Recognizing the Early Signs of Nursing Home Neglect: A Family’s Guide

Recognizing the Early Signs of Nursing Home Neglect: A Family’s Guide

Placing a loved one in a nursing home is a difficult decision for many families, and the expectation is that they will receive the best possible care. However, nursing home neglect remains a real issue in many facilities, often manifesting in subtle ways before it escalates into more serious harm. Nursing home abuse and neglect is such a pressing problem, that research suggests there is a much higher risk to experience abuse and neglect for the 2.5 million long-term nursing home residents than older adults who live at home (Hawkes, 2003). To be more specific, a study of 2,000 nursing home residents stated that 44% had been abused and 95% had been neglected or seen another patient neglected (Broyles, 2000). Recognizing the early signs of nursing home neglect can help families act before their loved one’s health and well-being are seriously compromised.

This guide highlights common signs of neglect that families should be aware of, along with steps they can take if they suspect their loved one is being mistreated.

Physical Signs of Neglect: What to Watch For

Physical neglect is often the most noticeable, but it can still be subtle in the early stages. Nursing homes are responsible for providing proper care, including assistance with hygiene, nutrition, and medical needs. When these basic needs are ignored, physical signs begin to emerge.
Here are some key indicators of physical neglect:

1. Unexplained Weight Loss

A resident who is losing weight rapidly without a medical explanation may not be receiving adequate nutrition. Nursing homes are responsible for providing proper meals and ensuring that residents with special dietary needs are accommodated. Sudden or dramatic weight loss could indicate that the resident is not being properly fed or hydrated.

2. Bedsores (Pressure Ulcers)

Bedsores are a common sign of neglect, particularly in residents who are immobile or bedridden. These painful sores develop when a person is left in one position for too long without being repositioned. Nursing home staff should regularly move residents to prevent pressure ulcers from forming. If you notice red, tender areas of skin or open sores, it may be a sign of neglect.

3. Poor Personal Hygiene

If a resident’s appearance becomes disheveled or unclean, it could be an indicator of neglect. Nursing homes are responsible for helping residents with daily activities such as bathing, brushing their teeth, changing clothes, and grooming. Poor hygiene, such as dirty clothing, unwashed hair, or an unkempt appearance, suggests that staff may not be providing the necessary assistance.

4. Frequent Injuries or Bruises

While accidents can happen, frequent or unexplained bruises, cuts, or fractures are often a red flag. Residents who fall repeatedly or suffer from untreated injuries may be victims of neglect. Inadequate supervision, improper mobility assistance, or unsafe living conditions can all lead to recurring injuries.

5. Untreated Medical Conditions

Nursing homes are responsible for managing and addressing residents’ medical needs. If your loved one’s health condition is worsening, or if they are not receiving proper medications or medical treatment, it may indicate medical neglect. Warning signs include unaddressed infections, worsening chronic conditions, or complaints of pain without treatment.

Emotional and Behavioral Red Flags

In addition to physical signs, emotional and psychological changes can signal nursing home neglect. Residents may feel isolated, depressed, or anxious if they are not receiving proper attention, social interaction, or emotional support.
Here are some emotional and behavioral signs to watch for:

1. Withdrawal or Depression

If a previously social or active resident becomes withdrawn, refuses to participate in activities, or shows signs of depression, this could indicate neglect. Emotional neglect often happens when residents are ignored by staff, denied meaningful social interaction, or left to spend long periods alone.

2. Sudden Change in Mood or Behavior

Changes in mood or behavior, such as increased irritability, aggression, or anxiety, can also signal neglect. A resident who feels neglected may become frustrated or act out in response to their lack of care. Sudden emotional changes, especially without an underlying medical cause, should not be ignored.

3. Fear or Anxiety Around Certain Staff Members

If your loved one expresses fear or anxiety about certain staff members or appears uncomfortable in their presence, this is a significant red flag. Fear or reluctance to interact with specific caregivers could indicate that the resident is being mistreated, verbally abused, or neglected.

4. Loss of Interest in Activities or Hobbies

A noticeable decline in participation in activities or hobbies that the resident once enjoyed may suggest emotional neglect. Nursing homes should provide opportunities for residents to engage in social and recreational activities. When these needs are ignored, residents may feel isolated and lose interest in the things that once brought them joy.

What to Do If You Suspect Neglect: Steps for Immediate Action

If you suspect your loved one is experiencing neglect in a nursing home, it’s crucial to act quickly. Here are the steps you can take to address the situation and protect your loved one’s rights:

1. Document Your Concerns

Start by documenting any signs of neglect you notice. Keep a record of dates, times, and specific details about your loved one’s condition. Take photographs of any physical injuries, such as bedsores or bruises, and note any changes in behavior or mood. This documentation will be valuable if you need to file a formal complaint or take legal action.

2. Talk to the Nursing Home Staff

Approach the nursing home’s staff and administration with your concerns. Ask direct questions about your loved one’s care, including their hygiene routines, medical treatments, and daily activities. Sometimes, issues can be resolved through better communication or by requesting specific changes to your loved one’s care plan.

3. Request a Care Plan Review

Nursing homes are required to create individualized care plans for each resident, outlining their specific needs and how those needs will be met. If you believe your loved one is being neglected, request a meeting with the nursing home’s care team to review and update the care plan. Ensure that the care plan addresses your loved one’s unique health, emotional, and social needs.

4. File a Complaint

If your concerns are not adequately addressed, consider filing a formal complaint with the nursing home’s administration. Nursing homes are required to investigate complaints and provide a written response. You can also report neglect to your state’s long-term care ombudsman, who can investigate the issue on your behalf.

5. Consult with an Attorney

If your loved one has suffered significant harm as a result of neglect, it may be necessary to consult with a nursing home neglect attorney. An experienced attorney can help you understand your legal options and hold the nursing home accountable for any negligence. Legal action can result in compensation for medical bills, pain and suffering, and other damages, as well as forcing the nursing home to improve its standards of care.

Conclusion

Nursing home neglect can be subtle, but the consequences for residents can be severe if it goes unchecked. By recognizing the early signs of neglect — whether physical, emotional, or behavioral — families can act quickly to protect their loved ones from further harm. If you suspect neglect, don’t hesitate to document the issue, raise your concerns with the nursing home, and take further action if necessary. Understanding your loved one’s rights and being proactive can make all the difference in ensuring they receive the care and respect they deserve.

The Powless Law Firm is an Indiana law firm that represents victims and families state-wide in serious cases involving nursing home neglect, medical negligence, personal injury and wrongful death. If you have concerns about nursing home neglect or abuse, please contact us at 877-469-1292. Together we can make a difference.

REFERENCES: 

• Broyles, K. (2000). The silenced voice speaks out: A study of abuse and neglect of nursing home residents. Atlanta, GA: A report from the Atlanta Long Term Care Ombudsman Program and Atlanta Legal Aide Society to the National Citizens Coalition for Nursing Home Reform.
• Hawes C. Elder (2003) Abuse in Residential Long-Term Care Settings: What is Known and What Information is Needed? In: National Research Council (US) Panel to Review Risk and Prevalence of Elder Abuse and Neglect; Bonnie RJ, Wallace RB, editors. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America. Washington (DC): National Academies Press (US). 14.