The National Council on Aging estimates that about 10% of people 60 or older have experienced some type of abuse. Abuse includes:

• Confinement, isolation, or restraint for non-medical reasons
• Emotional, physical, or sexual abuse
• Financial exploitation
• Neglect
• Willful deprivation

In all types of elder abuse, only 4.16% are reported to authorities. Medical caregivers, such as nursing home employees, are to blame in 12 to 13% of the abuse cases.

Neglect is often passive and involves a caregiver’s failure to meet an older adult’s essential needs. This includes clothing, food, medical equipment and treatments, as well as safe housing. Sometimes, the neglect is intentional. Willful or deliberate neglect is an intentional act where care or other essentials are withheld as a punishment, greed, or other form of self-interest.

California’s Elder Abuse and Dependent Adult Civil Protection Act and other state-mandated regulations protect an older adult from neglect and abuse. However, it’s often difficult to identify the signs of neglect and when to contact a personal injury attorney.

Being proactive and vigilant is key. You need to know how to identify neglect as early as possible.

Physical and Medical Indicators of Neglect

Aging or the advancement of an illness isn’t always a typical sign of aging or disease progression. Sometimes, they’re signs of neglect. Watch for:

• Blisters and sores on bony areas
• Complaints of thirst or hunger
• Dry skin and cracked lips
• Frequent UTIs
• Gradual weight loss
• Noticeable swelling

Pressure ulcers are of particular concern. California law requires a minimum of 3 1/2 hours of nursing care to be provided each day to each resident. If pressure sores develop, it can indicate a lack of care and potential medical neglect.

Behavioral and Emotional Indicators of Neglect

A resident’s emotional or behavioral actions also indicate the possibility of neglect.

• Angry outbursts and mood swings
• Anxiety
• Apathy (no longer interested in favorite hobbies or activities)
• Declining cognitive function when dementia isn’t diagnosed
• Fear of speaking up in moments when it’s appropriate
• Social withdrawal (refusal to join others in events and programs)

Watch for Nursing Home Red Flags

Several red flags are important to monitor as they’re more common in nursing homes with neglect and abuse complaints or violations. Watch for these.

1. Staff Turnover Rates

When there are frequent staff turnover rates, it’s a sign that employees are not treated fairly or are extremely overworked.

Neglect is more likely to occur if a nurse or aide has a high patient load and less time to complete tasks for each resident.

It’s also less likely that a new employee understands the resident’s history. Continuity of care is a problem when staff turnover occurs on a weekly basis. Medication errors, mobility assistance, and hygiene needs are more likely to be overlooked.

California law (42 CFR §483.35(g)) requires a sufficient number of staff. The facility must have enough licensed nurses and nurse aides to provide at least 3.48 hours of care per resident. A registered nurse must be on-site 24 hours a day, 7 days a week.

2. You Notice an Unexpected Emotional, Mental, or Physical Decline

During a visit, you notice your dad flinches when you go to hug him. He’s never done that before. He’s withdrawn and doesn’t interact in the manner you’re used to him acting. That can be a sign that he’s being neglected.

Try to get him to talk about it. If he resists, it’s time to ask to see his medical records. Asking other residents or family members about their experiences with your dad and the staff is also helpful.

3. Staff Avoid You or Don’t Have Answers You Expect

You ask questions and don’t get an immediate answer. You must hound the staff before anyone addresses your question.

Staff may not notice something you feel shouldn’t have been overlooked. You notice an old bruise on the side of your mom’s head, but the nurses brush it off as nothing concerning. No one notified you of a fall or injury.

You ask to look at medical records to see when it happened, and no one lets you see them. Any records a nursing home has on you or your family member must be provided to you within 24 hours of your request.

4. Cleanliness and Hygiene Guidelines Are Ignored

If the resident’s room or common areas smell of urine or feces, or clothing and bedding have an odor, it’s a problem. The need for clean, sanitized clothing and bedding is essential. Residents require regular assistance with toileting needs and skin care. Hygiene should not be overlooked.

5. The Culinary Department Refuses to Provide Special Menus

Residents have rights regarding food and nutrition care in a nursing home. This includes meeting a resident’s cultural or religious preferences. Foods must be cooked to the correct temperatures, meet nutritional needs, and be served in a comfortable, home-like environment. Bedtime snacks must be available.

6. Personal Items Disappear

When someone moves into a nursing home, it’s often recommended that personal items be left at home or with a family member. This is to prevent loss through theft. However, there are times when staff or other residents steal items.

When those items lead to situations of neglect, such as the continued theft of hearing aids or a cane, it puts the resident at risk. A lack of mobility or the inability to use assistive devices could lead to injury. It makes daily routines harder for the resident.

How to Respond to Suspected Neglect

If neglect is suspected, remember that you are your loved one’s best advocate. A long-term care ombudsman is also advised for advocacy with the nursing home.

The California Department of Public Health must be notified of potential care quality violations. If a situation seems urgent, contact Adult Protective Services.

Gather as much evidence as possible. Keep a list of conversations with staff, including the date, time, and names of the employees you spoke with. Take photos that are marked with the date and time.

It’s often easier to manage a stressful neglect situation with an advocate on your side. Contacting an attorney specializing in elder abuse and neglect is an excellent way to build a strong case that leads to appropriate actions.

Stay proactive and look for even the slightest indicator of neglect. If you suspect something is wrong, consult a personal injury attorney. You get an advocate to help you access the records you need, protect your parents or other family members, and ensure the nursing home cannot hurt someone else.

Hire an experienced attorney for emotional, financial, or physical abuse. Shegerian Conniff’s legal team has fought for its clients for years. Founded in 2018, the law firm’s founders possess extensive experience and have received multiple awards and honors.

When you schedule a free, confidential consultation with Shegerian Conniff, you’re choosing personal injury attorneys who have recovered more than $100 million for their clients. You could be next.