What are the Most Common Signs of Nursing Home Abuse and Neglect?

Nursing homes are entrusted with the care and well-being of some of society’s most vulnerable individuals—elderly and disabled residents who require around-the-clock assistance and supervision. However, within these facilities, there exists the unfortunate reality of nursing home abuse and neglect, which can have devastating consequences for residents’ physical, emotional, and psychological health. Abuse and neglect in nursing homes are serious issues that violate residents’ rights and compromise their dignity and safety. Understanding the definitions and signs of abuse and neglect is crucial in identifying and addressing these harmful practices.

In this article we will address the definitions of abuse and neglect that apply to nursing homes. We will also explore some of the most common signs of abuse and neglect. With greater understanding of abuse and neglect, the more likely we are to be able to spot it when it occurs and prevent it from recurring, ensuring that nursing home residents receive the compassionate and high-quality care they deserve.

What is Considered Nursing Home Abuse and Neglect? 

Both abuse and neglect are defined by Federal law. These are definitions that apply to nursing homes throughout the United States. Regardless of what state the facility is located in, these are the definitions that apply. As you will see, intent, ill-will, or a malicious heart, is required to show abuse and neglect. Abuse and neglect essentially mean that a nursing home resident has been deprived of some essential care or services. 

Nursing Home Abuse 

Abuse is defined as “the deprivation by an individual, including a caretaker, of goods or services that are necessary to attain or maintain physical, mental, and psychosocial well-being. 42 CFR 483.5

There are several different types of abuse that a nursing home resident may be at risk for:

  • Physical Abuse: Inflicting physical harm or injury on a resident, such as hitting, slapping, pushing, restraining excessively (either with physical restraints or through too much sedating medication), or using unnecessary physical force.
  • Emotional Abuse: Intentionally causing emotional pain, distress, or anguish through threats, intimidation, humiliation, verbal assaults, or isolation.
  • Financial Exploitation: Misusing or stealing a resident’s funds, property, or personal belongings for personal gain, coercion, or manipulation.
  • Wrongful Restraint: Using physical or chemical restraints on a resident without proper authorization or justification, which can lead to physical or psychological harm.
  • Verbal Abuse: Using words, tone, or gestures to threaten, intimidate, belittle, or humiliate a resident, causing emotional distress or mental anguish.
  • Violation of Rights: Denying a resident their legal or human rights, such as freedom of choice, privacy, dignity, access to information and communication, or adequate medical and nursing care. 
  • Neglect: Failing to provide essential care and assistance to meet the resident’s basic needs, including food, water, hygiene, medical care, medication management, and safety precautions.

Nursing Home Neglect 

Neglect means “the failure of the facility, its employees or service providers to provide goods and services to a resident that are necessary to avoid physical harm, pain, mental anguish or emotional distress.”

42 CFR 483.5

Like abuse, neglect does not require intent or ill will. Rather, neglect is simply the nursing home’s failure to provide services that the resident needs. It can encompass a wide range of deficiencies in caregiving, including but not limited to:

  • Medical Neglect: This occurs when residents do not receive necessary medical treatment, medication management, or attention to their medical conditions. Neglecting to address medical needs promptly can lead to serious health complications, unnecessary suffering, and a decline in overall well-being.
  • Hygiene Neglect: Neglecting personal hygiene needs, such as bathing, grooming, oral care, and changing clothes, can result in discomfort, embarrassment, and an increased risk of infections and skin problems for residents. Proper hygiene is essential for maintaining physical health and dignity.
  • Nutritional Neglect: Failing to provide residents with nutritious meals, adequate hydration, and assistance with feeding can lead to malnutrition, dehydration, weight loss, and related health issues. Proper nutrition is crucial for maintaining strength, immunity, and overall health in elderly individuals.
  • Mobility Neglect: Neglecting to assist residents with mobility, transfers, and positioning can result in falls, injuries, and a loss of independence. Lack of mobility support can also contribute to muscle weakness, joint stiffness, pressure ulcers, and decreased quality of life.
  • Social and Emotional Neglect: Neglecting residents’ social and emotional needs, such as companionship, social interaction, and emotional support, can lead to loneliness, depression, and feelings of isolation. Maintaining meaningful social connections and emotional well-being is essential for overall mental health and quality of life.
  • Environmental Neglect: Neglecting the safety and cleanliness of the living environment, such as inadequate maintenance, sanitation, and safety precautions, can pose health hazards and increase the risk of accidents and injuries for residents. A safe and hygienic environment is essential for promoting residents’ health and well-being.
  • Staffing and Supervision Neglect: Insufficient staffing levels, inadequate training, and supervision of staff members can contribute to neglectful care practices in nursing homes. Overworked or poorly trained staff may struggle to meet residents’ needs effectively, leading to neglectful behaviors and compromised care quality.

What are Signs of Nursing Home Abuse and Neglect?

Some signs of abuse and neglect are obvious, while others are more difficult to detect. It’s important that family, friends, and caregivers know what signs to look for. Signs of abuse and neglect can include the following. 

Physical Signs

Physical signs of nursing home abuse can provide important clues about the well-being of residents. These signs include bruises, cuts, and abrasions that cannot be easily explained, especially if they occur frequently or in unusual places like the back or thighs. Fractures or broken bones in elderly residents can also raise concerns, especially if there is no clear reason for the injury. Additionally, burns, scalding, pressure ulcers or pressure injuries (also known as bedsores), and signs of restraint use, such as marks on the wrists or ankles, may suggest mistreatment or neglect. Residents who show signs of malnutrition or dehydration, such as weight loss, sunken eyes, or dry skin, may not be receiving adequate nutrition and hydration. It’s important to remember that not all physical signs indicate abuse or neglect, as some may be due to underlying medical conditions. However, any unexplained or concerning physical changes should be taken seriously and investigated further to ensure the safety and well-being of nursing home residents.

Emotional Signs

Emotional signs of nursing home abuse can show up in various ways and might indicate that residents are feeling distressed or are being mistreated. One common sign is a sudden change in behavior, like becoming more withdrawn or anxious. People who used to be outgoing might start avoiding activities or interacting with others, especially certain staff members or parts of the facility. Residents might also seem more irritable or easily upset than usual, reacting strongly to small things. They could also appear sad or emotionally numb, lacking their usual energy or interest in things they usually enjoy. Some might even have trouble expressing themselves. Abuse can also lead to nightmares, flashbacks, or difficulty sleeping. Residents might become more cautious, always on edge and expecting something bad to happen. In serious cases, they might develop symptoms like feeling scared all the time or avoiding things that remind them of the abuse.

It’s important to notice these changes and take them seriously. Even though they might not always be easy to see, paying attention to shifts in behavior, mood changes, and how residents act can help us understand if they’re suffering from emotional abuse.

Financial Abuse Signs

Financial signs of nursing home abuse include unexplained changes in a resident’s financial status, such as missing funds or unauthorized withdrawals from bank accounts, unexplained credit card charges, or new accounts being opened in the resident’s name. Residents may report sudden changes in their financial situation or notice missing personal belongings. Coercion or manipulation by staff or other residents may also occur, leading to emotional distress and anxiety for the resident. Suspicions of financial exploitation should be reported for investigation to protect the resident’s financial well-being and rights. 

Poor Living Conditions Signs

Residents may be subjected to living in rooms or common areas that are dirty, cluttered, or in disrepair, posing potential hazards to their health and safety. Additionally, poor lighting, malfunctioning heating or cooling systems, or inadequate ventilation can contribute to discomfort and compromise residents’ well-being.

Another sign of environmental neglect is the lack of cleanliness and hygiene within the facility. This may show itself as unclean living spaces, including soiled bedding, dirty floors, and unwashed surfaces. Residents may be exposed to unsanitary conditions in bathrooms, kitchens, or dining areas, increasing the risk of infections and illness. Improper disposal of waste or hazardous materials can also pose health risks to residents and staff.

Verbal Signs

Residents may also exhibit signs of emotional distress or trauma, such as frequent crying, emotional outbursts, or withdrawal from social interactions. They may demonstrate signs of anxiety or hypervigilance, constantly scanning their surroundings for potential threats or dangers. Additionally, residents may display behavioral changes, such as refusing to eat or take medications, exhibiting aggressive behavior, or engaging in self-harming actions. These behaviors may serve as coping mechanisms in response to the trauma of abuse or neglect. It’s crucial to recognize and address these signs promptly to ensure the safety and well-being of residents, providing them with the necessary support and resources to heal from their experiences and regain a sense of security and dignity within the nursing home environment.

Staff Behavior 

Additionally, signs of staff behavior contributing to a neglectful or abusive environment may include witnessing staff members displaying signs of burnout, frustration, or apathy towards their duties. This could be displayed in neglecting residents’ needs, ignoring call lights, or failing to respond promptly to requests for assistance. Staff may exhibit disrespectful attitudes, speaking down to residents, or dismissing their concerns and preferences. Residents may also observe staff members engaging in inappropriate interactions with one another, such as gossiping or arguing in front of residents, which can contribute to a negative and distressing atmosphere. High staff turnover, frequent changes in personnel, or inadequate staffing levels can demonstrate these issues, leading to inconsistency in care and disruptions in residents’ routines. It is essential to address these behavioral patterns and systemic issues through comprehensive staff training, support programs, and regular monitoring to ensure a safe and respectful environment for residents in nursing homes.


Nursing home abuse and neglect are serious issues that compromise the well-being and dignity of vulnerable residents. Recognizing the signs and manifestations of abuse and neglect is crucial in identifying and addressing these harmful practices to ensure that nursing home residents receive the compassionate and high-quality care they deserve. From physical and emotional signs to financial, environmental, and behavioral indicators, it is imperative to remain vigilant and proactive in safeguarding residents from harm. By promoting a culture of respect, empathy, and accountability within nursing home facilities, and implementing robust monitoring, training, and support systems for staff, we can work towards creating safe and nurturing environments where residents can thrive and live with dignity. It is essential to prioritize the rights and dignity of nursing home residents, empowering them to live their lives with the utmost respect, care, and support.

Disclaimer: This information is provided for informational purposes only. Nothing in this article should be construed as providing legal advice or the creation of an attorney client relationship. Laws are updated frequently and change from state to state. If you desire legal advice, you can contact Michael Hill Trial Law at www.protectseniors.com, send an email to info@protectseniors.com, call (800) 659-2712 to begin an investigation or contact another attorney.