Case Types

Physical & Sexual Assault

Nursing home and assisted living facility residents are some of the most helpless, vulnerable members of our society. All residents have the right to live in a safe environment that ensures that they are treated with respect, dignity, and being free from abuse.

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How Common are Physical and Sexual Assaults at Nursing Homes?

As horrific as physical and sexual assaults of the elderly are, they are much more common than most people realize.

  • 15,000 nursing home abuse complaints were filed in 2020 alone
  • 94% of all nursing home sexual assault victims are women
  • 34% of nursing home sexual abuse victims were over 80 years old
  • 56% or less of the perpetrators are ever criminally charged
  • 24.3% of nursing home residents experienced at least one instance of physical abuse while in a nursing home
  • 29% of nursing home abuse complaints are for physical abuse
  • 7% of nursing home abuse complaints are for sexual assault
  • 22% of all abuse complaints are resident-to-resident sexual or physical abuse
  • 9.3% of nursing home staff have admitted to physically abusing elderly residents.
  • 51% of nursing assistants reported they had yelled at a resident
  • 23% of nursing assistants reported that they had insulted or sworn at a resident.
  • 5% or less of physical elder abuse cases are reported to the police.
  • 70% of reported elder abuse occurs in nursing homes

Despite these statistics, the problem of nursing home abuse is much worse than we know. The National Center on Elder Abuse has stated that “unfortunately, we simply do not know for certain how many people are suffering from elder abuse and neglect.”

What is Elder Sexual Abuse?

7% of all reported elder abuse in nursing homes is sexual abuse. Most of those assaults are committed by other residents.

Sexual abuse includes:

  • Inappropriate touching
  • Non-consensual sexual penetration
  • Any unwanted sexual behavior
  • Forced nudity
  • Photographing in suggestive poses
  • Forcing the person to look at pornography

What is Elder Physical Abuse?

Elder physical abuse is any form of violent act that causes an elderly person to suffer significant injuries. 24.3% of nursing home residents experienced at least one instance of physical abuse while in a nursing home. 29% of nursing home abuse complaints are for physical abuse. 9.3% of nursing home staff have admitted to physically abusing elderly residents.

Physical abuse can take any of the following forms:

  • Punching
  • Slapping
  • Pushing or shoving
  • Kicking 
  • Hitting 
  • Striking with objects
  • Unnecessary Restrains (chemical or physical)

Physical abuse by staff is often the result of overworked, understaffed, and frustrated workers who act out against their patients.

Who is Most at Risk of Elder Physical and Sexual Assault?

While all residents are at risk of experiencing physical or sexual abuse, some residents are at a greater risk of being physically or sexually assaulted than others. 

  • Female residents
  • Residents who were prior victims of abuse or experienced traumatic events
  • Residents with memory or thinking disorders such as Azheimer’s disease, dementia, and mental illness.

Is a Nursing Home Liable for Physical or Sexual Assaults?

Nursing homes are required to provide a safe environment and ensure that residents are free from abuse and neglect. To ensure the safety of their residents, nursing homes must actively protect residents, anticipate and prevent physical and sexual abuse, and supervise, monitor, and separate residents. Common failures that lead to nursing homes being liable for physical or sexual assault include:

  • Inadequate number of staff to assess, supervise, and monitor residents
  • Lack of staff training about preventing physical and sexual abuse
  • Having a high number of residents with dementia, but failing to provide meaningful activities and engagement to provide stimulation
  • Having crowded, unsupervised common areas where there are multiple residents in one room
  • Failure to monitor residents’ behavior, including verbal or physical aggression, prior sexually suggestive acts, and wandering into other resident’s rooms
  • Failing to conduct proper background checks on residents and staff

Assaults by Other Residents

Resident-to-resident assault is a serious and well known issue in nursing homes and assisted living facilities. Residents have the potential to harm one another for many reasons.

Sometimes residents harm other residents because of lifelong issues with committing sexual or physical abuse on other people. Because of this, nursing homes and assisted living facilities must perform criminal background checks and thoroughly assess residents to determine their likelihood of putting other residents at risk. If residents show any tendency to harm other residents, they must not be allowed to live there or only allowed to live there with strict security measures in place.

Some residents have a tendency to harm other residents physically because of confusion and mental state changes caused by dementia. Residents with dementia can become confused and act out in strange and unpredictable ways, which can include punching, striking, kicking, and otherwise harming other residents. This is not done out of ill will or because they are mean spirited people. They simply lack the ability to control or understand their behavior. Knowing that residents with dementia can act out in these ways, nursing homes must take steps to monitor and supervise residents to ensure that they are free from abuse.

Staff should monitor residents for any behaviors that may indicate the potential for abuse or which may provoke a reaction by residents: 

  • Verbally aggressive behavior, such as threatening, yelling, swearing, or making insulting comments about race or ethnicity
  • Physically aggressive behavior toward staff or residents, including throwing objects, threatening gestures, pushing, shoving, hitting, punching, kicking, or spitting
  • Sexually aggressive behavior, exposure of genitals, making sexually suggestive or derogatory comments, or inappropriate touching or grabbing of residents or staff
  • Taking or rummaging through other resident’s property or possessions
  • Wandering into other residents’ rooms

Resident to resident abuse can involve residents who have no history of physical aggression. For example, a resident may become startled or upset about a perceived slight, such as someone being confused and going through their property, causing them to strike another resident in response.

Assaults by Nursing Home Staff

Nursing home staff who are frustrated or exhausted may verbally or physically harm residents. If a staff member is observed engaging in any verbal or physically aggressive behavior, they should immediately be fired and the event should be investigated and reported to the state. If there is any evidence of physical abuse, law enforcement should be contacted. It is not enough for a nursing home to simply fire an abusive employee. Without a thorough investigation and potential prosecution by law enforcement, that staff member may be able to begin employment at another long term care facility and put other residents at risk.

Some opportunistic sexual predators seek to gain employment at nursing homes because of the especially vulnerable population. The vast majority of those who sexually abuse nursing home residents are men. They often target female residents with disabilities and illnesses that either prevent them from physically resisting the assault or credibly describing the assault after it has occurred. These include residents with Alzheimer’s, dementia, and mental illnesses. According to the US Department of Justice, nursing home residents with disabilities are 7 times more likely to be the victims of sexual violence.

How do Nursing Homes Prevent Residents from Being Assaulted?

Nursing homes must take ongoing, preventive measures to protect residents from physical and sexual abuse. There is no limit to what measures nursing homes can put in place, but the most common practices include:

  • Develop comprehensive, patient-specific care plans
  • Use best practices for supporting residents with potentially aggressive behavior related to mental impairments
  • Develop behavioral management plans to track residents, anticipate what triggers their behavior, and devise a plan to prevent or quickly reduce any such behavior
  • Avoid overcrowded areas and provide areas for supervised activities
  • Train staff to identify potential signs that a resident may engage in physical and sexually aggressive behavior
  • Develop and implement policies and practices to prevent physical and sexual abuse and to identify potential signs that abuse has occurred
  • Identify residents with risk factors for abusive behavior, address their needs, and monitor them carefully
  • Have consistent staffing assignments so staff become familiar with residents and their behavior
  • Ensure staffing levels are sufficient to meet resident needs and provide resident supervision
  • Document, investigate, and report any complaints of physical or sexual assault
  • Perform comprehensive background checks on staff and residents
  • Observe guests of the facility to ensure they are not engaging in inappropriate behavior

What are the Signs of Elder Physical or Sexual Abuse?

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Elderly victims of abuse may not be able to verbalize the abuse that has occurred. They may also not be able to fully understand the abuse they are experiencing, even while it may be emotionally devastating to them.

Many elderly nursing home residents shows signs of abuse, including:

  • Social withdrawal–including from family, caregivers, and groups
  • New difficulty standing or walking that is not explained by other medical conditions
  • Broken bones
  • Burns
  • Dislocated joints, including shoulders and hips
  • Bruises, especially bruises around the arms 
    Tooth loss
  • Torn, stained, or bloody clothing
  • New, unexplained sexual transmitted diseases (STDs)
  • Bleeding or irritation of the genitals or rectum
  • Abrasions, rashes, or scarring of the genitals
  • New depression, anxiety, or paranoia
  • Unexplained or uncharacteristic changes in behavior

Why are the Elderly Targets of Physical or Sexual Abuse?

Nursing home residents are a particularly vulnerable group of people. They are often isolated from family and friends and dependent on caregivers. Residents with dementia and other cognitive impairments are at an even greater risk of being victims of assault. Most vicitms of nursing home sexual assault are women over the age of 80.

Do the Elderly Die from Physical or Sexual Abuse?

Nursing home residents who suffer fractures or brain injuries from an assault may die soon after the incident from physical injuries experienced in the assault. For other victims of abuse, however, it is not so obvious that their death was caused by the assault.

A 13-year study conducted by the World Health Organization found that physical elder abuse victims are two times more likely to die prematurely than those who did not experience abuse.

Elderly victims of sexual abuse in nursing homes often experience a quick and steady decline. They frequently become socially withdrawn from staff and family; they often eat less or stop eating altogether; and they tend to show a decline in their cognition–like their dementia gets worse. This often happens for a matter of weeks before the resident dies.

Unfortunately, many doctors are unfamiliar with how physical or sexual abuse causes premature death. It is not uncommon for death certificates to incorrectly list other medical conditions as the cause of death, including Alzheimer’s disease and dementia.

Representative Cases


Dolores was an 88-year-old nursing home resident who lived in a memory care unit because she had dementia.  While she was sleeping, another female resident with dementia entered her room. Clearly confused, the woman was fully dressed and carrying a purse. She set the purse on the bed and pulled Dolores out of bed by her arms causing Dolores to crash to the floor. Dolores suffered two broken shoulders in the attack. Nursing staff did not respond, allowing the attack to continue. When nursing staff did arrive, they put Dolores back in bed. Over the following 48 hours, Dolores declined until she was no longer responsive. Dolores died as a result of the injuries suffered in the attack.


Loraina was a 92-year-old resident of a nursing home. She had severely impaired cognition because of dementia. She was almost completely immobile. A 75-year-old male resident was observed by staff sexually assaulting her. Following the rape, Lorraina declined. She died 3 weeks after the assault. The facility was found to have failed to follow its policies and procedures to keep residents free from abuse.


Lorraine was a 95-year-old resident of an assisted living facility near Kentucky. Lorraine had dementia and was unable to protect herself. Another resident had a history of exposing himself to other residents, making sexual advances, and being found in their rooms. One night, staff walked into Lorraine’s room and found the male on top of her in a chair sexually assaulting her. She was taken to the hospital where it was confirmed that she was raped. Over the next month, she became withdrawn, stopped eating, and died. This is a common scenario prior to death following an assault of an elderly person.

How Much is My Nursing Home Assault Case Worth?

Every case is unique and has to be evaluated on its specific facts. The only way to determine the value of your nursing home physical or sexual assault case is to begin an investigation.