What Are the Causes of Abuse in Nursing Homes?

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There are many different causes of nursing home abuse, one of which is understaffing. When there are not enough staff members to efficiently provide care, residents may be neglected or mistreated. Additionally, some staff members may lack proper training or may be overworked and stressed, which can lead to abuse. In some cases, residents may also be abused by other residents due to mental or physical health issues affecting the aggressor. Overall, addressing these causes of nursing home abuse requires increased staffing and training, as well as better education and support for residents and their families.

Staffing Shortages

Unfortunately, many staff members at nursing homes are overworked due to staffing shortages. When staff members have to cover multiple shifts or work double shifts without a break, it can be hard to provide high-quality care.

While some staff members function well under pressure, most have a breaking point at which they act in ways that are out of character. When a nursing home experiences a staffing shortage, some responsibilities get pushed to the top of the priority list while others fall off. In the short term, this may be necessary to provide the residents with vital care.

Over time, however, letting small responsibilities go can mean that some residents do not get the care they need. Some residents may be prioritized over others. Those who require more time and attention or are stressful to care for may fall to the bottom of the priority list. This can lead to neglect.

An understaffed nursing home can result in staff members feeling angry and stressed, even if they got into the field due to their love of caring for elderly patients. When staff members have a hard time prioritizing patient needs due to work-related stress, it can be hard to maintain a high standard of care.

Lack of Training

Staff shortages often lead to nursing homes onboarding new staff members quickly, which can mean some staff members do not get the training they need before providing patient care. Often, new staff members are doing their best to care for patients but are unaware of best practices and protocols.

Many nursing homes have standard training procedures in place. However, some new staff members may be pulled to take on more responsibilities than they’re ready for in the event that a nursing home is struggling to cover shifts. New staff members may not intentionally abuse patients, but their lack of knowledge and training can make it difficult for them to provide proper care.

Inexperienced Staff Members

Learning on the job is a key part of a nursing home caregiver’s training. Some nursing homes require that staff members shadow more experienced caregivers as a part of their training. When staffing shortages occur, this may not happen, as both the more experienced and less experienced staff members may need to care for patients on their own.

Inexperience can make it hard for caregivers to understand how to properly care for patients. In a nursing home, patient care is nuanced, and different patients receive different types of care. When shadowing a more experienced staff member, caregivers get the opportunity to learn about what each patient needs, and how to care for them properly. With shadowing and other on-the-job experience pushed to the side, staff members may struggle to get the knowledge that they need to perform patient care duties.

Poor Staff Self-Care

There’s no doubt about it—working in the health-care field is stressful, and it can be hard for nursing home staff members to find the time for self-care in their day. When nursing home members are working multiple shifts and are taking on overtime each week, they may find that their sleep, home life, and other factors of life outside of work suffer.

It’s important that health-care staff members have the ability to take the time they need to recover from their work, which can be both physically and emotionally taxing. When staff members aren’t dealing with personal stress in a way that helps them get through the day, they can end up taking stress out on patients. While this can lead to acute abuse, it can also lead to general neglect of patients. Staff members who are under stress and unable to prioritize self-care may be more susceptible to patient neglect as well.

Underpaid Staff

Many health-care positions offer low levels of pay. When staff members aren’t paid appropriately for their work, they may experience burnout. Staff members who are going through burnout due to low payment are often struggling with more than just work stress—they often struggle to make ends meet at home as well, which leads to additional stress.

When a staff member is angry for not being properly compensated for their hard work, they may feel less inclined to do their job well. Unfortunately, this doesn’t just affect management—it directly impacts residents in the staff member’s care.

Poor Supervision and Accountability

In addition to staffing hands-on caregivers, it can be hard to find nursing home supervisors who have the experience necessary to properly manage others. Often, this results in poor accountability, which means that staff neglect and abuse may go unnoticed or unreprimanded by nursing home management.

Even the best nursing home managers may find that they have a hard time balancing their responsibilities while also keeping an eye on staff members and watching out for signs of nursing home abuse. High turnover rates and constantly needing to train new staff members can take up much of a nursing home supervisor’s time during periods of staffing shortages.

Caregiver Home Issues

Stress at home—such as going through a divorce, managing the care of aging parents, and dealing with childcare issues—can all negatively affect a caregiver’s mental health and can make it more likely that the caregiver will participate in abuse or neglect of patients in their care. If a caregiver is dealing with an issue that makes it difficult for them to properly care for their patients, it’s important that they talk with their supervisor and let them know that they need extra support.

Resident Risk Factors

Sadly, patients who need high levels of care in a nursing home are at higher risk of abuse than patients who need low levels of care. Patients who have conditions such as memory issues or dementia may cause higher levels of stress for caregivers than other patients, which can cause caregivers to inappropriately take out stress on these patients.

Patients who have mental illnesses (like anxiety and depression) may also be more difficult to care for than others, putting them at a higher risk for abuse. Women are also more likely to experience nursing home abuse than men.

Signs of Nursing Home Abuse

If you have a loved one who is living in a nursing home, it’s important to be on the lookout for signs of physical and emotional abuse and neglect. Signs of physical abuse include bedsores, broken bones, cuts or skin tears, dental injuries, fatigue, dehydration, and malnutrition. Signs of emotional abuse can be harder to spot and may include anxiety, substance abuse, aggressive behavior, and suicidal thoughts or actions.

Medically Reviewed by:

Dr. Patricia Shelton, MD

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  • 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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Nursing Home Abuse Should Have Consequences.

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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.