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Complete Guide to Recognizing Elder Abuse

Complete Guide to Recognizing Elder Abuse

Elder abuse and neglect is becoming more and more common in the United States.  In order to help combat this problem in our society, it is important to learn more about the common forms of elder abuse, the signs and indicators of such abuse, and how to step in and help prevent abuse when it becomes apparent that a loved one or someone around you is suffering from elder abuse.  This article will serve as a guide to navigating the issues associated with elder abuse and neglect.

Bed Sores as an Indicator of Elder Abuse

Bed sores are one common form of elder abuse.

The proper medical term for bed sores is “decubitus ulcers”, however they may also be referred to as pressure sores.  When an elderly individual has bed sores, it can be an indication that they are not being properly cared for.

The Formation of Bed Sores

Bed sores start to form when substantial pressure is applied to an elderly individual’s body in some way.  It is often due to friction resulting from material such as bedding, or a cast or brace coming into contact with one’s skin.

Another way that bed sores can form is due to prolonged exposure of a person’s skin to cold temperatures for an extended period of time.  There are also certain areas of the body which are more susceptible to the development of bed sores.  Bed sores tend to form more often in areas where the skin tissue is closely connected to bone, such as the spine, elbows, hips, and tailbone.

Treating Bed Sores

Once bed sores have been formed, it is imperative to get treatment immediately.  The first step in the treatment process is to ensure that the wound is clean and that any necrotic (dead) tissue in the wound has been removed.  This step helps fight infection.

Medication, such as antibiotics, are often used as additional treatment for bed sores.  Bed sores can be extremely serious, even requiring surgical removal of necrotic tissue or amputation of the affected limb, depending on the severity of the wound.

An additional aspect of necessary treatment for bed sores also involves removing the source of pressure from the limbs or body parts injured so that further tissue damage is prevented before the injury can become more severe.  Keeping the affected elderly individual properly hydrated and ensuring that they maintain proper nutrition is also an important step in helping their body begin to recover and repair itself from the injury.

Due to the serious nature of these injuries, it is vital to treat bed sores immediately.  If there is a delay in treatment, the consequence may be serious injury or even wrongful death.

Elder Abuse – Sexual Assault

stop sexual elder abuse

Sexual assault is another unfortunate form of elder abuse.  Sexual abuse of an elder is defined as any action taken against an elder that is sexual in origin and unwanted.  Typically, elder sexual abuse occurs with elders that are sixty years of age or older.

Elder sexual abuse also includes sexual contact with an elderly person who cannot properly communicate their desire not to participate in the behavior, for reasons such as dementia or mental illness.

Additionally, this abuse also includes situations in which the elderly person cannot properly communicate their consent for the sexual activity. When an elderly individual is suffering from sexual abuse, it is also common for them to be experiencing emotional or physical abuse, as well.

There is a current need for more research in the area, as the sexual abuse of elders is poorly understood at this time.  The main reasons for the lack of research and understanding in this area is due to the fact that the victims of elder abuse tend to have more medical issues which result in trouble with communication, memory loss, and general confusion.  For these reasons, many cases of elder sexual abuse are not reported.

Indicators of Elder Sexual Abuse

If you are concerned that a loved one or someone around you may be a victim of elder sexual abuse, there are several signs and indicators that are commonly present in these types of situations.

Being aware of these signs can help you recognize the presence of elder abuse and allow you to step in and stop the abuse as soon as possible.

Sexual elder abuse signs include:
  • Difficulty walking or sitting
  • Pelvic injury
  • Genital bruising/inner thigh bruising
  • Recent development of a sexually transmitted disease
  • Torn or bloody underwear or clothing
  • Anxiety and panic attacks
  • Genital bleeding
  • Development of post-traumatic stress disorder (PTSD)
  • Attempts of suicide
  • Emotional or social withdrawal from others around them
  • Inappropriate or unusual sexual activities

Sexual Elder Abuse Statistics

The Pennsylvania Coalition Against Rape (PCAR) has performed various studies on the topic and uncovered the following statistics on the topic of elder sexual abuse in the United States.

The PCAR has found that:
  • Women are more likely than men to become victims of elder sexual abuse, at a rate of six times more likely.
  • Approximately 30 percent of victims of elder abuse over the age of 65 take the step of reporting such abuse to the authorities.
  • Nearly 83 percent of elder sexual abuse victims are living within an institutional care center, like a nursing home facility.
  • Approximately 27 percent of instances of elder sexual abuse happened inside the elder’s own house or in the perpetrator’s house.
  • Around 80 percent of the time, the person who was the perpetrator of the elder abuse was in a caregiving position to the elder.
  • Approximately 67 percent of sexual abusers of the elderly were actually members of the family.
  • Nearly 76 percent of elders who suffered from sexual abuse had the incident witnessed by another person.

Additionally, the National Institute of Justice (NIJ) conducted research studies which found that the oldest victims of elder sexual abuse were less likely than younger victims to help assist in the conviction of the perpetrator of their abuse.

The same study also found that elder victims who have suffered from sexual abuse are less likely to be believed, especially in situations where there are no apparent signs of trauma to the body.  According to the study, the elderly victims who resided in a nursing home tended to have the lowest chances of getting the perpetrator of their abuse convicted for the crime.

Elder Abuse and Neglect – Choking and Suffocation in Nursing Homes

elder man choking

One of the leading causes of death in nursing homes is choking and suffocation by elderly residents.  One reason for this is that patients who are suffering from Alzheimer’s disease, dementia, and other types of cognitive impairments may have trouble eating safely by themselves.

For these individuals, assistance may be required by nursing home staff to help them eat and swallow properly.  Unfortunately, while there are federal laws that require nursing home facilities to have adequate staff for their residents, there are many instances where impaired residents are unable to get the assistance they need while eating.

Choking Injuries in Nursing Homes

Although choking injuries may seem accidental, nursing home facilities can and should be held accountable for injuries sustained due to choking and suffocation in certain circumstances.

In cases where the choking injury occurred as a result of the elderly resident not being properly monitored, it may be the fault of the nursing home, and your loved one may then have a claim for compensation in a nursing home abuse case.

Suffocation Injuries in Nursing Homes

The same issues are also present when it comes to suffocation.  Some patients or nursing home facility residents are immobile or cognitively impaired or require supplemental oxygen, and these patients may need special assistance to make sure that they are not injured by getting their heads stuck in bed rails or entangled with other types of restraining devices.  Nursing home facility staff must take patients and residents with these special needs into consideration and be sure that they are effectively being monitored.

It is also necessary for the facility staff to make sure that oxygen tubes are kept free from any obstructions, which could endanger the elder resident.  It’s very important for the facility staff to make sure that patients with tracheostomies are getting proper care to ensure that their trachea is not inadvertently pulled out by other residents, incompetent staff, or even the patient themselves.

Injuries Resulting from Clogged Breathing Tubes

Another danger for elderly nursing home residents is clogged breathing tubes.  Like choking, it is possible for clogged breathing tubes to cause serious brain damage or even death.  It is a requirement that nursing homes and other health care providers are to make sure breathing tubes for their residents are kept clean and are working adequately.

One way to ensure proper care of elderly residents who require the use of breathing tubes is to increase the monitoring of these patients.  If the facility staff fails to adequately monitor these tubes, a clog may occur in the tube that disrupts or restricts the elderly person’s ability to breath.

If an elderly person suffers an injury due to the facility’s failure to properly monitor the resident which caused a clogged breathing tube, it is typically then considered the fault of the nursing home that such an injury occurred.  In that event, the elderly resident or his or her family may bring a nursing home abuse claim on their behalf.

Injuries Resulting from Eating

It is common for nursing home residents to have difficulty with chewing and swallowing their food.  They may also have poor judgment due to their age or onset of dementia.

If the nursing home facility is aware of the resident’s issues with eating, the facility staff should be assessing their patient to understand what foods are safe or unsafe for them to eat.  In order to meet the resident’s needs, the nursing home may need to provide soft food only or take action to cut up certain kinds of food in small pieces.  They also may need to ensure these residents are properly monitored while they are eating to avoid any choking injuries at mealtime.

Infections in Nursing Homes

elder woman nursing home infection

Another common type of injury suffered by the elderly population in nursing homes and other residential facilities is an infection.  Infections that occur in residents in nursing homes tend to be associated with increased risks of mortality and morbidity, and often result in hospitalizations and high healthcare costs.  It is estimated that approximately two million infections occur in nursing facilities in the United States each year.

Risk Factors for Infections in the Elderly

Some risk factors for infections occurring in elderly individuals include:

  • A recent hospital admission
  • Impairments in function
  • The use of indwelling devices
  • Other illnesses

For example, residents who require the use of feeding tubes tend to be more at risk for aspiration pneumonia and soft tissue and skin infections.

Common Types of Infections Acquired in Nursing Homes

Some of the more common infections contracted by elderly persons residing in nursing homes include:

  • Influenza
  • Urinary tract infections
  • Skin infections,
  • Gastroenteritis
  • Respiratory infections
  • Soft tissue infections


The leading cause of death among nursing home residents is pneumonia and similar lower respiratory tract infections.  These types of infections are also one of the most common reasons for the need to transfer residents to the hospital for treatment.  Residents at the highest risk of pneumonia are those that require feeding tubes.

Pneumonia in the elderly may not be immediately recognizable because the infection may present with some atypical symptoms.  About 25% of elderly adults may not develop a fever despite having contracted pneumonia, and they are also less likely to experience chills and chest and muscle pain when compared to younger patients with pneumonia.  A doctor will typically make the diagnosis of pneumonia in an elderly person based on blood test results and chest x-rays.

Elopement and Wandering by Elderly Nursing Home Residents

elderly man elopement from nursing home

Elopement, in the nursing home environment, is defined as a form of unsupervised wandering.  Elopement occurs when a resident actually wanders out of the nursing home facility.

In order to maintain a safe nursing home facility for the residents inside, it is crucial to have adequate monitoring systems in place.  It is also important that nursing home facilities ensure that their residents do not put themselves in a situation where they (or others around them) are susceptible to the risk of bodily harm.

When elopement occurs, it is generally a result of a nursing home facility failing to meet two requirements of proper care, security and supervision.

The Rising Risk of Elopement

Elopement in nursing home facilities has been on the rise in recent years.  There are significant dangers to residents that find themselves in this situation.

When a resident elopes and leaves the facility grounds on their own, they are putting themselves in danger.  By wandering outside unattended, they may be exposed to extreme cold or heat.  They are also at risk for falls in unfamiliar territory, as well as potentially suffering serious injury or death due to wandering into traffic or bodies or water.

Preventing Elopement

Proper training of nursing home staff, as well as adequate staffing and monitoring, is the best way to prevent elopement of residents.  The nursing home staff should be familiar with both the physical and mental issues personal to each resident so that they can make educated decisions about caretaking specific to each resident.  The main reason for elopement occurring is due to inadequate supervision, so addressing this issue is the first major step in preventing elopement.

Dehydration in the Elderly

dehydrated senior man

Dehydration has become a problem for elderly residents of nursing homes.  Dehydration occurs due to a lack of water and fluids.  It tends to be caused by not drinking enough water or by losing too much fluid.  This can happen when a person is experiencing vomiting or diarrhea.

Elderly individuals tend to be more susceptible to dehydration due to the physiological changes they experience as a result of aging.  For example, elderly persons typically have 1/10th the body fluid than a younger adult has.  They also may have a diminished thirst response due to their age and may not realize their body needs more fluids.  Additionally, they may be taking certain medications that can lead to dehydration of the body.

The Dangers of Dehydration

Serious instances of dehydration may result in severe illnesses or even death.  If your elderly loved one is a resident of a nursing home facility, it is important to make sure they are being properly monitored and closely watched so that any instances of dehydration are corrected immediately before it becomes a serious problem resulting in injury.

Malnutrition in the Elderly

malnutrition elder abuse of woman

Malnutrition is another serious problem that elderly individuals may face.  It is estimated that nearly one-third of nursing home residents in the United States have suffered from malnutrition or dehydration.  Instances of malnutrition in elderly residents in nursing homes is a major sign of nursing home staff neglect.

Causes of Malnutrition

Many cases of malnutrition in the elderly can be linked back to the conduct of the staff at the nursing home facility.  In many cases, there is just one certified nursing assistant that may be responsible for several different residents receiving proper meals and nutrition throughout their day, despite studies indicating that each staff member should be responsible for only two to three residents.  A common cause of malnutrition in these facilities is nursing home staff inexperience or inadequate staffing.

Signs of Malnutrition in the Elderly

There are several signs to look for when determining whether an elderly person is malnourished or not.  Below are some indicators of malnutrition:

  • Canker sores in the mouth
  • Thrush or yeast infection in the mouth
  • Muscle fatigue
  • Worsening vision
  • Red, glassy eyes
  • Inability to think clearly, confusion
  • Irritability
  • Dementia
  • Yellowing skin
  • New wrinkles
  • White skin beneath the fingernails

Improper caretaking by nursing home staff may result in your elderly loved one suffering from malnutrition.  This may be considered negligence and abuse.  If your loved one has not received sufficient medical care, they may have a claim for compensation under the law.

Reporting and Preventing Elder Abuse

Hand Identifying Elder Abuse in Los Angeles California

If you or your family suspect that your loved one has become a victim of elder abuse, it is essential to report the incident to the authorities.  You can also contact Adult Protective Services to launch an investigation into the matter.

Typically, once an investigation into an elder abuse case has begun, a caregiver will be assigned to the elder by the government, who will then investigate the facts surrounding the incident.  The investigator will take several things into consideration, including the current living circumstances, the elderly person’s mental stability, and the relationships in the elderly person’s life.

If the investigator concludes that there is a reason to suspect elder abuse, the elderly victim will then be moved to a new healthcare environment for their safety.  They also may receive counseling or may be prescribed medications.

Reporting suspected elder abuse is important because not all elderly individuals can speak for themselves or are able to stand up for themselves.  It may also be necessary to seek out legal representation in order to get compensation for the injuries that the elderly person suffered, especially in cases where the abuse occurred in nursing homes or residential facilities.

Hiring an Attorney to Help You and Your Loved One Pursue a Case for Elder Abuse and Neglect

elder abuse and neglect attorney

If you or a loved one has been a victim of elder abuse or neglect, it is imperative to report it as soon as possible to the nursing home or caretaking facility involved.  You will also want to document any discussions or interactions that you may have with that facility or agency.

For your free consultation or more information on elder abuse, call the Peck Law Group elder abuse and neglect attorneys today at (866) 999-9085 or fill out the form on our website.  The attorneys at the Peck Law Group have years of experience handling elder abuse and neglect cases and can help you bring a claim for compensation for the injuries that were suffered as a result of the abuse and neglect.

With multiple offices throughout California, The Peck Law Group’s elder abuse attorneys can you assist you with your case, whether you are in Los Angeles or other areas including (but not limited to):

Nursing Home Abuse & Neglect Attorney Steven Peck

About the Author

Attorney Steven Peck has been practicing law since 1981. A former successful business owner, Mr. Peck initially focused his legal career on business law. Within the first three years, after some colleagues and friend’s parents endured nursing home neglect and elder abuse, he continued his education to begin practicing elder law and nursing home abuse law.

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