Frequently Asked Questions about Nursing Home Abuse, Neglect and Exploitation, and Elder Abuse, Neglect, and Exploitation

If you suspect that you are or a loved one are suffering from Nursing Home or Elderly Abuse Neglect or Abuse, then you may contact any of the resources listed herein and you may also Contact Us to discuss your situation and for your free legal consultation. Nobody should suffer abuse, neglect or be exploited in any way and we are here to help you!

With the numbers of people aging in America today we are seeing more and more people in different kinds of living arrangements from Nursing Homes, Assisted Living, Living with Extended Family, and the like. All of these can be wonderful arrangements for our aging loved ones under the proper conditions. Under the wrong conditions, however, any or all of these situations, and more, can subject our loved ones to Elder Abuse and Neglect. This can be a traumatic event for anyone who has endured such a situation so it is imperative that we educate ourselves with as much information as possible and have the resources to act if there is a situation in which we know or suspect that elder abuse and/or neglect is, has been, or may happen in the future.

The following are some answers to Frequently Asked Questions about Elder Abuse and Neglect including, but not limited to, Nursing Home Abuse and Neglect. The good news is that there is help for victims so if you need to act there are resources available to you, and do not hesitate to contact me, Julie A. Rice, Attorney at Law, directly at (770) 865-8654 at any time of the day or night if I can be of further assistance.

1.) What is Elder Abuse and/or Neglect?

The first appearance of Federal Definitions of Elder Abuse and Neglect were in the year 1987 with certain Amendments to the Older Americans Act. These definitions enhanced and expanded the older Federal Definitions of Elder Abuse and Neglect. It is important to note, however, that these Federal Definitions were set forth as guidelines and that every State has its own definitions of Elder Abuse and Neglect. Those who research Elder Abuse and Neglect use the different definitions, both Federal and State, to continue their studies of the issues.

For example, the definition of Domestic Elder Abuse refers to any or all of the following types of treatment that is an act committed by a person who the elder person has a relationship with such as a sibling, child, caregiver, friend and/or a spouse, just to name a few. Institutional Elder Abuse also refers to any or all of the following types of abuse or mistreatment but this abuse or mistreatment occurs in a facility where the elder lives such as an assisted living facility, boarding or other care facility, foster home, group home, nursing home, or the like and is often committed by a person or persons who are legally or contractually obligated to care for the elder or provide some other type of protection or care.

It is important to note that Elder Abuse and Neglect can occur to any person regardless of ethnic or religious background, social standing, and/or gender.

The following is a list of the most common types of elder abuse and neglect and a brief definition of each:

1.) Emotional Abuse ~ this is the infliction of mental anguish, pain, and/or distress through means of nonverbal or verbal actions.

2.) Exploitation ~ this can be the taking, concealment, or misuse, of property, funds, and/or assets of an elder who is vulnerable.

3.) Sexual Abuse ~ any unwanted touching of any sort that is sexual in nature from anybody whether it be family, friends, caregivers, or the like.

4.) Physical Abuse ~ the actual infliction of pain as well as the threat to inflict pain and also the deprivation of basic needs such as food, water, shelter, and/or medication.

If you are further unsure whether or not you or your loved one has been subjected to or is being subject to, and/or may be subjected to Elder Abuse or Neglect then you may see a more detailed list of Types of Abuse for a more comprehensive list and definition of the types of abuse that an Elder may be subject to in the past, present or future.

2.) What are the Warning Signs of Elder Abuse and/or Neglect?

Although one single sign may not be an indication of abuse or neglect, it is wise not to overlook any sign that may indicate a problem and some specific signs to watch for include, but are not limited to:

  • Physical Marks such as broken ones, bruises, burns, pressure marks and/or abrasions or the like.
  • A change in the Elder’s alertness such as a withdrawing from activities that the Elder once enjoyed, depression, or any other change in behavior or attitude such as unusual shyness or silence.
  • Marks or Bruises around the genial areas or breasts that could indicate sexual abuse. Sexual abuse happens more often than we care to admit and this should be taken very seriously as Elders are especially vulnerable to this type of abuse.
  • If there is a change in the financial condition of the Elder or a lack of wanting to show the financial condition could indicate that some sort of exploitation has taken place.
  • Poor hygiene, bedsores, dirty bed linens or room conditions, medical needs that are not attended to, and weight loss or gain could indicate that neglect is taking place.
  • If a spouse or other family member or caregiver is verbally or emotionally abusive to the Elder such as threatening him or her, or using other sorts of power can indicate an abusive situation that should be addressed.
  • Arguments that are frequent in nature, tense or strained relationships among caregivers, spouses, or other family members and the Elderly person are signs that there could be abuse or neglect. For further information about these types of situations, see Fact sheets & Publications for more information.
  • More Publications on Elder Abuse and Neglect, and other issues related thereto, can be found at: Clearinghouse on Abuse and Neglect of the Elderly (CANE).

It is very important to remain alert and in tune with your Elder loved one(s) as the suffering that your loved one(s) may be enduring is very often in silence. Therefore, if you observe any changes in behavior, personality and/or emotional or physical condition, then you should begin to investigate further into what might be really going on.

3.) What is Meant by Self-Neglect and What is Really Going on in these Situations?

At times, an Elder may neglect his or her own care and this can result in injury or illness. Behaviors that constitute self-neglect include, but are not limited to:

  • Hoarding of animals, objects, mail and paperwork, magazines and newspapers, and anything else that compromises the safety of the individual or the community in which they live.
  • Not providing nutrition, food, medications or the like for oneself or failure to seek medical treatment when needed.
  • Placing oneself in a dangerous situation such as not attending to a burning stove and/or leaving it unattended.
  • Improper, poor, or unclean hygiene.
  • Not dressing appropriately for the weather.
  • Being confused.
  • Not able to keep up with housekeeping.
  • Being dehydrated.

Self-Neglect is one of the most frequently reported concerns brought to adult protective services. Oftentimes, the problem is paired with declining health, isolation, Alzheimer's disease or dementia, or drug and alcohol dependency. In some of these cases, elders will be connected to supports in the community that can allow them to continue living on their own. Some conditions like depression and malnutrition may be successfully treated through medical intervention. If the problems are severe enough, a guardian may be appointed.

4.) Why are Older Adults Vulnerable to Abuse and Neglect?

Although Elder Abuse and Neglect is a very complex situation like domestic violence, there are a general accepted set of principles involving a complex combination of social, psychological and economic factors that come into play in these situations as well as physical and mental conditions of both the victim and the perpetrator that seem to be contributing factors in elder mistreatment, abuse and neglect including, but not limited to:

Cognitive Impairments and Dementia
It appears that elderly people with cognitive impairments such as dementia are at a greater risk of neglect and abuse than those elders in the general population of elderly people. The risk factors associated with this not only depends upon the caregivers' increased perceived and actual burden of responsibility, but also to the elderly’s increased physical assault behaviors and psychological and behavioral assault tendencies.

Past Domestic Violence that Still Exists between Couples
A large percentage of elder people are spouses and out of this large amount another large amount are elder spouse abusers. Therefore, a large proportion of these cases are what we would consider violence of the domestic type gone old and, therefore, these partnerships tend to perpetrate themselves into the elder years so domestic violence very often still exists between these couples.

The Problems that are usually Personal in Nature of the Abusers
Many times adult children of elderly parents are dependent upon the parents for money, other forms of support, housing, and other things just to name a few. This dependency can be simply a form of habit or it can be as a result of the adult child having a mental illness, drug or alcohol abuse, children of their own that they are unable to provide for, or some other dysfunctional characteristic. In these cases, the risk, or the actual occurrence, of elder abuse can run high especially when the adult child or children live with the elder parent or parents.

Isolation Socially and Living with Others
Rates of elder abuse tend to be higher among those elders who are isolated socially or who live with another person. Although this seems to be contradictory it seems to be related since abusers who live with the elder have greater opportunities to abuse and may also be isolated from the community at large and may seek to intentionally isolate the elders from others to keep the abuse a secret. More research is being done to explore the relationship among these factors.

5.) What do we Know about the Abusers of Elderly People?

As we have discussed thus far and even though more research needs to be conducted on this most sensitive and important topic, it does appear that most of the cases of elder abuse come from abuse by people trusted and known by the elder and this includes, but is not limited to, friends, service providers, strangers, peers, and even family and the abusers can be men or women of any race, age, or socio-economic status. Elder abuse, as we are learning, does not discriminate.

6.) What, if any, are the Criminal Penalties for Elder Abusers?

From State to State, the laws vary in terms of the actual criminal penalty for those who commit elder abuse. Many States, however, have raised the penalties for those who commit crimes and victimize elderly people. Furthermore, throughout the country prosecutors, law enforcement officers, and others who work with elderly people are being trained about abuse faced by elderly adults and how civil and criminal laws can be used to bring these abusers to justice. Although laws vary from state to state, in most states there are several laws that address criminal penalties for various types of elder abuse. Some states have increased penalties for those who victimize older adults. Increasingly, across the country, law enforcement officers and prosecutors are trained on elder abuse and how to use criminal and civil laws to hold these abusers accountable and bring them to justice. To read about State Elder Abuse Laws, how to obtain access to the law in your State, and other issues that are important to know in your particular state, then you can access the following Laws Section.

7.) We are hearing more and more about Elder Abuse and Neglect. How have the Rates Changed Over Time?

One way to understand how the rates of Elder Abuse and Neglect have changed over time is to access the Statistics/Data section for more information about the prevalence and incidence of elder neglect, abuse, and exploitation.

8.) If I Suspect Elder Abuse and/or Neglect, then Who do I Contact?

If you suspect elder abuse and/or neglect, then there are many Federal, State, and Local organizations available to assist you. For example, if you witness abuse and need to report said abuse, then go to Reporting Abuse and State Resources for more information.

9.) If I am concerned about Elderly Abuse or Neglect in a Nursing Home, then What should I Do?

If you suspect Elderly Abuse and/or neglect of someone who lives in an Assisted Living Situation, a Care or Boarding Home, a Nursing Home, or the like, then immediately contact your local Long-Term Care Ombudsman, and you may find a Directory of State Reporting Resources and Numbers by visiting the State Resources page referenced directly herein above.

You may also visit the National Consumer Voice for Quality Long-Term Care (formerly NCCNHR). This organization facilitates the following:

  • Educates Families and Consumers
  • Supports and Trains Groups and Individuals so that they may Empower Consumers and Advocate for Consumers
  • Promotes the Best Practices in the Delivery of Quality-Care and the Role that is Critical for Direct-Care Workers
  • Supports the Quality of Life and Care by Advocating for Public Policies that Support Said Quality Life and Care

The aforestated Website provides resources and information to assist residents  in advocating for their own quality care as well as understand their rights for care that is quality in nature, and also for family members and friends.

10.) If I Call Someone for Help, then What Should I Expect?

If you call Someone for Help, then you should Expect Adult Protective Services (APS). APS are services that are provided to those whose well-being and safety is potentially at risk and are provided to make sure that the well-being and safety of those Adults with Disabilities and other Elders are protected from harm if they are in danger of being neglected or mistreated due to being unable to care for themselves, and who have nobody else to assist them to care for themselves. APS then provides interventions that include casework services. The APS caseworkers are first responders to vulnerable adults who are defined as persons who are mistreated or are in danger of mistreatment and are unable to protect themselves.

APS Interventions include, but are not limited to the following:

  • Being in Receipt of Reports of Neglect, Exploitation or Abuse
  • Investigate said reports
  • Assess the victim's risk
  • Assess the victim's ability to understand his/her risk and capability to understand and give informed consent
  • Develop a case plan
  • Arrange for services that are supportive, arrange medical care, arrange legal assistance, and provide emergency shelter
  • Monitor Services
  • Conduct Evaluations

More Information About APS

For more information, you may select from the following list:

11.) If I am Looking for a Good Nursing Home or Facility, then What Should I Be Looking for?

To assist you in understanding and comparing local options for Nursing Home or Long-Term Care facilities you may contact a Long-Term Care Ombudsman.

CMS (The Centers for Medicare and Medicaid Services) provides support for Nursing Home Compare that is a federal website that will allow you to find and compare by a variety of standards Medicare and Medicaid certified nursing homes in your area. A website that can be used in conjunction with the Nursing Home Compare website is the “Nursing Home Checklist” that you can utilize when visiting different nursing homes. CMS provides information on Alternatives to Nursing Home Care as well.

12.) I have Head About Frauds and Scams. How Do I Avoid Frauds and Scams?

It is unfortunate but very true that people who have no conscious will target Elderly people and take advantage of them and abuse them as well. To avoid frauds, scams, and abuse of Elderly people, try implementing the following:

  • Know the Warning Signs of the Types of Elder Neglect and Abuse
  • Visit and get on the Do Not Call Registry at: www.DoNotCall.gov or call 888-382-1222 to register your phone number.
  • Do not be Taken Advantage of by a “Loan”, “Investment”, or “Prize" especially if it seems to be too good at all to be true because it probably is so avoid it all costs.
  • Do Not be Intimidated or Pressured into Making Big or Fast Decisions, and Before making any Large Investments or Purchases, be sure that you Consult with Someone you Trust first and foremost.
  • Do Not Sign Any Documents without First Consulting with an Attorney, Family Member and/or close Friend that you Completely Trust.
  • If Someone Calls You, Do Not Under Any Circumstances provide Any Personal Information such as a Credit Card Number, your Social Security Number, your Address, or the like.
  • Before you Throw Sensitive Information into the Trash such as Receipts, Financial Records, or Bank Statements be sure that you Tear them Up or Shred Them.
  • Conduct a Complete Background Check if you hire Someone for Any Services whether it be Personal Services, Services in your Home, or otherwise to make sure that they don’t have a Criminal Background, and also Get as Many Personal References about said People from as Many People that you Know and Trust.

You may utilize the following services for tools and information for Older Americans:

Consumer Financial Protection Bureau, The Financial Fraud Enforcement Task Force that offers reports and resources to assist you in protecting yourself against Scams and Frauds and To Stay Abreast of Scams and Frauds, and check Consumer Protection Sites such as Fraud.org and FBI Common Fraud Schemes

13.) How Can I Protect Against Elder Neglect, Abuse, and Exploitation?

To Prevent Elder Neglect, Abuse and Exploitation it is imperative that we Educate Ourselves, our Seniors, our Caregivers, our Professionals, and the Public about Elder Neglect, Abuse and Exploitation. The following are simple but very important steps that we can utilize on an individual level to reduce the risks:

  • Make Taking Care of your Health your Top Priority
  • Get Help for Alcohol, Drug, Depression or any other similar concerns and encourage your Family Members to do the Same.
  • Educate Yourself and Learn as Much as Possible about Domestic Violence and Services for Domestic Violence and, for Yourself and Your Spouse, Attend Support Groups.
  • Develop an Estate Plan for Your Future. Have a Will, a Living Will, a Limited Power of Attorney, and any other necessary documents to address Health Care Concerns so as to avoid Family Problems and Confusion in the unfortunate event that you should become Incapacitated or otherwise unable to make decisions for yourself. Do not, however, execute any of these documents until you have reviewed them with a trusted Professional accordingly.
  • To avoid Social Isolation that, as we have stated, is connected to Elder Abuse, stay Active in your Community and stay Connected with Family and Friends. .
  • If you Engage the Services of a Family Member or Paid Caregiver, then you have the Right to Voice your Opinion and your Preferences. You need to Know your Rights. Likewise, if you live in a Long Term Care Facility, a Nursing Home, a Boarding Home, or any other type of Living Arrangement, then utilize your Long Term Care Ombudsman as your Advocate and know that said Ombudsman has the power and right to intervene on your behalf.

If you are unsure of the ombudsman services, and community and home care services and family care supports in your State, then call the Eldercare Locator at 800-677-1116 for information about the services in your area, and these services can also help older adults with daily living and the activities pertaining thereto.

To get involved in Prevention in your area, visit Get Involved to learn how citizens of all ages can become involved accordingly.

14.) Why is it Important that I learn about Elder Abuse, Neglect, and Exploitation?

Elder Abuse can happen to anyone whether it be ourselves, our loved ones, our neighbors, our mentors, our community leaders, and anyone who is an important part of our lives. In fact, it is estimated that 1 in 10 American Elders is affected by Elder Abuse. As we have discussed herein, Elder Abuse can happen in many types, if not all types, of relationships and it is up to US to make the progress that is necessary to change these statistics and change the abuse that is currently taking place in our society. If that is not enough for you to convince yourself to get involved and realize the importance of your involvement in this critical issue in our aging society, then please kindly read the NCEA fact sheet, “Why Should I Care About Elder Abuse?” for more helpful resources and information.

15.) If I am going to be Visiting with an Elderly Relative, then what are the Signs that I should Watch out for?

To get in tune with what to watch out for when visiting Elderly relatives, please kindly read the NCEA “Home for the Holidays” document to be more aware of the relevant signs of neglect and abuse by others to your elderly relatives, and self-neglect so that you are fully informed and can watch for the signs.

16.) In Nursing Home or Long Term Care Facilities, how can Exploitation be Avoided?

Financial Exploitation means that someone improperly or illegally misappropriates an elder adult’s belongings or money for their own personal use. As the fastest growing form of Elder Abuse and since it is a crime that is often not reported, it is imperative that we are aware of the signs of Financial Exploitation. In order to learn how to protect our loved ones and ourselves from this heinous crime, you may use the following fact sheets:

Nursing Homes:

Protect yourself
Protect your loved one

Assisted Living Facility:

Protect yourself
Protect your loved one

At Julie A. Rice, Attorney at Law, & Affiliates we are experts at representing you and your loved ones who have been victims of Nursing Home Abuse, Neglect, or Exploitation so please Contact Us if you suspect that you or a loved one have been the victim of Nursing Home Abuse, Neglect or Exploitation or other Elderly Abuse, Neglect or Exploitation so that we may assist you and your loved one.

We look forward to hearing from you soon!