A growing concern that goes largely unreported.

An alarming yet silent problem

Much below average – that is the official rating of the quality of care provided in the Brookhaven Manor nursing home in Kingsport, Tennessee, according to the nursing home benchmark maintained by Medicare.gov. Judging by the action taken last December by the Tennessee Department of Health, the assessment does not seem to be unsubstantiated. As local media outlets reported a couple of months ago, new admissions to Brookhaven Manor were suspended after the annual survey and complaint investigation had discovered 9 cases of abuse of the elderly residents. According to a 77-page report, some of the residents were subjected to verbal abuse; others, allegedly, suffered some form of neglect. Apart from the suspension, the facility was also fined $5,000. The Sullivan County District Attorney opened a formal investigation into the matter; however, in February, DA Barry Staubus stated there was no “sufficient evidence of a violation of criminal law” to pursue criminal action.

The controversial case of the Brookhaven Manor nursing home is just the tip of the iceberg of a much larger problem that, reportedly, concerns almost one in ten elderly individuals in the US and which produces more than two million cases a year. More statistics on the issue are equally alarming. For example, it is maintained that as much as a third of all nursing homes’ residents experience some form of mistreatment. According to another study, 5,000 nursing home patients’ deaths in 1999 may have been due to negligence. Also, it has been reported that in 2007, there was on average 20 complaints filed concerning the quality of care provided per one nursing home. What is even more concerning is that it is likely that the grand majority of instances of mistreatment go unreported. It can be expected that, as more and more Americans continue to get older and seek the services and assistance of a skilled nursing facility, more cases of elder abuse will come to the surface. In many circumstances, nursing home elder abuse may constitute a reason to take legal action and seek compensation. Therefore, those whose loved ones may be at risk of experiencing such abuse need to know what it exactly involves, how it can be identified, and what steps can be taken to protect their aging relatives.

Elder abuse – definitions and symptoms

In the context of nursing homes, there are at least 4 types of mistreatment that elders are most vulnerable to. According to one report on long-term care, the most common type of abuse reported is physical abuse. It entails any action in which physical force is used to inflict pain or cause injury. Practices such as force feeding or false arrest – that is restraining someone’s movement against their will – are likewise considered to be forms of physical abuse. Emotional abuse refers to acts that aim at causing distress, discomfort or pain on psychological level. Emotional abuse can be both verbal – for example, resorting to insults or threats – and non-verbal – referring to specific actions that may cause anguish, such as ostracism. If physical or psychological needs of an elderly person are ignored by their caregiver or the facility in which they reside so that it constitutes a breach of duty to provide the care needed, then the caregiver or the facility may be found guilty of neglect. This is probably the broadest category of abuse, especially considering that neglect can be both active and passive; in any case, it consists of a failure to provide things or services that an elder needs. Sexual abuse refers not only to all types of non-consensual sexual acts but also to a situation where an elder is not able to give consent or comprehend the situation. Forced nudity or taking sexually explicit photographs of an elder are considered to be instances of sexual abuse too.

What are the tell-tale signs that an elder may experience some kind of abuse at the facility they reside in? The symptoms will vary according to the type of abuse the resident may be subjected to. For example, in the case of physical abuse, the signs may include some marks evidencing use of physical force, such as bruising or unexplained injuries. Neglect may be evidenced by symptoms such as poor personal hygiene, unclean clothing, sores or rashes. Emotional abuse will entail unexplained mood or personality changes, signs of depression, and withdrawal. In fact, symptoms of emotional abuse may be signs of all forms of abuse since abuse of any kind can reflect on a person’s psychological well-being.

Legal assistance for victims and their families

Those who suspect their loved one may be undergoing some kind of abuse at their nursing home or care facility may turn for help to Adult Protective Services. These agencies not only work closely with law enforcers but also employ specialized personnel trained to investigate cases of elder abuse. When it comes to the protection the law offers for elderly victims of abuse, usually wrongs committed against elders will be prosecuted according to general criminal code. Nevertheless, some states have harsher penalties for perpetrators if the victim is a senior citizen; other enacted specific criminal penalties for elder abuse. If elder abuse does not entail instances of violation of the criminal law, caregivers and nursing homes may still be subject to civil liability lawsuits, especially in the case of neglect.

Of course there are many nursing facilities and caregivers that provide excellent care for elderly citizens. The present article by no means aims to inspire distrust for elder care services or to incriminate nursing homes. However, the sad reality is that the problem of elder abuse in nursing facilities exists and, as data suggest, is severely underreported. Understanding what constitutes abuse, how to identify it, and what legal actions can be taken to fight it, are vital to those who want to ensure that the physical and emotional well-being of their elderly relatives, is properly taken care of.