Do You Know the Early Signs of Nursing Home Neglect or Abuse?

With nearly two million Americans living in long-term care facilities, abuse or neglect of the elderly is a concern to many. That’s why it’s important to understand the various types, signs, symptoms, and legal technicalities surrounding nursing home and elder neglect and abuse.

Know The Difference Between Neglect and Abuse

Abuse is legally defined as the intentional infliction of injury, intimidation, or punishment resulting in physical pain, harm, or mental distress.

Neglect is intentionally or unintentionally failing to provide a person with the necessary care and services to ensure protection from pain or harm or the failure to appropriately assess and handle a dangerous situation that causes harm or anxiety to the resident.

Knowing the legal distinction between neglect and abuse is crucial when dealing with elder abuse in nursing homes.

Most Common Types of Abuse

Nursing home abuse can happen in a variety of ways, but the most common types are as follows:

  • Physical abuse

  • Sexual abuse

  • Emotional/Psychological abuse

  • Neglect

  • Abandonment

  • Financial/Material exploitation

  • Self-neglect

Physical Abuse

Physical abuse is defined as using physical force or bodily contact to intentionally inflict pain, injury, or physical trauma on a resident. This type of abuse can even lead to impairment.

Physical abuse includes but is not limited to striking, beating, pushing, kicking, punching, slapping, or burning a resident.

Furthermore, the inappropriate use of physical restraints can also be a form of physical abuse.

Signs of physical abuse can include the following symptoms:

  • Falls, fractures, or head injuries

  • Unexplained injuries such as wounds, cuts, bruises, or welts in various stages of healing

  • Broken eyeglasses/frames

  • Signs of being restrained

  • An elder’s claim of having been mistreated or a sudden change in the elder’s behavior

  • A caregiver’s refusal to allow guests to see an elder alone

Sexual Abuse

Sexual abuse is any non-consensual sexual contact with an elder. Sexual abuse can include unwanted touching, taking unwanted photographs, and all varieties of sexual assault, such as sodomy, coerced nudity, or rape.

Signs of sexual abuse can include the following symptoms:

  • Unexplained venereal diseases or genital infections

  • Torn, bloody, or stained underclothing

  • Bruises near the breasts or genital areas

  • Unexplained anal or vaginal bleeding

Emotional/Psychological Abuse

Emotional/Psychological abuse is inflicting pain, anguish, or trauma upon a resident through verbal or nonverbal acts.

It can come in the form of threats, verbal assault, intimidation, humiliation, and harassment.

Isolating elderly people from their families, friends, or activities are also examples of emotional abuse.

The caregiver may insult, threaten, humiliate, or harass an individual through words or actions.

Signs of emotional/psychological abuse include the following symptoms:

  • An elder becoming emotionally upset, agitated, extremely withdrawn, or non-communicative

  • Torn, bloody, or stained underclothing

  • Demonstrating unusual behavior typically tied to dementia (such as sucking or biting)

  • An elder claiming he or she was emotionally mistreated


Neglect is failing to provide for the resident’s necessary needs or failing to offer crucial services.

Signs of neglect can include the following symptoms:

  • Bed injuries, asphyxiation, and bedsores

  • Dehydration, malnutrition, or rapid weight loss

  • Untreated health problems

  • Unsafe living conditions (improper wiring, lack of heat or running water)

  • Unclean or unsanitary living conditions

  • Elders claiming they’ve been mistreated


Abandonment takes place when the nurse-patient relationship is terminated without reasonable arrangements being made. In other words, it is the desertion of an elderly person by someone who had assumed responsibility for them.

Signs of abandonment can include the following symptoms:

  • Desertion of an elder at a hospital or nursing facility

  • Desertion of an elder in public locations

  • An elder claiming he or she was abandoned

Financial/Material Exploitation

Financial or Material exploitation takes place when somebody improperly uses or exploits an elder’s funds, assets, or property. This can include forging signatures, coercing or deceiving an elder into signing documents, misusing or stealing the elder’s money or possessions, and improper use of guardianship or power of attorney.

Assets are commonly taken via forms of deception, false pretenses, coercion, harassment, duress, and threats.

Signs of financial or material exploitation can include the following symptoms:

  • Changes in bank account or banking practices

  • Unexplained withdrawals of large sums of money

  • Sudden changes in will or other financial documents

  • Discrepancies regarding funds

  • Uninvolved relatives suddenly claiming their rights to finances


Self-neglect is the behavior of an elderly person who risks his or her own safety. This usually occurs when elderly people refuse to provide themselves with sufficient food, clothing, water, personal hygiene, medication, and other basic safety procedures.

Signs of self-neglect can include the following symptoms:

  • Dehydration, malnutrition, or poor personal hygiene

  • Lack of necessary medicine or medical care

  • Inadequate housing or shelter

What To Do If You Suspect Your Loved One is the Victim of Nursing Home or Elder Abuse?

First: take pictures documenting any evidence of abuse. This provides key evidence that will be critical to your case going forward.

Second: document the names of any staff members you suspect were involved with the abuse.

Third: document all conversations you hold with any staff member concerning care, treatment, or suspected abuse.

Next: get in contact with the following programs, all of which are funded in every state under the federal Older Americans Act (OAA):

Depending on severity of the situation, such as immediate harm or theft – contact the police and your state’s district attorney.