Elder abuse is a growing problem as the number of people reaching old age increases. Many will require placement in residential or skilled nursing facilities as they are unable to care for themselves. Our elders need to spend their later years in safety and comfort, not in fear or deprivation.

Recognizing the signs of nursing home abuse or neglect helps ensure that your loved ones do not experience these things.

There are four basic types of nursing home abuse and they include:

1. physical abuse
2. emotional abuse
3. sexual abuse
4. financial abuse

Neglect, while not strictly abuse, is the absence of care or attention that should be provided to the resident and can be just as damaging, if not more so.

physical abuse It is the most reported type of abuse. It occurs when a caregiver inappropriately touches or hits someone in her care. This can be pinching, kicking, biting, hair pulling, hitting, or under- or over-medicating the resident. The disabled are at greatest risk, and the risk is equal between male and female residents. Signs of physical abuse can be sores, welts or bruises, broken bones, scratches, or bite marks. A loved one who is lethargic or unresponsive may be overmedicated or may need untreated treatment for a physical or behavioral condition.

emotional abuse can cause mental suffering in a vulnerable resident. A caregiver who yells, curses or threatens a resident can cause fear and depression in those who depend on him for her care. Isolating, restricting, refusing to talk to a resident or allowing them to access news, phone calls, or interact with others can be emotional abuse. A resident who was interactive and sociable who becomes quiet and withdrawn may fear further abuse.

sexual abuse it is often driven by the need to control and dominate. Frail, elderly, or disabled men and women are at risk of abuse by sexual predators due to their inability to protect themselves. Signs of sexual abuse can be injuries around the genital area, a diagnosis of sexually transmitted diseases, or discomfort in the buttocks or genital area. It can be forced sexual contact, manipulating a person with a mental disability into sexual behavior, or making inappropriate comments of a sexual nature.

financial abuse is the misappropriation of a resident’s belongings, money, or improper access to bank accounts. A caregiver who requests tips or compensation in addition to her salary may be guilty of financial abuse. Billing for care that was not provided can be a form of financial fraud and abuse.

Negligence is the failure to care for or keep a resident safe from harm. It can be physical neglect or emotional neglect. Dehydration, malnutrition, weight loss, poor hygiene, unsafe or dirty environments, lack of social opportunities and stimulation can all be signs of neglect. Failure to treat a decline in medical condition may be negligence or medical malpractice.

Nursing home staff should be screened for a history of abuse and trained in abuse prevention and how to care for residents with behavioral disorders. But this is not a guarantee that abuse will not occur. Staff impatient or unable to depersonalize behaviors and understand why they occur are at risk of abusing the behavioral resident.