What is nursing home abuse and neglect?

Nursing home abuse can include, but is not limited to the following: physical abuse, rape or sexual assault, over-sedation, and verbal or emotional abuse. Neglect can consist of failure to provide enough clean clothing and bed linens, denial of proper nutrition and medical care, lack of protection from abuse at the hands of other residents, and protection from health and safety hazards.

What are some signs that nursing home abuse is occurring?

It is always important to determine if a resident is receiving proper care. Weight loss, bruises or welts, frequent swelling, dehydration, bedsores, and soiled clothing or bed sheets are clues that abuse is occurring. Also, the resident may appear withdrawn, fearful, or depressed. Regardless of the resident’s mental condition (e.g. suffers from Alzheimer’s or dementia), listen to the resident and look for evidence. Often, doctors and nurses who are busy attending to many residents at once, overlook physical, as well as emotional signs of abuse.

Are there other forms of nursing home abuse?

Yes. Other forms of abuse can include the misappropriation or theft of a resident’s funds or property, restriction of private phone calls or visits from family members and friends, restriction of visits from any state or local representative, noncompliance with the resident’s decision to allow or not allow visits, preventing the resident from moving or changing facilities (if the resident is not mentally capable of such a decision, the immediate family can intervene), restriction of a resident’s religious observances, and the unlawful eviction of a resident. (Federal law requires that all care facilities provide a 30-day written notice and must document a legal reason for discharge such as failure to pay rent, inability to provide specific medical treatment, etc.)

Once abuse is determined, where and to whom should it be reported?

If you feel that a resident is in fact being abused, notify the nursing home administrator immediately. Federal law requires administrators to report claims of abuse to state agencies, whose investigators will be assigned to the case. You can also contact the Ohio Long-term Care Ombudsman at 800-282-1206 or at

However, if the resident appears to be in immediate danger, contact the police or any local hospital to have the resident removed from the facility until arrangements can be made with another care provider. Usually, the very report of abuse prompts the facility to immediately remove the abusive perpetrators, but if it is unclear who committed the abuse, more investigation is required, and the resident is better off being away from the facility.

Why is nursing home abuse becoming so common?

There are several factors that shed light on the increasing reports of elder abuse and why long-term care facilities are experiencing such problems: Nursing home employees are usually paid significantly less than hospital employees, they are expected to do more work in a shorter period of time, and some facilities are dangerously understaffed. Given these stressful working conditions, it becomes increasingly difficult to attract and keep qualified, skilled, and adequately trained staff capable of providing high-quality care.

Is there a way to rule out chances of abuse when selecting a care facility?

The most important step is to visit the facility — talk with staff and the other residents who live there, and observe the living conditions. Notice if residents seem happy and well-cared for. Also, notice if phones ring for long periods of time without being answered, or if trays are left in the halls or rooms long after meal time. You can also review nursing home inspection reports to check the current staff’s qualifications and length of employment.

The most effective prevention is to combine strategies to ensure a resident’s proper care. Under the Nursing Home Reform Act, an assessment of the resident’s interests, personality, and health care needs are used to develop a care plan that determines not only how the resident will be cared for but also who will carry out the various tasks. State and federal legislation requires documentation of these care plans. You should then monitor the plan and make sure it is being followed. Check records regularly, maintain contact with nurses and doctors, and participate in care plan meetings. Help the resident stay connected with family, friends, and other residents as much as possible, as social isolation increases the risks of abuse. Also, monitor any new employees who become responsible for the resident’s care. Ask to see their credentials and inquire of their background.

To learn more about prevention strategies, or the Nursing Home Reform Act, visit the National Center on Elder Abuse at