetrators for one or more crimes, such as assault, homicide, manslaughter, abuse, or sexual or financial coercion.

Work with Medical Experts

If you aren’t sure if an elderly person is being abused, but you suspect that that may be the case, you can ask for help from a trusted doctor or nurse. Medical professionals are trained to identify the differences between the normal side effects of aging and elderly abuse.

Common side effects or signs of abuse can include any of the below:

  • Documented but untreated injuries
  • Undocumented injuries or fractures
  • Pressure sores
  • Poor oral care or lack of cleanliness
  • Malnourished residents with no previous record of low weight
  • Bruising in abnormal locations
  • Unchanged linens
  • Strong odors or urine or feces
  • Trash cans that haven’t been emptied
  • A history of reports of abuse in the facility

If you do want to work with a medical expert, it is best to choose someone who is not part of the nursing home or assisted living facility itself, unless they are known to be trustworthy.

You may choose a family doctor or general practitioner experienced in elderly care. They may ask to review the medical records of the elderly person and interview family, close friends, doctors, and nurses at the facility. This is done to determine whether the potential victim is acting outside the normal range of their behavior.

In many states, medical professionals are mandated by law to report suspected cases of elder abuse. This includes doctors, nurses, home health aides, and nursing home staff. The specifics depend on the state, but the report is usually made to Adult Protective Services.

Reporting Types and Signs of Nursing Home Abuse

There are six different types of elderly abuse. These include physical abuse, emotional abuse, sexual abuse, financial abuse, abandonment, and neglect. Abuse of an elderly person can be traumatic to the victim and their families and loved ones.

Understanding each type of abuse can go a long way to recognizing when it occurs and stopping it from recurring.

Physical Abuse

Elderly physical abuse occurs when there is a use of violence or force against an older person in an attempt to cause harm. It may take several forms, including actual violence, the threat of violence, or physical restraint. 

Physical abuse may occur due to an abuser’s mental health or substance abuse problems or if a caretaker is particularly stressed or frustrated with their role. Elders who have dementia are prone to becoming agitated, and this may lead them to strike a caregiver. In some cases, the caregiver may strike back, and this can constitute abuse.

Signs that physical abuse has occurred include injuries such as fractures, lacerations, bruising, and organ damage. Due to the fragility of an elderly person, these injuries may be much more threatening than they would to a young person. 

For example, a cut to an elderly person’s arm might require stitches, whereas it may just require a bandage in a younger person. Sprains and fractures to the limbs are particularly dangerous since they may cause the victim to become immobile without the assistance of a wheelchair or other apparatus.

Emotional Abuse

While emotional abuse may not show visible scarring on the body, it can be traumatic to the elderly victim. 

Examples of psychological abuse include attempts to intimidate or belittle an older person with words or actions. These can include verbal abuse, threats, isolation, or limiting choices so that they may no longer act with independence. 

Abuse may be driven by mental illness or substance abuse by a caretaker. Other times, a caretaker may have longstanding patterns in their lives that lead to psychological abuse rather than handling problems.

Indications that an elderly person may be experiencing psychological abuse include changes in eating patterns, difficulties with short-term memory, withdrawal or isolation, less attention to self-care, frequent sickness, difficulties sleeping, or low energy. 

If you see these changes in the normal behavioral patterns of your loved one, it’s important to reach out for assistance immediately.

Financial Abuse

Financial abuse occurs when someone takes money or property from an elderly individual without their knowledge or consent. Since many elderly victims may not have all of their cognitive abilities, they can be easy prey for theft. 

Common schemes involve taking money or credit cards, obtaining property through means of control such as identity theft, or using coercion to change a will or enter into a financial transaction that the elderly person does not understand.

Typically, financially abusers see the opportunity to take advantage of someone and act on it. The elderly usually have some retirement funds, pensions, or home equity. These assets are attractive to those who are not doing well financially and need the money to meet their own needs, such as food or rent, or wish to make an extravagant purchase. 

If financial abuse occurs, it can severely disrupt the quality of life that the elderly individual can enjoy, especially if the theft was significant. 

Signs that financial abuse may be occurring are sudden large transactions from an account that normally doesn’t have much activity, bank and credit card statements that no longer go to the individual’s address, or high credit card balances that appear out of nowhere.

Sexual Abuse

Sexual abuse doesn’t occur as often as financial or psychological abuse, but it does happen. It involves unwanted sexual contact with an elderly individual, unwanted advances, or sexual activity with someone who doesn’t have the intellectual capacity to consent. 

Elderly sexual abuse occurs the most with elderly persons who have an intellectual disability, such as Alzheimer’s. These people may have heightened sexual urges due to the nature of their disease, which can result in others taking advantage of them.

Sexual abuse can cause physical or emotional injuries such as anxiety, depression, sexually transmitted diseases, or pelvic injuries. It is also likely to overspill into physical or psychological trauma.


Neglect is the most common abuse experienced by elderly patients in nursing homes. It is the failure of a caregiver to meet the medical or psychological needs of an elderly person. It may involve not providing medical care to older adults or not helping with their daily living tasks. 

Elderly neglect may be intentional, such as in the case of a caregiver who deliberately withholds care from an elderly person. It may also be unintentional, such as when a caregiver does not have the capacity to provide the necessary care.

Signs that neglect is occurring can include a deterioration in the individual’s health, malnutrition, or indications of hygiene problems, such as bedsores.

What to Do After Reporting Nursing Home Abuse

If you file a report for nursing home abuse, make sure to document all items in your report. These can include types of abuse, evidence seen, and the names of individuals suspected of engaging in the abuse. Next, consult an attorney to determine whether the nursing home or long-term care facility may be liable for abuse or wrongful death.

Long-term care facilities may be responsible if they are understaffed, have engaged in negligent hiring practices, make medication errors, or provide inadequate staff training. Staff and contractors may be held responsible for intentional harm or neglect.

If you suspect abandonment and other forms of nursing home abuse, reach out to our experienced legal team for a free case review.

Medically Reviewed by:

Dr. Patricia Shelton, MD

Picture of a woman smiling


  • University of Washington, Doctor of Medicine – MD. June 2008
  • University of Washington, Bachelor of Science – BS, Jun 2003


Neuroscience and Medicine


  • Dr. Shelton primarily writes content for health-related websites, but has also written test prep materials, white papers, published research articles, court documents, and more.
  • Dr. Shelton teaches anatomy and physiology at the college level for the National Institutes of Health.

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Our fact-checking process begins with a thorough review of all sources to ensure they are high quality. Then we cross-check the facts with original medical or scientific reports published by those sources, or we validate the facts with reputable news organizations, medical and scientific experts and other health experts. Each page includes all sources for full transparency.