Nursing home neglect is a tragic but all too common occurrence in the U.S. While many facilities treat all 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.
Per the National Center for Victims of Crime, 15.3% of elder abuse complaints are for neglect. 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 and 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’s 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’s 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 that 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, or 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 don’t do something they should are harder to blame. Despite this difficulty, there has 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 wellbeing of residents. Hygiene, physical and mental health can be directly affected in numerous ways:
- Hygiene Consequences
- Bad odor / smell
- 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 & 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.
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.
Furthermore, nursing homes that allow staff to neglect elders leave themselves open to costly lawsuits. Settlements and punitive damages for cases of nursing home neglect have resulted in payouts of over $1,000,000 in some cases.
Signs & Symptoms of Elder Neglect In Nursing Homes
Neglect can be extraordinarily difficult to detect, as 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:
- Bruises, lacerations, skin tears, broken bones & other physical injuries
- Bedsores / pressure sores / ulcers
- Excessive use of restraints (physical or medical)
- Malnutrition
- Dehydration
- Improper medications:
- Incorrect medication dosages given or prescribed
- Ineffective medications being prescribed long term
- Prescriptions with conflicting medications or excessive side effects
- Burns, often accidentally self-inflicted
- Hygiene issues
- Insomnia / sleep loss
- Significant personality changes
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’re 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 some 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 burnt out, overworked staff who can’t 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 aren’t well suited for a caregiving position. People who have struggled with mental health issues, addiction or have been abuse victims themselves are statistically more likely to become abusers, 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’s 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 are less likely to become victims of neglect, and these social networks should therefore be supported and encouraged within nursing home environments.
Reporting Neglect
Because of 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, as he or she is directly responsible for ensuring quality of care in nursing homes. 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 any elder is experiencing neglect in a nursing home, report it.
References:
- http://www.helpguide.org/articles/abuse/elder-abuse-and-neglect.htm
- http://www.apa.org/pi/aging/resources/guides/elder-abuse.aspx
- https://www.ncbi.nlm.nih.gov/books/NBK98800/
- http://www.bermanlawyers.com/verdicts-settlements/nursing-home-care-facility-case-results/
- http://www.csfwlaw.com/successful_nursing_home_abuse_lawsuits
- https://www.hg.org/article.asp?id=19990
- http://www.cdc.gov/violenceprevention/elderabuse/riskprotectivefactors.html
- https://www.nspcc.org.uk/preventing-abuse/child-abuse-and-neglect/neglect/signs-symptoms-effects-neglect/
- https://www.healthlinkbc.ca/healthlinkbc-files/prevent-abuse-older-adults
