Frequently Asked Questions
Elder Neglect & Abuse: Frequently Asked Questions
If you believe your elderly loved one has been the victim of nursing home abuse or neglect, contact us today for a free consultation by calling (800) 800-4600. We have qualified professionals standing by at all times, ready to take your call and answer your questions.
You can also contact Hughes & Coleman by using our online consultation form or by visiting our Kentucky offices in Bowling Green, Louisville and Elizabethtown.
What is elder neglect and abuse?
Elder neglect or abuse is the mistreatment or neglect of any elderly adult that causes physical, emotional, sexual or psychological harm. The World Health Organization defines elder abuse as “a single, or repeated, act, or lack of appropriate action where there is an expectation of trust which causes harm or distress to an older person.” Unfortunately, elder neglect or abuse is far more common than most people realize. While statistics are difficult to come by – most experts believe that 75 to 90 percent of all cases of elder neglect or abuse go unreported – the National Institute of Justice estimates that about 11 percent of people over the age of 65 suffer some form of abuse every year. In Kentucky, reports of elder neglect or abuse have been increasing. During an average year, Kentucky Adult Protective Services receives over more than 9,000 calls involving adults over 60, although many of these do not involve neglect or abuse.
How common is elder neglect and abuse in nursing homes?
Reports of the abuse and neglect of nursing home residents are increasing every year. It is not clear whether this is because more incidents are occurring or whether it is a result of a larger percentage of incidents being reported. However, any nursing home abuse or neglect is unacceptable. In 2001, a special report prepared by the Special Investigations Division of the House Government Reform Committee revealed that 30 percent of all nursing homes in the United States had been cited for abuse or neglect in the previous two years. Another study by researchers from Cornell University showed that 10 percent of nursing home staff members admitted to physically abusing their patients, while another 40 percent confessed to psychological abuse. Neglect is also distressingly common. For example, a study by the Commonwealth Fund revealed that up to one-third of all nursing home residents in the U.S. suffer from malnutrition and dehydration.
How common is elder neglect or abuse in Kentucky nursing homes?
There is no comprehensive report for Kentucky similar to the national studies that have been done on nursing home neglect and abuse. However the Centers for Medicaid and Medicare Services (CMS) examine and investigate every nursing home in the country, ranking them on the Five Star System to give residents and prospective residents an indication of the quality of services, safety precautions and staff. In addition, each year CMS compiles its own list of the “worst” nursing homes nationwide. By examining and analyzing this data, it’s possible to get a sense of the state of nursing home care in Kentucky.
There are 285 nursing homes in Kentucky, with a total of 25,874 beds for skilled nursing care. Approximately 90 percent of these beds are occupied at any given time. Kentucky’s overall average on the Five Star System is only 2.9, ranking Kentucky 44 out of 50 states. Eighteen percent of Kentucky nursing homes received the lowest possible rating – one star or “much below average” – while another 21 percent of the state’s nursing homes received two stars, a “below average” rating. It’s also possible to track the number of abuse and neglect complaints filed by residents of nursing homes. In 2009, only 35 percent of Kentucky nursing homes had no complaints. Thirty percent of nursing homes received 1 to 3 complaints, and a disturbing 35 percent received three or more complaints.
Last summer, an independent review by the Lexington Herald-Leader revealed that many serious cases of nursing home neglect or abuse were never investigated by the proper authorities. From 2006 to 2009, more than 107 Type A citations were issued to Kentucky nursing homes, but only 7 were prosecuted as crimes. These included many very serious cases, including incidents that ended with hospitalizations, broken bones and amputations, and 18 cases that resulted in death. The Herald-Leader’s report prompted a series of recommendations by the Cabinet for Health and Family Services for investigating and reporting nursing home abuse and neglect. The recommendations call for specialized Adult Protective Services teams, joint investigative teams among various branches of government, and additional training for law enforcement agencies and prosecutors on elder abuse and neglect. Governor Steve Beshear ordered that these recommendations be implemented.
Can nursing homes be held legally accountable for neglect and abuse?
Yes. Individual nursing home administrators, physicians, nurses or staff who neglect or abuse residents can be arrested and charged under various criminal statutes. If convicted, they can face fines or prison time. While it’s true that in recent years the state of Kentucky has not been as aggressive in prosecuting these cases as it could have been, it’s also true that Governor Steve Beshear has implemented changes to improve investigations, reporting and prosecution of abuse and neglect in nursing homes.
In addition, it is possible for victims and their families to win civil suits against nursing homes if a resident has suffered abuse or neglect there. At Hughes & Coleman, we know how to compile a compelling case including affidavits from witnesses, photo evidence, medical reports, and other evidence that will help you prove your case. Our lawyers have extensive experience in holding nursing homes accountable for the abuse and neglect of residents.
Are nursing homes required to report abuse or neglect?
Absolutely. Kentucky is a mandatory reporting state, which means that anyone who has knowledge of or reason to believe that an elderly person is being neglected or abused must report it to the Cabinet of Health and Family Services. The Cabinet must report the allegation to appropriate law enforcement officials within 24 hours. Administrators or staff who fail to do so can be held accountable in both criminal and civil court.
Last year, an elderly resident at a nursing home in Kentucky suffered a sexual assault. Although the administration was aware of the incident, the abuse went unreported. When family members alerted nursing home officials that the resident had become withdrawn and frightened, the officials claimed nothing had happened. Later, a second sexual assault happened to the same resident – an assault that might have been prevented if the nursing home had reported the first incident.
Kentucky state law requires physicians to report elder abuse. However, only two percent of elder abuse and neglect cases come to the attention of state authorities through physicians. Studies suggest that this is because relatively few physicians are aware of the signs of elder abuse.
Who abuses nursing home residents?
Nursing home residents may suffer abuse at the hands of a variety of people, including administrators, nurses, physicians and staff. Visitors to the home, either the patient’s own family and friends or other visitors, may also inflict abuse. A surprising amount of abuse comes at the hands of other residents. In one recent study, 2.5 percent of residents reported that they had experienced physical abuse from another resident over the course of the previous two weeks, and 7.3 percent reported experiencing verbal abuse from the same source during that time period.
Resident-on-resident aggression frequently takes place among patients with dementia, who are often segregated from other residents. Other factors associated with residential assault include overcrowding, a lack of maintenance and cleanliness in common areas and a lack of nurses’ involvement with their patients. In all cases, it is the responsibility of nursing home administration and staff to prevent such incidents. Nursing home residents have the right to a safe environment. Nursing homes that fail to provide one can be held legally accountable.
What are the signs of elder abuse and neglect?
Signs of physical abuse of the elderly include: frequent injuries, such as bruises, burns and broken bones; multiple bruises in various stages of healing; bruises in particular places such as the inner arms or thighs; obvious malnutrition or dehydration; loss of bladder or bowel control; slap marks; certain types of burns or blisters; and explanations that don’t fit the pattern of other physical injuries.
Signs of emotional abuse of the elderly include the residents’ withdrawal from normal activities and unexplained changes in alertness.
Signs of sexual abuse among the elderly include: evidence of unexplained sexually transmitted diseases; irritation, injuries or bruises to the mouth, genitals or anus; bruises around the breast area; distress when being changed or bathed; fear of a particular person; and loss of bladder or bowel control.
Signs of neglect of the elderly include: malnutrition or dehydration; dirty or uncombed hair; offensive body odor; torn or dirty clothing; neglect of shaving; hoarding; lack of glasses, dentures or hearing aids; lack of medical care; apparent weight loss; and untreated bedsores.
Do nursing homes’ neglect of safety precautions cause illness and injury?
Simple safety precautions taken by nursing home administrators and staff can make a significant difference in the lives of nursing home residents. For example, the most common cause of injury in nursing homes is falling – the average patient in a nursing home falls more than once a year. About 1,800 nursing home residents die each year because of falls, and many more are hospitalized. The most important step nursing homes can take to prevent falls is to keep the facility free from clutter. Elder care facilities can also make simple changes to make falls much less likely, such as putting in grab bars, adding raised toilet seats, lowering bed heights, installing hand rails and using adjustable bed heights.
A second major cause of death in American nursing homes is the flu. More than 18,000 people over the age of 65 die of the flu every year. Nursing homes can ensure that all residents receive flu shots – and that nursing home staff receive flu shots as well. Recent studies also show that simple hygiene precautions, such as consistent hand washing, actually do more to lower flu rates than vaccines. Nursing homes should institute serious policies requiring consistent hand washing by staff members.
Other simple precautions such as fire safety can make a big difference as well. Every year, 2,300 of the nation’s 16,000 nursing homes report some kind of structural fire. However, few deaths occur in nursing homes equipped with automatic sprinkler systems. There has never been a multiple death fire in an elder care facility with a full sprinkler system.
Nursing homes are responsible for the care and safety of their patients. If illnesses, injuries or deaths occur because a nursing home has neglected to employ or implement simple safety precautions, that facility can be held legally responsible.
What problems result from insufficient staffing?
One of the most serious problems in many nursing homes is a lack of sufficient staff to care for elderly patients. Unfortunately, national standards for minimum staffing requirements are limited. The government requires only that there be federally licensed nurses on duty 24 hours per day; that there be an RN on duty eight hours per day, seven days a week; and that there be an RN Director of Nursing at each facility. The National Citizens’ Coalition for Nursing Home Reform recommends that each facility have one licensed caregiver for every 5 residents during the day, every 10 residents during the evening and every 15 residents at night.
Unfortunately, most nursing homes fall far below these recommendations, and the residents suffer the consequences. One caregiver simply cannot meet the needs of 30 or more residents per shift. Basic services, including eating, bathing, dressing, security and dispensing medications, require the services of a minimum number of staff. A recent high profile lawsuit awarded millions of dollars to residents of a California nursing home chain which failed to maintain sufficient staff to care for residents. Residents and their families testified that patients in these facilities sometimes had to wait hours to be bathed, changed or taken to the toilets. Other serious consequences of insufficient staff can include patients who are malnourished or dehydrated due to lack of food and water. One study showed that in some nursing homes between 30 and 50 percent of all patients are malnourished.
What rights do nursing home residents have?
Nursing home residents have certain rights and protections under federal law, and those are set out on the Medicare website. Nursing homes must list and give all new residents a copy of these rights. Those rights include:
- The right to be treated with dignity and respect.
- The right to be informed in writing about services and fees before you enter the nursing home.
- The right to manage your own money or to choose someone else you trust to do this for you.
- The right to privacy, and to keep and use your personal belongings and property as long as it doesn’t interfere with the rights, health, or safety of others.
- The right to be informed about your medical condition, medications, and to see your own doctor. You also have the right to refuse medications and treatments.
- The right to have a choice over your schedule (for example, when you get up and go to sleep), your activities and other preferences that are important to you.
- The right to an environment more like a home that maximizes your comfort and provides you with assistance to be as independent as possible.
If you believe your elderly loved one has been the victim of nursing home abuse or neglect, contact us today for a free consultation by calling (800) 800-4600. We have qualified professionals standing by at all times, ready to take your call and answer your questions.
You can also contact Hughes & Coleman by using our online consultation form or by visiting our Kentucky offices in Bowling Green, Louisville and Elizabethtown.
