Abuse and Neglect in Nursing Homes

More than two million people age 65 and older1 call “home” the 17,000-plus nursing homes they reside in throughout the United States. Unfortunately, “home” is a nicer place for some than it is for others.

The Nursing Home Reform Law of 1987 requires nursing homes to provide all residents with quality care in an environment that improves or maintains the quality of their physical and mental health. Residents rights entitle them to freedom from neglect, abuse, and misappropriation of funds. But the law alone can’t guarantee that every resident is able to exercise those rights. If you witness abuse or neglect in a nursing home, taking action can preserve the well-being of all residents.

Neglect can be unintentional as well as deliberate. A caring aide who is inadequately trained can unknowingly be responsible for dehydration, increased falls, or malnutrition among residents.

Abuse, however, means causing intentional pain or harm including physical, mental, verbal, psychological, and sexual abuse, corporal punishment, unreasonable seclusion, physical or chemical restraint, and intimidation. These are deliberate acts meant to harm the resident.

Misappropriation of funds occurs when a resident’s belongings or money is misplaced or misused without the resident’s consent. For example, not placing the funds in separate interest-bearing accounts where required or stealing or embezzling a resident’s money, jewelry, or clothing.

In addition to the federal law established by The Nursing Home Reform Act, Michigan state law concerning residents rights specifically addresses discrimination, privacy in treatment and care, refusal of care, the resident’s role in determining care, the right to lodge formal complaints, how a resident is transferred or discharged, and the resident’s right to associate and communicate privately with people of his/her choice, as well as other issues.2

Federal law requires nursing homes to have intervention strategies and regular monitoring programs in place to prevent neglect and abuse. However, anyone can, and should, report occurrences of suspected neglect and abuse. If you believe these crimes are occurring, or if a resident tells you they are experiencing neglect or abuse, report the allegation immediately.

You can inform the nursing home administrator, preferably by written letter documenting the event. It’s also a good idea to keep a copy of the letter for your own records. Michigan law requires specific steps to be followed by the nursing home to investigate any claim of abuse or neglect. You also can report the allegation directly to the Michigan Department of Public Health at 517-373-3500 or the Michigan Department of Consumer and Industry Services at 517-241-4712.

To learn more about nursing home regulations and residents’ rights visit the National Citizens’ Coalition for Nursing Home Reform at www.nccnhr.org.

When visiting a nursing home, be aware of all that is going on around you. Listen to conversations between residents, between aides and residents, and between health care professionals. Think about what you see in the context of how it might affect residents who are living there 24-hours-a-day, seven-days-a-week, and consider if you are witnessing any of the following:

  • Misuse of physical and/or chemical restraints.
  • Incorrect body positioning leading to limb contractions.
  • Lack of help eating and drinking leading to malnutrition and dehydration.
  • Verbal/emotional abuse including berating, ignoring, ridiculing, or cursing a resident.
  • Ignoring call bells and cries for help.
  • Physical abuse including hitting, pinching, shoving, force-feeding, slapping.
  • Improper handling of accidents.
  • Poor hygiene.
  • Lack of respect for residents.
  • Rough handling during care-giving, medicine administration, or moving a resident.
  • Poor care resulting in immobilization, incontinence, pressure sores, depression.

1 www.infoplease.com Population 65 Years and Over in Nursing Homes by Age, 1990 and 2000. Source: U.S. Census Bureau, Census 2000 special tabulation; 1990 Census of Population, Nursing Home Population; 1990 (CPH-L-137).

2 www.michiganlegilsature.org Public Health Code (Excerpt) Act 368 of 1978;