Nursing Home Abuse

There may be times when you observe signs of abuse but were not actually a witness to what happened. The tangible signs or indicators of abuse, neglect or exploitation described on the following pages tend to be ones that can be detected by trained observers such as facility staff members. More difficult to detect or to determine are intimidation and mental anguish. Residents who are ridiculed, maliciously teased, cursed at or threatened may fear retaliation if they speak up or complain about a family member, another resident or a member of the facility staff. It takes skill and sensitivity beyond that required for routine observation to find out if verbal abuse has occurred.

      Physical Abuse Indicators

Physical assaults, cruel discipline, excessive use of physical or chemical restraints, and unnecessary or incorrect medication may cause any one of the following:

• Broken bones
  Pain and inability to move a limb may be a sign of a broken bone. This may occur when a resident with osteoporosis is handled roughly by visitors or staff. Broken bones in various stages of healing and spiral fractures may indicate abuse as well as fractures of the skull, nose or facial structure.
• Burns
  Burns and blistering skin over a wide area may show up because a resident was placed in a scalding hot tub of water. A more confined spot of burned skin may indicate purposeful burning with a cigarette. Rope burns on arms, legs, neck or torso may also indicate abuse.
• Cuts
  Cuts or scratches may result when a resident was jabbed with a sharp object such as a pencil or scratched with fingernails.
• Internal Injuries
  Watch for such signs as vomiting, pain, stuporous states, bleeding, swelling or bloody stools. You may observe any one or a combination of these if someone gave a resident alcohol or drugs that can cause sickness; or if someone overdoses a resident with anti-diarrhea medicine causing severe constipation; or if a blow to the stomach or head has caused internal injuries.
• Marks/Bruises
  A resident may have a hand-print shaped bruise where a person slapped them across the face or buttocks. Multiple bruises in various stages of healing may indicate abuse. Look for injuries to the face, neck, inner arms, inner thighs, especially bilateral injuries on upper arms.
• Scars
  Scars could indicate that the resident has been a victim of repeated or past abuses.

     Definition of Sexual Abuse:

      "Sexual abuse or exploitation" means contact or interaction of a sexual nature involving an       incapacitated or dependent adult without that adult's consent (22 MRSA §3472).

     Sexual Abuse Indicators

• A family member offers affectionate gestures to a resident that are too lingering and seductive or become centered on the sex organs, anus or breasts.
• Injury to a resident's genitals, anus, breast or mouth.
• A resident attempts to talk an incapacitated resident into sexual intercourse, fellatio, or cunnilingus.
• A young resident tells you that her father manipulates her genitals, buttocks and breasts during his visits.
• A staff member exposes his/her genitals to a resident.
• A visitor takes nude photographs of residents.
• Venereal disease, torn, stained or bloody underwear, difficulty walking or sitting, and pain or itching in genital area are all suspicious of sexual abuse.

     Definition of Neglect

      "Neglect" means a threat to an adult's health or welfare by physical or mental injury or       impairment, deprivation of essential needs or lack of protection from these (22 MRSA §3472).

     Indicators of Neglect

• Residents suffer from neglect when they are left alone, ignored by staff or left with staff who fail to care for them appropriately.
• A group of assaultive residents have been left alone and unsupervised.
• An aide has fallen asleep or is intoxicated while on duty.
• A resident has bleeding gums and some loose teeth, indicating that a visit to the dentist is long overdue.
• A resident is continually fearful about leaving her room and seems almost panicky when it's time to leave the facility for an outing. Staff "leave her be" rather than attempting to determine the cause of her fear.
• A resident fell several days ago. Her ankle is swollen and bruised, and she complains of pain when walking. The resident's doctor or family were not notified of the fall immediately. X-rays taken several days after the fact reveal a fracture.

     Definition of Exploitation

      "Exploitation" means the illegal or improper use of an incapacitated adult or his resources       for another's profit or advantage. (22 MRSA §3472) Maine law prevents facility employees       from being appointed guardians or conservators (18-A MRSA §5-311).

     Indicators of Exploitation

• A resident's relative, who is representative payee, fails to pay nursing, boarding or foster home bills and provide personal needs money.
• The facility administrator, who is a resident's representative payee, purchases furniture or clothing not intended for the resident.
• A resident is manipulated into giving away money or personal property such as a TV, jewelry, or furniture.
• Disappearance of personal property; transfer of property, savings, insurance; unexplained change in cash flow; change in will, representative payee, power of attorney; or depleted bank accounts.

      If you believe a loved one may be a victim of nursing home abuse, please fill out and submit        our Case Evaluation Form.