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Are You or a Loved One Suffering Bedsores or Other Forms of Neglect or Abuse?

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The elderly are all too often silent victims of abuse and neglect in a place you assume will keep them safe. Nursing homes have gained notoriety for neglecting patients and even committing outright abuse. Many times, no one notices the effects, and the senior is too afraid or unable to speak up about what is happening.

Abuse should never happen in a place that is supposed to be committed to keeping people safe and healthy, regardless of their age or condition. If you suspect abuse to someone you love, you should report it. You may also be entitled to compensation for the injuries and other damages in this kind of case. However, you must understand what abuse and neglect are, how to recognize them and what to do when you see it is happening.

What is Elder Abuse and Neglect?

To understand how to deal with abuse or neglect of an elderly loved one, you must know what it is and be able to recognize the signs. While the majority of elder abuse cases are female, elderly men may also suffer abuse. A report from 2010 showed that over half of the staff in a nursing home admitted that they had mistreated elderly residents in the past year. While most of the incidents were from neglect, there were instances of abuse, both physical and mental.

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It is estimated that only one in five cases get reported, which means the numbers may be even higher. When you realize how prevalent the situation is, you recognize the need to be more aware of what happens with your loved one in a long-term care facility.

Abuse of an elderly person may include any of the following:

  • Physical abuse
  • Verbal abuse
  • Emotional abuse
  • Sexual abuse
  • Financial abuse
  • False imprisonment

Physical abuse may include hitting, slapping or other physical contact with a person. Signs of this type of abuse include broken bones, injuries from a fall, bruises, marks from restraint and medication overdose. Verbal abuse includes calling someone names, yelling at them, getting mad and raising their voice when the elderly person does not respond. The elderly person may be fearful around their abuser or other people, they may show signs of anger or depression, may mumble incoherently and rock back and forth.

When the abuse is emotional, the abuser may appear angry or ignore the senior. They may try to manipulate them to get the person to do what they want. The elderly person may be agitated or cry often, or show signs of depression. They may isolate themselves and have changes in their personality.

Sexual abuse also happens more frequently than you might imagine. Signs include bleeding or bruising in the private areas, complaints of soreness or sexually transmitted diseases. The person often appears frightened and may be depressed or anxious.

Financial abuse happens when someone uses the elderly patient’s checking or savings account information for their own expenses. They may take a credit card or even cash without their knowledge or force them to give the money.

False imprisonment occurs when someone will not allow the elderly person to leave a room. They may take away a wheelchair, walker or crutches so they cannot leave. The person may also threaten them if they attempt to leave. In some cases, the person may actually be restrained.


Neglect is different from abuse, but it can be just as serious. Neglect is more about what is not done rather than what is done. It can happen when the person fails to feed or bathe the person or does not turn them as often as they should or fails to perform other bask personal care tasks.

Signs of neglect are often easier to detect. They can include dirty clothes, bedsores, loss of weight from lack of food, unwashed and uncombed hair and an unpleasant odor. The patient may develop more health problems or experience a lack of energy. Neglect can even come from a lack of supervision for a patient that needs continual monitoring. A person who wanders outside of the facility and is not found for several hours may be a victim of neglect.

While most abuse happens between the caregiver and patient, it can also occur between two patients. One resident may be abusing another and the staff may not be aware.

Late Stage Bedsores Should Never Happen

Considered ‘never-events’ by the medical community, late-stage bedsores (stage 3 and stage 4) should never occur in a hospital setting. Yet, more than 2.5 million patients will develop bedsores this year alone while being cared for in hospitals, nursing homes, rehabilitation centers, and in-home healthcare settings. Worse is that 60,000 patients diagnosed with bedsores will die as a direct result of them.

Bedsores also called pressure ulcers and decubitus ulcers, are diagnosed based on stages. Stage 1 and Stage 2 bedsores are an indication of tissue breakdown. But Stage 3 and Stage 4 bedsores are indicative of a serious care problem because bedsores typically get this bad when the patient is a victim of improper care.

Some patients are more prone to bedsores, such as patients with limited mobility and the elderly, but patients who are undergoing cancer treatment, have poor circulation or a lung condition, those who have cardiovascular disease, are diabetic, have neurological issues, and who suffered a stroke are all more likely to develop bedsores if precautions are not taken.

When patients who are more likely to develop bedsores are admitted to healthcare or medical facilities, a care plan should be developed that discusses how staff are to prevent, diagnose, and treat bedsores for that specific person. Part of the plan should entail monitoring the patient regularly for tissue breakdown, repositioning the patient on a regular schedule, such as every two hours, based on that patient’s risk assessment and current health, and keeping the patient clean and dry.

Common Areas for Bedsores to Develop

Bedsore danger zones for patients confined to bed include the side and back of the head, shoulder blades, elbows, lower back, hips, buttocks, tailbone, ankles, heels and behind the knees. All of these places are points of direct pressure between the body and the mattress.

Patients who are confined to a wheelchair may develop pressure ulcers on their buttocks, upper thighs, behind the knees, elbows, shoulder blades, forearms, spinal column, tailbone, and soles of the feet. These are the places of the body that make direct contact with the wheelchair, making them more likely to suffer tissue break down and sores.

Patients who must lay on their fronts for extended periods of time, such as those with spinal surgeries or burn victims may develop decubitus ulcers on their chests, lower abdomen, hips, thighs, knees, shins, and the tops of their feet as these are parts of the body that are under direct pressure.

But bedsores can also develop anywhere the skin stays moist, such as in the fold of the skin, so care must be given to these areas also.

Four Stages of Bedsores

Be aware that bedsores are extremely painful, even at the first stage, so any complaints of sore or tender areas must be investigated quickly.

Stage 1 bedsores typically involve the upper layer of skin. They may feel hotter or cooler to the touch than the surrounding skin and if you press your finger on the suspect area, it generally will not blanche with color. The sore may appear pink, red or discolored. If proper treatment is given, Stage 1 bedsores can heal quickly, sometimes in less than a week, depending on the patient’s health.

Stage 2 bedsores have penetrated to the deeper layers of the skin and may look red, swollen, and angry. The sore may ooze pus or fluid or look like a blister. If the patient receives proper care now, the wound may heal in weeks.

Stage 3 bedsores have penetrated through the skin layers into the fatty tissue beneath. The wound may drain fluid or pus, have a foul smell, and have black or dead tissue. The patient may require antibiotics for infection, and the wound may need to be carefully cleaned by a doctor. If proper treatment is given now, the wound may heal in weeks to months or longer, depending on the patient’s health.

Stage 4 bedsores have penetrated to the ligaments and muscles, and you may be able to see bone. The skin surrounding the sore is black with hot, red edges. The wound has a foul smell and may drain pus and infection. Surgical intervention is typically needed at this stage and even with proper care, it could take months if not years for the wound to heal.

Bedsores start because of lack of monitoring and progress to late-stage wounds because of lack of proper care. In fact, the Department of Health and Human Services has established federal guidelines for the prevention and treatment of bedsores and all facilities are required to follow them. When they don’t, it is always the patient that suffers most.

Why Abuse Goes Undetected

Many times, the abuser can continue their abuse for weeks or even months without being caught. The victim may be unable to tell others if they cannot speak or if they are confused or suffer from dementia. Often, they are afraid to speak up because they fear no one will believe them or the abuser will find out and treat them worse.

Family members may not visit as often as they would like because they live far away or have busy lives of their own. When they see their elderly loved one and the changes from the abuse, they may assume it is part of the normal process of aging. In fact, it is quite possible for the elderly person to die from neglect or abuse and no one to know the real reason why.

Nursing homes are often understaffed, so other staff may not pay enough attention to the patients who are victims of abuse. A quick glance or conversation in the hall is not usually enough time to assess the person’s health and demeanor and recognize the need for concern.

Reporting Abuse or Neglect

If you suspect abuse or neglect, you must report it. You can begin by reporting it to the director of nursing. They should launch an investigation into your report to find out if there is evidence to support the suspicion of neglect or abuse.

If nothing is done or the report comes back with no evidence of abuse, you can take it a step further and contact Adult Protective Services.  You can also contact your state’s Department of Health or the Department of Aging Long-Term Care Ombudsman. If the abuse is criminal, you can even go to the police or the state Attorney General’s Office.

Just make sure you follow up on any complaints you file to make sure action is being taken. Your elderly loved one should be removed from the situation as quickly as possible to ensure their safety.

Negligence Under the Law

A nursing home is responsible for the safety and care of its residents. The facility may be held responsible for abuse or neglect to one of its patients in certain circumstances. If the nursing home or any employee fails to provide care which is considered adequate and reasonable, they may be liable for negligence. If the facility fails to investigate claims of abuse, they may also be held responsible.

To determine if there is a legal case for negligence or other charges for the nursing home or a staff member, you may need to do some research. You cannot assume that a fall is normal for your loved one or that medication is affecting their ability to function. Ask questions about your loved one’s health and any concerns you may have. Find out what caused the fall and what safety procedures are in place to ensure it doesn’t happen again.

There are several ways you can take action against a nursing home you believe has been involved in either abuse or neglect. The most obvious is to file a claim of negligence. You can also file a breach of contract since the facility failed to provide the care that was promised in the contract you signed.

Other options include a violation of the person’s civil rights or consumer protection violations. There may be licensing violations or False Claims Act if the facility was reimbursed by the government for the resident’s care. Criminal charges may be filed for some types of abuse.

Most states have a patient’s rights law which defines the rights of long-term care residents. These right include the right to:

  • A safe, clean environment
  • To be treated with dignity and respect
  • Prompt response to all reasonable requests
  • Adequate care which is appropriate to the situation
  • To be free from physical and chemical restraint

One important fact of which you should be aware is the deadline for filing a claim against the nursing home. All states have a statute of limitations, essentially a clock that starts ticking the date you became aware or should have become aware of the injury.

Learn More about Your State Ombudsman

The primary purpose of the Long-term Care Ombudsman program is to advocate for the rights of residents in long-term facilities as well as those who may be placed in such a facility in the future. All services provided by this program are free.

The ombudsmen visit the facilities on a regular basis to ensure adequate care of residents. They handle any complaints against a facility or employee and conduct investigations. They advocate for seniors and they provide information to anyone who needs to know about these facilities.

The ombudsmen handle all types of complaints, including eviction from a facility, disrespectful attitudes from staff members, lack of response to requests, issues with medications, stolen property, falls and other injuries, being handled roughly or lack of hygiene. In fact, over half the time ombudsmen are working is spent handling complaints.

This program has no regulatory or policing power, but they can offer solutions to the families of residents and help find resolutions to the issues. They also have contacts and other resources who can assist families and seniors.

An ombudsman can be helpful when you are choosing a facility or when you need a complaint resolved. You can communicate with them about problems in confidentiality.

When You Need an Attorney

If the issue of abuse or neglect has resulted in injury or death to your senior loved one, you need to contact an attorney. They can advise you on whether you have a case for litigation and if you are entitled to damages for the incident. They are aware of the latest state laws regarding long-term care and can investigate the matter to find the evidence needed to support your claim.

If the injury which derived from abuse or neglect results in medical expenses, you may be entitled to be compensated for those costs. In addition, you may receive damages for the pain and suffering your loved one went through during and after the incident.

It is important to contact the appropriate authorities right away to move your case forward. Even if you are not sure of the cause for the injury to your loved one, you should ensure it is investigated thoroughly and that a satisfactory explanation is found.

Anyone can report elder abuse. If your loved one has suffered at the hands of a nursing home employee or from multiple staff members due to nursing home neglect, there is a chance that other residents have been victims as well. Your loved one should not have to suffer physical, mental or emotional distress as well as the loss of dignity.

Make sure you know what constitutes elder abuse or neglect, that you recognize the signs and that you know how to report it and to whom. Contact an attorney who can help you pursue legal action against those who are responsible for the abuse or neglect to your loved one.

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