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nursing home neglect

Nursing home abuse is a form of medical malpractice. When you place your loved one in a nursing home, you expect them to receive exceptional care. Unfortunately, residents in nursing homes are vulnerable, and far too many nursing homes expose their residents to abuse and neglect.

These abuses don’t just happen in the lowest-cost nursing facilities. Abuse and neglect are persistent problems throughout the long-term care industry. In fact, in a survey of nursing home staff conducted by the National Center on Elder Abuse, 50% of staff admitted to mistreating residents. This alarming prevalence of abuse is why it’s important to know how you can protect your loved ones from nursing home neglect and abuse — and what you should do if you find out your loved one has become a victim.

Signs of Nursing Home Abuse

While every nursing home abuse case is unique and requires a thorough investigation, there are certain behavior patterns and symptoms that should raise alarms over the possibility of abuse and neglect.

If you observe any of the signs listed below, you should visit the website for the Virginia Office of the State Long-Term Care Ombudsman. Then, find your local long-term care ombudsman, contact them, and request an investigation. And if your loved one is in imminent danger of physical harm, call 911 right away.

Below, we will outline some of the more common signs of nursing home abuse and neglect.

Signs From Your Loved One

Emotional and Physical Changes

Abuse and neglect often lead to physical and emotional changes in victims, including:

      • Emotional changes: Your loved one may seem less able to function normally, and they may stop participating in activities or act withdrawn and distant. Other signs may include agitation, fearfulness, weight loss, decreased appetite, and changes in mood and sleep patterns.
      • Physical changes: Signs of physical abuse or neglect may include unexplained bruising, ulcers, and lacerations. Often, abusers will inflict these wounds around hidden areas such as the hips, thighs, and upper back. Other times, insufficient fall protections in a facility can lead to bruising, broken bones, and other injuries.

Although many of the signs listed above can be caused by medical negligence and neglect, they can also be symptoms of an underlying disease or another health issue. Consider these signs in the broader context of your loved one’s health and the behavior of facility staff. And make sure to ask your loved one’s primary care physician about any physical and behavioral changes you notice.

 Emotional Distress

If your loved one seems distressed or uncomfortable around any staff members, take their anxiety seriously. Make sure to observe your loved one when staff is around as well as on their own and watch for any alarming changes in behavior or demeanor.

Dehydration and Malnourishment

While nursing homes have a duty to provide sufficient food and fluids to their residents, dehydration and malnourishment are two of the most common signs of elder abuse and neglect among nursing facility residents. Since many older people experience reduced thirst and appetite, they may not even know they are suffering from the effects of too little food or water. Understaffing and insufficient training are the root cause of many dehydration and malnourishment claims.

To spot dehydration and malnourishment, watch for symptoms like:

      • Weight loss
      • Sunken eyes
      • Low blood pressure
      • Decreased urine output
      • Constipation
      • Dry skin
      • Dry mouth
      • Lack of sweat
      • Rapid breathing or panting
      • Unusual smell
      • Confusion

Signs From the Facility and Staff

Refusing to Answer or Avoiding Questions

Long-term care experts agree that observing facility staff and asking questions is one of the best ways to detect and deter nursing home abuse and neglect.

“If staff are evasive with your questions, unable to answer your questions, or refuse to discuss your loved one’s care with you, this is a big red flag that care may be suboptimal,” says Amy Jo Haavisto Kind, an assistant professor in geriatrics at the University of Wisconsin School of Medicine and Public Health.

Examples of staff responses that should concern you might include:

      • Regularly failing to provide answers to your questions
      • Indifference or dismissive attitude from staff in response to questions
      • Providing unsatisfactory answers such as, “This is how we do things around here.”

Inadequate Staff and High Staff Turnover

Some nursing home abuse and neglect occurs because facility staff members are overworked and constantly stressed. This fact doesn’t excuse the abuse. It does indicate that the behaviors may be a “top-down” problem that stems from poor management, and it can help you spot a potentially dangerous situation for your loved one.

Signs that may indicate a nursing facility has a staffing problem include:

      • Inadequate staff: A nursing home’s staff should stay busy, but the facility shouldn’t feel chaotic every time you visit. Watch out for employees displaying unfriendly attitudes and keeping to themselves rather than talking to residents during meal and activity times. And make sure that you and your loved one are familiar with supervisors and leadership. Uninvolved leadership is a classic warning sign of a bad nursing home.
      • High staff turnover: Some staff turnover is unavoidable in nursing homes. But if you notice your loved one’s nursing home is constantly training new staff and no one knows your loved one, it could indicate serious culture problems at the facility.

Unanswered Call Lights and Ringing Phones

Take note if the staff doesn’t have time to pick up phones or answer call lights. If your loved one says they have to wait a long time after pushing the call button, investigate the problem. You may want to put the call light on yourself and see how long it takes for a staff member to show up. When you bring any concerns up with the staff, make a note of the conversation and any measures the staff members say they will take to address your concerns. Then follow up with your loved one later to make sure the staff members have followed through.

Poor Hygiene and Lack of Cleanliness

Watch for hygiene and cleanliness issues among staff, residents, and the facility itself, even if they don’t seem to be affecting your loved one so far. Evidence of understaffing or other staff issues can include:

      • Poor resident hygiene
      • Disorganization and clutter around the facility
      • Unclean rooms and common areas
      • High rates of contagious illnesses and infections among residents and staff

How a Nursing Home Abuse Lawyer Can Help Stop Abuse

After you contact the relevant authorities and make sure your loved one is out of danger, you should contact an experienced attorney if you suspect your loved one is suffering from abuse or neglect. An attorney can work with authorities to move the investigation forward. At the same time, they can build a legal case to hold the abusers accountable and prevent other vulnerable nursing home residents from suffering abuse and neglect in the future.

RELATED VIDEO: Frances and Richard G.’s Story

Because many nursing home abuse claims involve medical malpractice, look for an attorney with significant experience handling both elder abuse and medical negligence lawsuits. These claims require a careful legal and factual analysis and guidance from expert witnesses. If your lawyer doesn’t understand the nuances of medical malpractice cases, you’ll be at a significant disadvantage.

RELATED ARTICLE: Proving Medical Malpractice: Why Experts Matter for Your Lawsuit

If you decide to file a lawsuit against a nursing home, expect resistance from the facility. Most likely, they’ll try to argue that your loved one suffered harm because of underlying health issues or factors beyond the facility’s control. Your lawyer will need to conduct a thorough, painstaking investigation to counter these defenses. Although most cases settle out of court, you and your attorney will need to approach the case prepared for a trial to seek a fair settlement offer.

Contact Phelan Petty if You Suspect Nursing Home Abuse or Neglect in Virginia

If your loved one has suffered abuse or neglect in a nursing home or other long-term care facility, or if you’re concerned about the possibility of abuse or neglect, contact Phelan Petty today to schedule your free initial consultation and get advice from an attorney at no cost. Our attorneys have years of experience handling complex malpractice and personal injury cases, and if we’re able to take your case, we’ll investigate thoroughly and fight aggressively to get your loved one the justice and compensation they deserve.

To schedule your initial consultation with an experienced attorney, fill out our online contact form or call us at 804-980-7100.


Hiatt, K. (2013, February 26). 9 warning signs of bad care. U.S. News & World Report. Retrieved from

The National Center on Elder Abuse. (1998, September). The National elder abuse incidence study: Final report. Washington, D.C.: U.S. Department of Health and Human Services. Retrieved from

The content provided here is for informational purposes only and should not be construed as legal advice on any subject.