Nursing homes carry a lot of stigma in the United States, often regarded as a place where the elderly are sent to be discarded, treated more like burdens than the people they are. Nothing could be further from the truth. True enough, not every nursing home lives up to its purpose, nursing homes are facilities meant to provide a level of attentive care that isn’t possible in most at-home settings, equipped with facilities intended to treat a variety of conditions and on-the-clock staff at all hours. While often regarded with a level of suspicion and fear, nursing homes can be a fantastic option for older adults that need extensive levels of care or for family members that just don’t have the assets to treat them appropriately.
Unfortunately, people with abusive tendencies tend to seek out any opportunity to put themselves in positions of power over vulnerable populations, contributing to a rising number of older adults experiencing elder abuse. According to the World Health Organization, 6 out of 10 adults over 60 have suffered from a form of elder abuse, and 2 out of 3 healthcare workers have confessed to committing it. While it may seem as though nursing homes are less safe than other healthcare options for older adults, the reality is that no communal setting is free of risk: abusers are everywhere, and the same statistics that apply to long-term care facilities apply to other communal environments.
The possibility that your older adult will experience elder abuse is challenging to avoid altogether, even with comprehensive research on the facilities you’re planning on sending them to and with the benefit of word of mouth. A lot of abuse happens in the shadows, with some patients never vocalizing the horrible things that have happened to them and even more instances flat out undiscovered. Abuse is impossible to catch until it happens, so if you have to send your parents to an extended care facility, you need to know some of the primary signs of elder abuse, as well as some of the forms elder abuse can take.
Are you concerned about your older adult’s safety? Here’s a comprehensive guide to elder abuse so if needed, you can recognize the signs and remove them from that harmful environment.
Forms of Elder Abuse
A general definition of elder abuse is any action or lack of action that causes harm or distress to an older adult, carried out by a person said older adult has reason to trust. That definition is fairly broad, as there are lots of things that can fit under that umbrella. Let’s discuss some of them below.
Perhaps the most immediately recognizable form of abuse, physical abuse is the use of physical force against an older adult, causing harm, broken possessions, or even death. Common signs of physical abuse include unexplained bruises or burns, repeated “accidents,” wounds that appear to be self-treated, and any broken bones or sprains. If you notice that some of the possessions of your older adult are also damaged, like glasses or prized possessions like necklaces, you may also want to investigate.
It also bears noting that you will want to pay attention to your older adult’s reactions toward staff. Sometimes, the victims of abuse can give away the perpetrators without realizing it. If you notice that your older adult has a disproportionally bad opinion of one of the staff members or displays signs of fear or stress around them, they may have information you don’t.
Little needs to be written about this form of assault, except that it is, unfortunately, more common than you may think. If you notice that your older adult has been wounded in more sensitive areas, such as the groin or posterior, or you see bloody or torn underwear, definitely pull them out of that situation immediately and file charges. Psychological symptoms can also be very telling, so keep a close eye out for the sudden development of suicidal tendencies, social withdrawal, or anything else that may indicate something is deeply wrong.
This one can be hard to catch, especially if you don’t have access to your older adult’s financial records. But generally speaking, financial abuse is the misappropriation or misuse of an older adult’s possessions or assets by a caregiver. Some signs to keep an eye out for include strange charges to your older adult’s bank account, checks cut out to the caregiver that neither you nor your older adult were aware of, the disappearance of valuable possessions, or financial agreements cited by the older adult without any written paperwork to prove their veracity. Generally speaking, either you or your older adult should be aware of the state of their finances at all times: entrusting them entirely to a third party leaves room for disaster.
Emotional (or sometimes psychological) abuse is an attempt to dehumanize, humiliate, or emotionally attack an older adult and can take many forms, including name-calling, limiting access to facilities, attempts to humiliate or frighten the older adult, or isolating them from others. The goal of emotional abusers is to attack the mental health of older adults, making them feel small, limited, and unable to fight back. If you notice that staff seem to be particularly unkind to people in the community, emotional abuse may be a prevalent problem in that facility.
Negligence: A Tricky One to Define
Negligence can be hard to recognize, as many times injuries that are the result of negligence on the part of hospital staff are written off as accidents or one-off incidents. In short, negligence is the failure of hospital staff to follow through on providing necessary care for the vulnerable population in their charge: it can take forms like not helping older adults access the facilities, not making sure they get out of bed and are physically active, not maintaining healthy eating and sleeping patterns for older adults in their charge, and not helping older adults go through the processes necessary to maintain good hygiene. This is by far the most common form of elder abuse, as nursing facilities are often understaffed and their workers are usually overworked.
Common signs of negligence include the development of bedsores, a recurrence of similar kinds of accidents, the formation of unhealthy eating, sleeping, and socialization habits, and any signs of malnutrition or depression. The symptoms of negligent behavior can overlap with the signs of other abusive behaviors, so when in doubt, remove your older adult from that setting and investigate further. Listening to your older adult and the way they communicate their needs will be paramount in identifying abusive behaviors.
Spreading Awareness and Seeking Justice
Once you have determined that your older adult is in an unsafe situation, your first move should be to extract them from that situation and consult a lawyer. Good nursing facilities might help you investigate the situation thoroughly, but it’s best not to count on their help as some are more interested in protecting their reputation than extracting the bad apples in their midst. Getting in touch with professionals who are more experienced in investigating and prosecuting cases like yours might help you avoid pitfalls that will weaken your case and make it easy to dismiss.
Regardless of how you decide to conduct an investigation into the misbehaving facility, once it has been determined that abusive behavior took place, you should move to take legal action as soon as possible. The reasons for this are twofold:
- One, suing a nursing home for mistreatment makes it easier for others to avoid a similar fate. Word of mouth spreads quickly, especially with the prevalence of the elder abuse problem: others who are seeking helpful accommodations for their older adults will be looking for cases like yours, seeking to avoid facilities with checkered pasts. While nothing can make up for the abuse your older adult suffered at that facility, perhaps your lawsuit can make it possible for the next person to avoid being mistreated.
- Two, the process, while arduous, can provide a sense of justice for your older adult. Consult with your older adult before filing a suit against their abuser, as they deserve a voice in the decision-making process; it’s entirely possible that they just want to move on and forget the whole thing. But for some, especially those who suffered psychological abuse, taking their abuser to court and demanding accountability can reaffirm their damaged sense of personhood and provide some consolation for their suffering.
A Problem that Cannot Be Solved Immediately
Unfortunately, there’s no way to be 100 percent certain your loved one will be safe when put into the care of a third party. It’s a frightening realization, especially when said third parties can provide care that you, for one reason or another, cannot. Like many other forms of abuse, elder abuse is underreported and insidious, an ugly reality hiding under a façade of respectability and compassion. All you can do is be prepared for the worst, and knowing the most common forms of elder abuse and having a plan in place in the event you need to take action will likely help you and your loved one sleep better at night.