According to the Nursing Home Reform Act of 1987, all residents in nursing homes are entitled to receive quality care and live in an environment that improves or maintains the quality of their physical and mental health. This includes freedom from neglect, abuse and misappropriation of funds. Neglect and abuse are criminal acts whether they occur inside or outside a nursing home. Nursing home residents do not surrender their rights to protection from criminal acts when they enter a facility.

Neglect is the failure to care for a person in a manner, which would avoid harm and pain, or the failure to react to a situation which may be harmful. Neglect may or may not be intentional. Examples include incorrect body positioning which leads to contractures and skin breakdown; lack of toileting or changing of disposable briefs, causing incontinence resulting in residents sitting in urine or feces, increased falls and agitation, indignity and skin breakdown. Lack of assistance with eating or drinking can lead to dehydration and malnutrition. Lack of assistance with walking can lead to immobility. Lack of bathing can lead to indignity and poor hygiene. Poor hand washing can lead to infection. Lack of assistance with participating in activities of interest can lead to withdrawal and isolation. Ignoring call bells or cries for help is yet another form of neglect.

Abuse is causing intentional pain or harm and may be physical, mental, verbal, psychological or sexual. Residents may experience abuse from a staff member or an intruder or visitor from outside the facility—including a family member. Forms of physical abuse include hitting, pinching, shoving, force-feeding, scratching, slapping or spitting. Forms of psychological abuse include ignoring, berating, ridiculing, cursing and threats of punishment or deprivation. Sexual abuse includes improper touching or coercion to perform sexual acts. Substandard care is another form of abuse and may result in immobilization, incontinence, dehydration, pressure sores and depression. Abuse may also include rough handing during care giving, medicine administration, or moving a resident. Financial abuse occurs when a resident’s belongings or money are misplaced or misused without the resident’s consent. Examples include not placing resident funds in separate interest-bearing accounts and stealing or embezzling a resident’s money or personal property, such as jewelry or clothing.

Nursing homes are required by law to have intervention strategies and regular monitoring to prevent neglect and abuse. Anyone suspecting abuse or neglect may report to the facility’s administrator or director of nursing, the state or local ombudsman, the local police or state law enforcement, adult protective services, or the state survey agency that licenses and certifies nursing homes. More information about abuse and neglect of the elderly may be obtained by contacting Ombudsman Supervisor Michelle Goins at 1-800-375-8255 Ext. 127. Ombudsman volunteers continue to be needed. Training is free, flexible and available in your area.