Recognizing Signs Of Abuse and Neglect

• Physical Abuse
• Emotional Abuse
• Neglect
• Nutrition and Hydration

What you may have once dismissed as simply the signs of getting older, may be something more - abuse or neglect. If you find your loved one more listless, more agitated, or suffering more of the effects of dementia when you visit them, you need to be concerned. Here are some signs to look for:

Physical Abuse

Physical abuse can be the most obvious to detect. Take notice of any open wounds, cuts, bruises, welts, discoloration, or broken bones. If the facility staff cannot adequately explain what has happened, you need to immediately take steps to investigate. Also, take note of any sudden change of behavior in your loved one. If he or she begins to cower when certain staff members approach, that could be a sign of physical abuse.

If you witness someone abusing your loved one or another resident, take immediate action. Move the resident to a safe location such as a hospital or another nursing home and call 911, the State's Adult Protective Services Department, the State Survey Agency, and the facility administrator. You may also wish to contact an Ombudsman.

Emotional Abuse

Emotional abuse may be more difficult to recognize. Look for signs of your loved one being unusually upset or agitated, extremely withdrawn, or noncommunicative. If you notice unusual behavior, like rocking in bed or sucking a thumb, you may be witnessing the aftershocks of serious emotional abuse. Sometimes residents will not tell you what is happening to them because they are fearful of retaliation from facility staff.

Neglect

can also be difficult to determine. If you notice your loved one losing weight and becoming listless he or she may not be getting the nourishment and food needed to maintain his or her health. Dry cracked lips and skin is a sign of inadequate hydration and the need for more fluids.

To detect other signs of neglect you have to familiarize yourself with some of your loved one's more intimate details. You may need to discretely examine undergarments and skin to see if they are soiled with feces or urine. Residents who lie in their waste are much more likely to develop preventable pressure sores.

If you recognize any of these situations, your loved one may be neglected or abused. There are steps you can take if suspect abuse or neglect. You should first contact the administration at the home. Express your concerns and problems immediately and demand action be taken to improve the conditions.

If you do not get any response from the facility you should contact the state department that regulates nursing homes and file a complaint. The state will visit the facility and investigate the situation. Be sure to follow-up with the investigator to see what actions are being taken to improve care.

You should also contact the state's Ombudsman. The Ombudsman serves as a resident advocate and supports residents' highest possible quality of life and is responsible for investigating, and attempting to resolve concerns and complaints made by, or on behalf of, residents.

Nutrition and Hydration

Lack of proper nutrition, or malnutrition, can be a serious health problem for older people. This problem is more than not getting enough to eat. It also can mean not getting enough vitamins and minerals in your food or not being able to process food after eating.

There are different reasons for malnutrition. Some people just cannot feed themselves and the nursing home does not have enough staff to help them eat. Poor dental health can make eating difficult. Another reason for malnutrition is certain physical conditions and the medications used to treat them can alter the taste of food. If food doesn't taste or smell good, people may not feel like eating. Whatever the reason, the effects of malnutrition can lead to confused thinking, a reduced resistance to illness or the ability to recover from illness, and reduced physical ability.

Dehydration is another serious health problem for many older people who may take multiple prescription drugs that dry out their bodies. People in long-term care facilities may become dehydrated because:

• Water and other fluids may not be readily accessible, or may not be offered to residents frequently enough;
• Residents with dementia may not recognize water pitchers or water fountains and must depend on staff to offer fluids;
• Residents who need assistance with drinking may not get it due to lack of staff;
• Bed-bound residents may not be able to reach the water pitcher;
• They have a decreased sense of thirst and just do not feel thirsty;
• They want to avoid going to the bathroom as often if moving about is difficult for them; or
• They do not get help quickly enough to get to the bathroom and are afraid of incontinence.

Not getting enough fluids is dangerous. It can make people more vulnerable to illness and problems like low blood pressure, dizziness, and confusion. Dehydration can lead to hospitalization and even death.

Abuse and neglect in any form should not be tolerated. When all is said and done, you should take any and all steps necessary to protect the safety of those you love, including moving the resident to another facility. If they are not receiving adequate and appropriate care, you may need to take steps to enforce your legal rights. Don't stand for abuse or neglect. Take action.