It is troubling to think that the topic of elder care abuse and neglect in nursing homes is one we have to discuss, but, unfortunately, it is an issue that can adversely affect the older, and more vulnerable, people in our lives. Due to the nature of nursing homes, sometimes signs of abuse, or cries for help, are dismissed as indicators of old age or dementia. It is important to be cognizant of elder care signs of abuse and neglect to ensure the best care of our loved ones in their later years.The first thing to be aware of are the types of nursing home abuse that can occur. According to the National Center on Elder Abuse (NCEA), each type of abuse causes different types of symptoms that can indicate abuse:
Physical abuse is defined as the use of physical force that may result in bodily injury, physical pain, or impairment. Physical abuse may include, but is not limited to, acts of violence such as striking (with or without an object), hitting, beating, pushing, shoving, shaking, slapping, kicking, pinching, and burning. Also, inappropriate use of drugs and physical restraints, force-feeding, and physical punishment of any kind are also examples of physical abuse.
Signs and symptoms of physical abuse include, but are not limited to:
- bruises, black eyes, welts, lacerations, and rope marks;
- bone fractures, broken bones, and skull fractures;
- open wounds, cuts, punctures, untreated injuries in various stages of healing;
- sprains, dislocations, and internal injuries/bleeding;
- broken eyeglasses/frames, physical signs of being subjected to punishment, and signs of being restrained;
- laboratory findings of medication overdose or under utilization of prescribed drugs;
- an elder’s report of being hit, slapped, kicked, or mistreated;
- an elder’s sudden change in behavior; and
- the caregiver’s refusal to allow visitors to see an elder alone.
Sexual abuse is defined as non-consensual sexual contact of any kind with an elderly person. Sexual contact with any person incapable of giving consent is also considered sexual abuse. This includes, but is not limited to, unwanted touching, all types of sexual assault or battery, such as rape, sodomy, coerced nudity, and sexually explicit photographing.
Signs and symptoms of sexual abuse include, but are not limited to:
- bruises around the breasts or genital area;
- unexplained venereal disease or genital infections;
- unexplained vaginal or anal bleeding;
- torn, stained, or bloody underclothing; and
- an elder’s report of being sexually assaulted or raped.
Emotional or Psychological Abuse
Emotional or psychological abuse is defined as the infliction of anguish, pain, or distress through verbal or nonverbal acts. Emotional/psychological abuse includes, but is not limited to, verbal assaults, insults, threats, intimidation, humiliation, and harassment. In addition, treating an older person like an infant; isolating an elderly person from his/her family, friends, or regular activities; giving an older person the “silent treatment”; and enforced social isolation are examples of emotional/psychological abuse.
Signs and symptoms of emotional/psychological abuse include, but are not limited to:
- being emotionally upset or agitated;
- being extremely withdrawn and non-communicative or non-responsive;
- unusual behavior usually attributed to dementia (e.g., sucking, biting, rocking); and
- an elder’s personal account of being verbally or emotionally mistreated.