What to look for, who to call, and how to make a claim if you suspect nursing home abuse
Placing an older family member in a nursing home is a difficult decision. You might not have the capability or resources to care for a parent or grandparent in your own home, and they might not be able to stay in theirs. And, often, these decisions need to be made quickly because of a sudden change in a person’s condition.
While you want the best care for your loved one — at an affordable cost — you might also be concerned about what happens to them when you’re not around, especially if you’re not sure they can communicate with you effectively.
You might also be caring for a person who’s not elderly but who requires long-term care. This would be a person with a chronic condition, trauma, or illness that limits their ability to manage daily needs. There are a variety of ways someone could receive long-term care, including:
- Adult day services
- Home health care
- Homemaker services
- Home telehealth
- Continuing care retirement community
- Supportive housing programs
- Assisted living facilities
- Family caregiving
Nursing homes and other long-term care facilities are regulated by the North Carolina Division of Health Service Regulation (DHSR), which is a division of the North Carolina Department of Health and Human Services (NCDHHS). Among other things, the DHSR provides licensing for acute, home care, and adult care and handles complaints about licensed facilities.
The North Carolina State Data Center estimates that by 2025, there will be more people over age 60 than under 18 in 90 of the 100 counties in the state — there are 2.4 million people born between 1946 and 1964 who will be entering retirement.
June 15th is World Elder Abuse Awareness Day.
- The CDC estimates that about 13% of people (1 in 8) age 85 or older live in a nursing home or long-term care facility, as compared to 1% of people age 65 to 74. As of the CDC’s most recent report, about 1.4 million people across the country were living in nursing homes.
- 52% of people age 65 or older will require long-term care at some point in their lives. An estimated 47% of men and 58% of women age 65+ will require long-term care
- Senior men require long-term care for an average of 1.5 years, whereas women average around 2.5 years of care.
- 14% of people need long-term care for longer than 5 years.
- 8% of people between the age of 40 and 50 have a disability that requires them to obtain long-term care services.
- It’s estimated that only 7% of elder abuse cases are reported to authorities.
6 types of nursing home abuse
- Physical abuse could be any event or condition that causes physical injury or harm. It could be intentional, like aggressive handling. It also includes neglect, such as a lack of physical care or overuse of restraints.
- Sexual abuse is unwanted sexual attention or exploitation. It might also involve sexual acts against a patient who experiences dementia, Alzheimer’s Disease, or other cognitive deficit that leaves them unable to know what’s happening or express their wishes because they’re incapable of providing consent.
- Neglect can be unintentional. Often, it happens when a facility is inadequately staffed to appropriately care for residents’ needs. Neglect includes failing to provide personal hygiene, food, clothing, or water.
- Financial exploitation is when a caregiver takes advantage of a patient’s financial situation. This can mean stealing a resident’s personal property, but it could also be theft from a bank account, using the patient’s personal information to apply for credit, or other types of identity theft for personal gain.
- Psychological or emotional abuse can be the most difficult to detect. A caregiver might yell, criticize, shame, or humiliate a patient in a way that causes anxiety, upset, or behavior changes.
- Resident-to-resident abuse happens, too. Not all abuse is at the hands of a caregiver. This is usually physical, psychological, or sexual. It’s the caregiver’s responsibility to keep every patient safe and free from harm by other individuals, no matter who they are.
Bruising in older adults who are being physically abused
We know that older adults are more prone to bruising and are more likely to be injured in a fall than younger individuals. The Centers for Disease Control and Prevention (CDC) reports that 3 million older adults are treated in an emergency department each year for fall injuries. In many instances, a fall happens because of the person’s own condition — weakness, difficulty balancing, effects of prescription medications, vision problems, or foot problems.
An older adult might fall for any of these reasons, and it’s “just” an accident. But part of the role of a nursing home is to have staff available to prevent a fall from happening. Considering the population that lives there, a nursing home should have enough staff that someone is available to provide a resident (especially one who has one of the conditions mentioned above that might affect their mobility) with assistance moving from one location to another. Failure to do so might be compensable as part of a nursing home neglect lawsuit if your loved one has fallen and sustained a serious injury.
However, there are ways to look at a bruise and see if it seems to be indicative of “normal” bruising in an elderly person or if there’s cause for alarm.
The Center of Excellence on Elder Abuse and Neglect at the University of California published a study on how to tell if an older adult is being physically abused. Here’s what you should know about bruises in an older adult:
- Bruises tend to be larger in adults who are being abused. Most people in the study who were being abused had at least 1 bruise that was 5 cm (2 inches) or larger in diameter.
- Adults who are being abused tend to have more bruises on the head, face, arms, hands, elbows, abdomen, and lower back.
- Even among adults with dementia or other memory problems, 90% could say how they got their bruises if they’ve been physically abused.
- Bruises and cuts around a person’s wrists or ankles might indicate use of restraints, which could be a sign of abuse.
Liability for nursing home abuse
Who’s liable if you believe your family member is being or has been abused in a nursing home?
There are a lot of people and entities that could be liable, sometimes depending on if the facility is privately or publicly owned.
For instance, you might file a lawsuit against:
- Staff members who intentionally harmed or neglected your family member.
- Supervisors whose responsibility involves overseeing and managing staff.
- The owner or operator of the facility.
How and when to file a lawsuit for nursing home abuse in North Carolina
If you believe that a loved one is being harmed or at risk of harm in a nursing home, you should call the Complaint Hotline at 1-800-624-3004 (within North Carolina) or 919-855-4500. You can also fax a complaint to 919-715-7724 or mail it to: Complaint Intake Unit, 2711 Mail Service Center, Raleigh, NC 27699-2711. Printable complaint forms and other information is available from the NCDHHS website.
A lawsuit is for an injury that has already happened.
The basis of a personal injury lawsuit is that a person was injured because of someone’s negligence. In any injury lawsuit, there are 5 elements for proving negligence:
- The defendant had a duty to either act or not act in a specific way.
- The defendant breached their duty.
- Breach of that duty was the cause of the plaintiff’s injury.
- The defendant should have foreseen the likelihood that someone would be harmed by their action or inaction.
- The injury resulted in actual damages.
Types of damages in a nursing home abuse lawsuit
You can recover damages for costs associated with the injury, or for a wrongful death.
Damages for a nursing home lawsuit include:
- Medical treatment. A personal injury award almost always includes the cost of medical care, both to repay what you’ve already spent on care and to pay for estimated future treatment related to the injury.
- Property loss. If the abuse was of a financial nature, involving theft of any kind (either direct theft of money or possessions, or identity or credit-related theft), you can sue for the amount of money lost.
- Emotional distress. Emotional distress damages compensate a plaintiff for the non-physical effects of an injury. This might include fear, anxiety, sleep disturbances, post-traumatic stress disorder, or other psychological conditions that arise following a trauma or serious injury.
- Loss of enjoyment. Life is about more than the necessities. You might be able to eat, sleep, and function, but can you enjoy your time? Anyone who has been injured to the extent that they lose some level of capacity to do the things they previously enjoyed—even if it’s playing chess or visiting with grandchildren—could be eligible for a damage award for loss of enjoyment.
Signs of nursing home abuse
Whether you’re nearby or far away, there are some things to look for as a loved one receives nursing home care. It’s hard to know what’s happening inside the doors of a nursing home. A lot of people feel guilty or stressed about putting a family member in a nursing home, but you shouldn’t. The vast majority of people in nursing homes are well-cared for, content, and as healthy as possible.
However, elder abuse and neglect is a serious problem in nursing homes in North Carolina and nationwide.
Here are some of the signs of nursing home abuse:
Keep a list of dates and observations. If you see a strange bruise, your family member says something unusual, or the number of pills in their possession seems a little off, make a note of it. This could be your best evidence if you need to pursue the matter further.
Steps to protect your loved one from nursing home abuse
- Appoint a guardian. If you’re unable to visit regularly, contact a volunteer agency to see if you can find a helper who can visit your loved one regularly. A person who has family or friends “drop in” is less likely to suffer abuse.
- Review financial statements. If your loved one isn’t able to manage their own financial details, be sure that you or another trusted family member are regularly reviewing their financial statements. Even a fast monthly or quarterly skim of bank accounts, credit card bills, and legal documents is enough to check for any unusual transactions or changes.
- Unannounced visits. If you’re able to visit, do so without the facility knowing ahead of time that you’re coming. They can’t require you to call ahead, though it’s reasonable to expect that you’d come during daytime or evening hours and not when residents are likely to be sleeping. It’s your family member — you have a right to visit whenever you want.
- Get to know the staff. If your family member has specific caregivers on certain shifts, get to know those people. A caregiver will feel more accountability when you know them by name and see their interactions or relationship with the person in their care.
If you believe your loved one has been injured or neglected while in the care of a nursing home or long-term care facility in North Carolina, there are lawyers who can help you protect their well-being and seek financial compensation for any harm or injury suffered. The Enjuris law firm directory is your guide to finding a competent, experienced attorney in your area who will guide you through the process.
See our guide Choosing a personal injury attorney.