Signs of
Nursing Home Abuse - What are Signs of Nursing Home Abuse?

Nursing home abuse can be devastating to the elderly person who experiences it, as well as their families and friends who witness it. It may involve intentionally causing harm, or neglecting to provide the elderly person with proper care.
The abuser is often someone that the elderly person should be able to trust, such as a caregiver or relative. Unfortunately, for a variety of reasons, the abuser may take advantage of the relationship and cause mental or physical harm.

Incidents of nursing home abuse are quite common in the United States, so it is very important to recognize the signs that it may be occurring. The statistics of injuries and nursing home abuse are quite concerning:
- 64% of staff at nursing homes admitted to elder abuse in 2019
- Victims of nursing home abuse experience a mortality rate three times higher than non-victims
- For every reported case of elderly abuse, there are about 24 unreported cases
- Cases of elderly neglect are even higher, with only 1 in 58 cases reported
- An estimated 5 million elderly people are abused each year
With the prevalence of sexual nursing home abuse, it’s obvious that steps need to be taken to curtail it. Individuals who are around the elderly regularly may be in the best position to recognize the warning signs of elder abuse.
Types of Nursing Home Abuse
The common types of nursing home abuse include physical abuse, emotional abuse, financial abuse, sexual abuse, and neglect.
Physical Abuse
Physical abuse includes using violence or force against an elderly person in an effort to cause injury or harm. It may take several different forms, including physical violence, threats of violence, or inappropriate physical restraints.
This type of abuse is more commonly committed by someone with mental health or substance abuse issues. A caretaker may also perform an act of physical abuse if they are particularly tired or stressed out.
Finally, some elderly people have dementia, which may lead to aggressive behavior. A caregiver who experiences an elderly person’s anger may lash back.


Emotional Abuse
Emotional abuse occur when an individual attempts to demean, intimidate, or belittle an older person with words or actions. It can include verbal abuse, such as yelling or cursing at an older person, withholding critical support, isolating them from friends, or limiting choices so they are no longer independent.
Psychological abusers may have long-standing patterns of behavior like the inability to communicate with others to resolve their problems. They choose to act by using insults or derision instead.
Financial Abuse
A common type of abuse experienced by the elderly is taking money or property without their knowledge, understanding, or consent. This may include directly stealing their assets, such as money or property, or creating a scheme designed to take their money that they don’t understand.
Financial abusers of the elderly may include their inner family circle who have knowledge of their finances and take advantage of their trust to gain access to money for their own purposes. Outsiders may take advantage of the elderly by offering services that they don’t need, such as home remodeling or scams through the internet.


Sexual Abuse
Senior sexual abuse can take a few different forms. It may arise when someone close to an elderly person makes unwanted advances towards them or actually initiates an act of sexual assault.
It can also occur between two elderly people who do not have the mental capacity to consent to sexual contact. This is common when one person has a condition, such as Alzheimer’s disease, that causes them to act out inappropriate sexual urges.
Victims who have a disease involving mental incapacity may be unable to communicate that they have been sexually assaulted or taken advantage of. This can severely exacerbate the issue.
Neglect
Neglect is the most common type of nursing home abuse. It occurs when a caretaker doesn’t ensure that the elderly patient has their physical, psychological, or social needs met. For example, they may not receive their medication or food in a timely manner, or their hygiene needs may suffer.
Oftentimes, neglect occurs due to a shortage of staff at an assisted living facility or nursing home. It may also happen when a caregiver is unable to meet the needs of the victim because of their own medical problems.
Many elderly individuals are vulnerable to neglect because they have a high need for care.


Common Signs of Physical Abuse in Nursing Homes
Once you know what to look for, it is easier to determine whether an elderly resident is being physically harmed.
Common signs of physical abuse include:
- Bruises, black eyes, welts, lacerations, or rope marks
- Bone fractures, broken bones, or skull fractures
- Open wounds, cuts, or wounds that do not heal
- Sprains or dislocations
- Broken eyeglasses or other signs of being physically mistreated
- Signs of bodily injury
- Medication overdoses or under-utilization of prescribed drugs
- Changes in behavior
- Elderly person reports being hit, slapped, or otherwise injured
If you notice any of these signs of abuse, it is important to take action and ask for additional help.
Common Signs of Emotional Abuse in Nursing Homes
Evidence of emotional abuse isn’t always immediately apparent. A sudden change in behavior is often a red flag that an issue exists. You may also witness a situation where another person is controlling a vulnerable elderly person in an inappropriate way.
Other warning signs to look for include:
- Being emotionally upset or agitated
- Seeming unusually withdrawn, non-communicative, or non-responsive
- Odd behavior, including sucking, biting, or rocking
- Changes in sleeping patterns or eating habits
- Changes in personality
- Depression or anxiety
- An older person’s report of being mistreated
While psychological abuse won’t leave physical marks on an older person, it can lead them to act in unusual ways.
Common Signs of Sexual Abuse in Nursing Homes
Sexual abuse is the least common form of abuse experienced by people in nursing home facilities. However, it does occur.
Common red flags include:
- Bruises around the breast or genital area
- Unexplained venereal disease or genital infections
- Irregular vaginal or anal bleeding
- Showing fear or agitation when a particular person is around
- Pornographic material being shown to an older adult with intellectual impairments
- Blood found on sheets, linens, or clothing
If you see warnings of sexual abuse, it’s important to have the elderly person examined immediately and try to determine who is performing the abuse.
Common Signs of Neglect in Nursing Homes
Dehydration and malnutrition due to neglect is a very common occurrence, especially in nursing homes or assisted living facilities. Oftentimes these places are understaffed, and if an elderly person doesn’t have trusted family or friends checking in on them regularly, there may not be as much pressure on staff to ensure they receive adequate care.
Signs of neglect can include any of the following:
- Dehydration, malnutrition, untreated bedsores, and poor personal hygiene
- Unattended or untreated health problems
- Hazardous or unsafe living arrangements
- Unsanitary living conditions, such as soiled bedding, strong odors, or inadequate clothing
- Abandoning an older adult at a hospital, nursing facility, or other public location
- Lack of food available in refrigerators or cupboards
- Elder’s reports of being neglected or abandoned
If you visit your elderly family member and see that they are not adequately taken care of, it is important to step in and ensure they get the assistance they need. You may need to visit more often or have them transferred to a more attentive facility. If this is a regular occurrence or if the neglect is severe, you should file a report.

Common Signs of Financial Abuse in Nursing Homes
Many elderly individuals fall prey to financial abuse. They may have mental limitations that prevent them from understanding when they are being taken advantage of monetarily.
Indications of financial abuse to look out for are:
- Changes in bank accounts or banking practices
- Unexplained withdrawal of large sums of money by someone accompanying the elderly individual
- Inclusion of additional names on the person’s bank signature card
- Abrupt changes in a will or other financial document
- The disappearance of funds or valuable possessions
- Unpaid bills despite the availability of funds
- Forged signatures for financial transactions or titles to possessions
- Uninvolved relatives who appear and want rights to the elderly person’s property or possessions
- The sudden transfer of assets to a family member or another individual
- Provision of services that aren’t necessary
- An older adult’s report of financial exploitation
- Unexplained credit card charges
If an elderly person is unable to fully look after their finances, it may be best to hire an independent trustee who can provide a duty of care and ensure their finances are properly maintained. This is especially true if there are divisions in the family or if people close to the elderly person show signs of financial distress.
Risk Factors for Nursing Home Abuse
There are a number of risk factors that can increase the chance of an elderly person falling prey to abuse. These may be traits associated with the victim or with the perpetrator. They can also be associated with the living environment itself.
Common elements or traits of elderly individuals who experience such abuse include the following:
- Chronic medical conditions and poor physical health
- Functional disability and dependence
- Mental health problems
- Cognitive deficits
- Financial dependence
- Lower socioeconomic status
- Substance abuse
- High levels of stress and poor coping mechanisms
- Prior exposure to trauma
- Limited social support
- Poor relationship between the victim and the perpetrator
- Chronic medical conditions and poor physical health
- Mental health problems
- Cognitive deficits
- Financial dependence
- Substance misuse
- High levels of stress and poor coping mechanisms
- Negative attitudes toward the older adult
- Early childhood abuse
Many of the traits associated with a person who is more likely to commit abuse are similar to the victim’s traits. If the abuse occurs between family members, there may be a history of conflict within the family extending all the way back to childhood.
When an elderly person is put in a nursing home, there may be a risk of abuse if the facility is understaffed or has a history of poor care. While it may not be possible for the elderly individual to live on their own or with a family member, it’s important to choose a facility with a strong reputation for maintaining the health and sanitation practices of its patients.
Before selecting a home, ensure that you perform significant research. Visit it to see if patients seem happy and taken care of. Speak with nurses and other staff members and observe the level of cleanliness in the facility. If it seems worn-down, smelly, or dirty, it is likely not somewhere you would want your loved one to spend their days.
What to Do If You Suspect Abuse in a Nursing Home
Whether you are a family member or friend of a nursing home resident or an employee or contractor of a nursing home, you should always be alert for signs of abuse of the elderly.
Many elders aren’t in a position to defend themselves or to ensure that they are being treated fairly. Checking in on them regularly and notifying staff if there appears to be an issue can go a long way to improving their well-being in their later years.
If abuse seems to be severe or continuous, it is important to document it and give details of signs and patterns to the nursing home administration.
If nothing changes, reach out to your state government for assistance. They have advocates who work on behalf of elderly individuals who are residents in nursing homes or other similar types of facilities.
For example, the Administration of Aging oversees the Long-Care Ombudsman Program. You can find the contact information for your state through the Consumer Voice website.
In addition to the Long-Care Ombudsman Program, Adult Protective Services can also assist with filing a report of suspected elderly abuse.
If you suspect nursing home abuse or wrongful death, reach out to us for a free case review. We can listen to your concerns and assist you with documentation to ensure the elderly person in your life receives the care that they deserve.
