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Home » Consumer Information » Elderly Care

Types of Abuse

There is a wide range of categories, indications, and levels of abuse that occurs in residences for the elderly and nursing homes.

General neglect

General neglect by a nursing home caretaker or someone who has guardianship of a senior is the most common type of elderly abuse. Neglect happens when a nursing home staff member or affiliated medical professional does not meet the expectations of the resident. Examples include general care, bathroom duties, and financial neglect, or not paying bills. The most serious offense is refusal to service residents with the proper essentials like food, water, shelter, hygiene, medication, safety, and any additional features that the resident may be deprived of and can't live without such as:

  • Satisfactory sanitary bodily conditions or attire.
  • Appropriate medical treatment, prescriptions, and physical or mental therapy (unless the resident refuses any of these services).
  • Monitoring a resident's wellbeing and safety.
Physical warnings of neglect
  • Lesions or rashes on the skin
  • Stench of urine or feces on a resident's body, in their living quarters, or other frequented areas
  • Safety and/or health risks in the resident's living area
  • Medical problem that has been ignored
  • Visible malnourishment
  • Noticeable dehydration
  • Improper dress
Physical abuse

Physical abuse by a nursing home staff member or an individual with custody of an elder is the second most common form of elder care mistreatment. The definition of physical abuse differs depending on the state and authority in a particular region. Physical abuse takes place when a person uses force to cause bodily harm, pain, and suffering to a senior. The following are examples of physical abuse:

  • Hitting
  • Pushing or shoving
  • Burning
  • Slapping
  • Kicking
  • Improperly restraining
  • Restraining for a long period of time
  • Unnecessary or overly drugging
  • Coercing residents to consume food or drinks
  • Denying residents of food or drinks
Evidence of physical abuse
  • Marks, swelling, or bruising on the face or body
  • Bedsores (pressure sores and skin, decubitus, dermal, and pressure ulcers)
  • Puncture wounds, scrapes, scratches, lacerations
  • Resident appears uneasy when a certain staff member is in the room
  • Resident is hesitant to explain marks, bruises, etc.
  • Soiled clothes, bedding, or living quarters
  • Failure of staff to address medical conditions
  • Medical issues that do not coincide with resident's prior health records
  • Burns on body from cigarettes, ropes, restraints, etc.
  • Considerable weight loss (not attributed to illness)
  • Dehydration (not attributed to illness)
  • Malnutrition
  • Excessive skin irritation
  • Bleeding beneath scalp
Sexual abuse

Sexual abuse is quite possibly the most deplorable act that any nursing home employee or caretaker can be associated with. Sexual abuse arises when someone participates in a sexual act with a resident in which the elder did not give consent. Sometimes, the resident is incapable of communicating, and a staff member will take advantage of them. This is also considered sexual abuse. Some common examples of sexual abuse within a nursing home include:

  • Forced sex
  • Forced nudity
  • Suggestive touching
  • Rape
  • Sodomy
  • Sexual assault/battery
  • Taking sexually explicit pictures
  • Pornography
Evidence of sexual abuse
  • Inappropriate affectionate behavior displayed by a staff member
  • Flirty or coy behavior around a certain resident
Psychological abuse

When a caretaker knowingly causes a resident emotional torment through verbal or nonverbal behavior, this is considered psychological abuse. Here are some examples of psychological abuse:

  • Verbal unpleasantries
  • Bullying
  • Physical threats
  • Sexual threats
  • Degradation
  • Harassment
  • Isolation from friends and family
  • Silent treatment
  • Babying
Evidence of psychological abuse
  • Bewilderment
  • Unprovoked rage
  • Depression
  • Frantic behavior
  • Abnormal quietness
  • Vulnerability
  • Unwillingness to speak candidly
  • Questionable storytelling
  • Denial
  • Panic
  • Withdrawal
Desertion

If a caretaker chooses to abandon an individual in an instance when any sensible person would continue overseeing them, it is known as desertion. During this act of abandonment, the elder is deprived of necessities like food, water, materials necessary to maintain hygiene, etc.

Evidence of desertion
  • Resident appears baffled and alone at their residence or somewhere in public
  • Resident claims the caretaker left them to fend for themselves
Financial abuse

When the person responsible for monitoring an elder's spending habits exploits their position through the misappropriation of funds, property, or other assets, this is viewed as financial abuse. Some examples include:

  • Tardy bill payments
  • Using funds or property for their own benefit
  • Cashing checks without consent from the owner
  • Forging signatures to gain access to funds or possessions
  • Taking advantage of their power of attorney for personal advancement
  • Tricking a resident into signing a will, contract, or other legal document.
Evidence of financial abuse
  • Resident has no involvement in their finances to the point that they have no idea how their money is being utilized
  • Resident's rent or other monthly bills are past due
  • Resident's appearance and personal belongings do not correspond with financial status
  • Improper usage of bank accounts
  • Signatures on checks do not match resident's, or checks are signed when it is a known fact that person is incapable of writing
  • Changes made to resident's will when that person does not have the mental capacity to make choices of this magnitude
  • Caretaker believes too much money is being spent on resident's care and services
Evidence of staff abuse

The following list includes signs that a nursing home employee may be neglecting, mistreating, or providing subpar care to residents. The caretaker:

  • Displays obvious dislike towards residents
  • Bars residents from visiting fellow residents or speaking without a caretaker being present
  • Demonstrates antagonistic behavior aimed at residents
  • Has abused residents in the past
  • Has history of drug and alcohol addiction
  • Deliberately fails to be present during activities with residents
  • Exhibits hostility towards residents
  • Files injury reports that don't coincide with residents'
  • Becomes defensive when confronted about offensive behavior
  • Attempts to quarantine resident
  • Is hesitant to offer residents assistance of any kind, including medical
Risk factors

The following risk factors can have a negative impact on the overall nursing home experience.

Resident risks
  • Verbally abusive
  • Aggressive behavior
  • Threatening or disparaging remarks
  • Making demands
  • Interfering with other resident activities
  • Manipulative
  • History of drug and alcohol abuse
  • Sexually inappropriate behavior
  • Lack of self-control
  • Mood swings
  • Inability to speak or hear
  • Organic Brain Syndrome (OBS)
Staff risks
  • Substance abuse
  • Violent behavior
  • Problems at home
  • Monetary issues
  • Competitions among employees
  • Lack of training
  • Psychological problems
  • History of jobsite infractions
  • Numerous absences
  • Reliance on residents to satisfy needs
  • Social seclusion
Facility risks
  • Inadequate employee training
  • Below average upkeep on building structures
  • Unnecessary stress on faculty
  • Short-staffing
  • Underpaid employees
  • Taking in residents with unique needs that the facility us unable to support
  • Overcrowding of residents
  • Excessive employee absences
  • Unspecified staff responsibilities
  • Delayed or no reaction to reports of resident abuse
  • High employee turnover rate
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