What is Nursing Home Neglect?

Nursing home neglect is a tragic but all too common occurrence in the U.S. While many facilities treat their residents with care, dignity and respect, there are others that fail to meet a basic standard of care. These facilities are neglecting their residents.

Although neglect is less likely to occur in nursing homes and other senior care facilities than within an elder’s own home, it is still a possibility. It also happens more often than it should.

Neglect in nursing homes is most often the result of inadequate staffing. Employees who are stressed or overworked may not be able to provide the quality of care necessary to keep an elder healthy and happy. Some staff and facilities may be actively aware of the neglect, while others may not be cognizant of their shortcomings. Regardless, failure to meet an elder’s basic needs is neglect, and it is always unacceptable.

Elder Neglect vs. Elder Abuse

Elder neglect can be intentional or accidental, but either circumstance is a form of elder abuse.

In some cases, it is clear the neglect is causing direct harm to an elder. These cases of elder neglect are a more severe form of abuse and may overlap with physical or emotional abuse. Individuals who recognize they are neglecting an elder and willingly continue to do so must be held directly responsible for their actions.

More commonly, caregivers neglect elders due to a lack of resources or support. For example, understaffed nursing homes may find it challenging to maintain weekly bath quotas. Understaffed facilities may result in an environment where individuals only receive care on a pre-set schedule without room for necessary modifications when unexpected needs arise.

Unfortunately, neglect can be challenging to prosecute within the U.S. as our legal systems tend to require action for liability. Individuals who simply do not do something they should are harder to blame. Despite this difficulty, there have still been numerous successful elder neglect lawsuits, especially when the consequences are severe.

Consequences of Nursing Home Neglect For Elders

Nursing home neglect can have a significant impact on the health and well-being of residents. Hygiene, physical and mental health can be directly affected in numerous ways.

Consequences of nursing home neglect include:

• Hygiene Consequences
  • Poor odor
  • Dirty skin or orifices
  • Unclean clothes
  • Ill-fitting, damaged or missing clothes
• Potential Health Consequences
  • Untreated medical or dental issues
  • Failure to provide proper medication
  • Recurring sicknesses
  • Repetitive injuries
  • Weight loss or malnutrition
  • Dehydration
  • Anemia
  • Fatigue
• Social & Emotional Consequences
  • Unpaid bills or other debts
  • Personality changes
  • Depression, anxiety or fear
  • Isolation and loneliness
  • Loss of trust in others
  • Insomnia or sleep loss
  • Substance use or abuse
  • Suicidal thoughts or actions

In the most severe cases, elder neglect in nursing homes will result in death.The Boston Globe reported that a Vietnam veteran died in a Massachusetts nursing home because his nurse spent the night playing video games while on duty instead of checking on him.

The report also revealed widespread dissatisfaction with other patients and families in the facility. Complaints include patients going long hours without food or changes of clothes and even months without showers—obvious signs of neglect.

Consequences Of Neglect For Nursing Homes

In many states, the contract between a nursing home and an individual in care is a legally binding document. Failing to provide adequate care can result in administrative, civil or criminal penalties. Some states also have statutes for eliminating institutional abuse, giving prosecutors additional laws to work within.

Individuals or nursing homes found to have neglected an elder may also be denied the ability to continue their work with the elderly or other vulnerable individuals. In addition, they may be subject to significant fines or lose their licenses entirely.

Signs & Symptoms of Elder Neglect In Nursing Homes

Neglect can be extraordinarily difficult to detect because it often requires the testimony of witnesses. Neglect is also most likely to happen to people with mental impairments, like dementia, making it even more challenging to identify and resolve. However, there are some common symptoms of abuse and neglect that can help identify when an elder is being neglected.

Common signs and symptoms include:

• Bruises, lacerations, skin tears, broken bones and other physical injuries
• Bedsores/pressure sores/ulcers
• Excessive use of restraints (physical or medical)
• Malnutrition
• Dehydration
• Burns, often accidentally self-inflicted
• Hygiene issues
• Insomnia/sleep loss
• Significant personality changes
• Improper medications
  • Incorrect medication dosages given or prescribed
  • Ineffective medications being prescribed over long periods of time
  • Prescriptions with conflicting medications or excessive side effects

Physical injuries that result from neglect are often accidents from situations that are entirely preventable. For example, a staff member who rushes through their tasks due to understaffing may unintentionally cause an injury or fall.

Elderly individuals who have managed to hurt themselves while in nursing homes may not be receiving the proper level of assistance. For example, an individual in a low interference living facility who accidentally sets fire to their kitchen may need more supervision than they are receiving. Caregivers should be responsible for recognizing these needs and acting on them.

Preventing Neglect

Neglect is generally caused by inaction rather than action, which means most instances can be prevented with forethought, planning and care. There are many ways that nursing homes can prevent neglect.

These include:

• Ensure adequate staffing levels
• Provide proper training for staff
• Implement effective employee vetting
• Provide elder abuse education for staff and residents
• Encourage strong support networks
• Develop reporting procedures
• Take all complaints seriously

Elder neglect is most likely to occur when caregivers are stressed, either due to improper training or too much responsibility. Impossible workloads lead to overworked staff who cannot fulfill their duties and are more likely to make mistakes. Therefore, proper staffing and ongoing training are two of the most beneficial ways to prevent elder neglect in nursing homes. Adequate staffing and education should be every nursing home’s first line of defense in preventing neglect.

In addition, nursing homes can ensure they hire the right individuals to be caregivers. Criminal record checks and extensive interviewing can help vet potential employees and eliminate candidates who are not well-suited for a caregiving position. People who have struggled with mental health issues and addiction or have been abuse victims themselves are statistically more likely to become abusers when compared to individuals without these troubles.

Creating a system for reporting and reviewing complaints is an important quality control measure that can help prevent abuse of all forms, including neglect. It is critical that nursing home staff know the processes and procedures for reporting concerns and that proper action is taken after those concerns are received. In addition, elders who come forward with abuse allegations should be taken seriously and have their complaints heard with a non-judgemental perspective.

Enabling seniors to have a strong social community is yet another way to help prevent neglect. An individual surrounded by friends, family and visitors is less likely to become a victim of neglect. These social networks should, therefore, be supported and encouraged within nursing home environments.

Reporting Neglect

Due to the severe consequences of elder neglect, it is critical that all cases of neglect are reported. Reporting neglect helps ensure the health and safety of the individual, and it puts pressure on nursing homes to improve their practices for all residents.

The local Long-Term Care Ombudsman should always be contacted when neglect occurs within an assisted living facility. The Ombudsman in each individual state will have their own processes for investigating claims of elder neglect and ensuring all elders are receiving proper care.

In addition to the local Ombudsman, local law enforcement and social service workers can also be involved. Individuals who report elder neglect are welcome to involve numerous authorities if desired.

If you suspect that you or your elderly relative is experiencing neglect in a nursing home, report it.