Nursing Home Dangers - Elder Abuse

Pam Flores @phflores Health Guide
  • October is Domestic Violence Awareness Month, and we will be looking at the impact it has on chronic illness and disability.  In addition, many other HealthCentral writers will be contributing as well from their unique medical perspectives which can be found at our Domestic Violence Awareness Month page.


    Our focus here will be on osteoporosis and elder care abuse, and how fractures can precipitate health care in the home, nursing homes and elder care facilities.


    To demonstrate the vast occurrence of abuse, let's look at some of the statistics for abuse in nursing homes.


    More than 30% of all nursing homes experience some form of resident abuse: Nearly 1/3 of all nursing homes have residents that are subject to abuse, whether it's by staff or other residents. These include malnutrition, physical abuse, psychological distress, exploitation, neglect, and sexual abuse.

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    90% of abusers are known: Nearly all of the time, those who abuse nursing home residents are not strangers. That means staff members, residents, or familiar visitors are almost always to blame for nursing home abuse.


    5,000 deaths in 1999 may be due to negligence: Red flags for nursing home negligence were listed on 5,000 death certificates of nursing home patients in 1999. These include starvation, dehydration, or bedsores as the cause of death.


    92% of all nursing homes employ at least one convicted criminal: Nearly all nursing homes open their doors to at least one convicted criminal, and there are no national requirements for background checks for nursing home employees.


    Osteoporotic fractures are just one reason why an elder loved one may end up in a long-term elder care facility.  We know that approximately 1.6 million hip fractures occur worldwide each year.  5-10% experience a recurrent hip fracture and the risk of dying after a hip fracture remains for an additional 5 years after the occurrence.  According to the International Osteoporosis Foundation, a 50 year old woman has a 2.8% risk of death related to hip fracture during her remaining lifetime, equivalent to her risk of death from breast cancer and 4 times higher than that from endometrial cancer.  With hip fractures there is almost always a loss of independence and mobility that requires on-going physical assistance in the elderly and also in younger individuals.


    Hip fractures are not the only type of fracture that can cause a patient to need in-home or nursing home health care.  Other fractures that are also very debilitating are pelvic, femur, metatarsal and spinal fractures.  These fractures take a tremendous time to heal in the elderly and while they are recuperating they'll usually need medical and physical assistance. 


    When your bones are fragile, it puts you at greater risk for fractures and compounded injuries due to abuse; so let's look at some of the warning signs.


    What are the Red Flags of elder abuse?

    • Bed sores
    • Unkempt appearance
    • Bruises
    • Disinterest in eating
    • Dry mouth and dehydration
    • Bed railings not in use
    • Inadequate help or expertise in transferring patients resulting in additional falls
    • Cluttered room, causing client to fall easily
    • Skin breakdown or burns
    • Cuts and abrasions


  • These are not all of the red flags associated with elder abuse, so we have a video for you at the end of this article to show what to look for. 

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    How do we prevent elder abuse?


    Not all instances of elder abuse can be prevented, but if we take some simple steps to keep in daily touch with our loved ones and talk to them frequently, we can learn a lot.  Most patients will not be aware of their abuse because they are in a situation of control and power by their care-takers, and when in this situation, they come to believe this is normal care.  The patient may be kept in an area that is hard to reach via phone, since they may be kept away from devices for contacting you.  If a patient can't reach the phone and can't walk without assistance, they can't call you, so you must reach out to them frequently. 


    Check to see if the facility or home health care service has a patient advocate that can check in on the patient regularly.  This service should be available, so please use it.


    How do you screen your nursing home?

    If you suspect elder abuse, who do you contact?


    What is the prevalence of in-home abuse on elders?


    In 1996, nearly 450,000 adults aged 60 and over were abused and/or neglected in domestic settings. Factoring in self-neglect, the total number of incidents was approximately 551,000.


    To prevent in-home abuse of elders, screen your care-giver thoroughly, using the links above and also use the National Center on Elder Abuse for this and many other very helpful links.


    We hope we've shed some light on this deplorable situation with elders, and ways to combat it, screen for better care and what to look for in identifying abuse.


    ** The following video will give you some insight on normal and abnormal age-related injuries and disease processes.  This video is graphic in its explanation and visuals on injury and abuse in our elder population. **





    Masters of Health Care June 8th 2011   


    National Elder Abuse Incidence Study. 1998. Washington, DC: National Center on Elder Abuse at American Public Human Services Association


    National Ombudsman Reporting System Data Tables. 2003. Washington, DC: U.S. Administration on Aging




Published On: October 26, 2011