If you believe a loved one is suffering from nursing home neglect, read on. Nursing home neglect is sadly a common problem in the United States, but you can learn about how to recognize it, as well as how to prevent it and what you can do if neglect is taking place.

What Is Nursing Home Neglect?

Although sometimes people confuse nursing home neglect with nursing home abuse, the two are technically and legally different. In the case of nursing home abuse, a caregiver or other person at the facility has the intention to harm a senior.

Nursing home neglect, on the other hand, is a failure on the part of caregivers to provide care or the providing of substandard care to residents. In instances of nursing home neglect, caregivers have breached the duty they were supposed to fulfill as part of their job.

Neglect can be intentional or unintentional. It can include lack of direct care as well as failure to fix situations in the environment that could cause harm, such as refusing to address tripping hazards or slippery floors.

Unfortunately, the statistics on nursing home neglect are quite depressing. According to the National Center for Victims of Crime, 15.3 percent of elder abuse complaints involve gross neglect. About half of seniors with dementia experience abuse or neglect.

Are There Different Types of Nursing Home Neglect?

All nursing home neglect is not the same. Nursing home neglect can be divided into four different categories.

Neglect of Basic Needs

Basic needs include food and water, as well as a clean and safe environment. Nursing homes that fail to provide this can be guilty of neglect of basic needs.

Medical Neglect

Medical neglect means failing to provide adequate medical care, such as for chronic conditions like diabetes, or to prevent medical conditions like bedsores and infections.

Neglect of Personal Hygiene

Every nursing home should follow personal hygiene best practices when it comes to patient care. Nursing homes that do not bathe residents adequately or who fail to help with things like brushing the teeth or laundry are neglecting basic personal hygiene standards.

Social or Emotional Neglect

This type of neglect can show up in several ways, from not answering nursing home residents’ calls to venting anger or calling residents names.

elderly neglect

How Can You Tell If a Loved One Is Being Neglected in a Nursing Home?

Depending on the type of neglect taking place, it can be difficult to know if your loved one is being neglected. For example, if you’re not there to witness emotional neglect, and if your family member cannot speak or remember things, you may not know they are being yelled at by a nursing home caregiver.

Sudden or Severe Weight Change or Obvious Malnutrition

It’s possible a loved one in a nursing home isn’t being fed properly, which would show up as weight loss or gain, as well as malnutrition. This could happen if a nursing home resident were being fed the wrong foods or too little food. It could also result from nursing home staff not following up on a resident’s refusal to eat or complaints about meals.

Internationally, nursing home malnutrition is an enormous problem, with over one-fifth of global nursing home residents experiencing inadequate nutrition.


Bedsores are pressure ulcers resulting from lying in one place for too long. This is one of the most common problems for seniors with reduced mobility and a frequent sign of nursing home neglect–although they can occur in bedridden patients even with the best of care.

In neglect cases, bedsores develop when a nursing home resident isn’t moved or rolled often enough, as per doctor’s orders or the family’s request. Bedsores can also result from not changing someone’s clothing often enough and from not providing the right kind of sleeping or lounging surface.


Bedsores can progress to infections, which is an overgrowth of bacteria or fungi. Serious ulcerations that become infectious can result in tissue necrosis (tissue death, like gangrene) and even amputation. Because many seniors already have reduced circulation to speed immune cells to wounds, infections with this group are often more life-threatening than with younger populations.

There are other types of infections common in nursing homes, including:

  • Urinary tract infections (UTIs)
  • Respiratory infections, such as pneumonia or strep throat
  • Gastrointestinal infections
  • Influenza

Additionally, over-reliance on alcohol-based hand sanitizers, neglectful lack of handwashing, and overuse of certain antibiotics can spread gastrointestinal infections with resistant pathogens, like Clostridium difficile, which can be fatal.

Seniors who have bouts of vomiting or diarrhea need medical attention immediately, as these conditions could indicate an infection or precipitate other health problems. Likewise, prolonged coughing or difficulty breathing should be treated by a doctor. There should be extra attention given to cleaning the living environment of anyone who is ill.


Dehydration results when anyone doesn’t consume enough water, but seniors are particularly vulnerable. Some medications predispose seniors to dehydration, but it can also be caused by nursing home staff failing to offer fluids or respond to its early signs. A senior with vomiting or diarrhea is particularly prone to dehydration. Signs of dehydration include:

  • Skin tenting
  • Confusion
  • Lack of urination
  • Dizziness
  • Dry mouth or lips
  • Difficulty ambulating
  • Joint pain
  • Inability to sweat
  • Fast heart rate or respiration
  • Low blood pressure
  • Sunken eyes
  • Constipation

Seniors who are prone to dehydration or who have had episodes of dehydration in the past should be weighed daily, on top of having their fluid consumption and urine output monitored, to ensure they are not at risk for dehydration.

Symptoms of Pre-Existing Medical Conditions Flaring Up

Elderly folks with pre-existing medical conditions, like diabetes or heart disease, could see their disease flare up with inadequate care. Medications need to be given on time and in the right dose. Signs of medical problems need to be charted and reported to a physician, or it constitutes neglect. It’s a potential sign of neglect or medical malpractice if a nursing home resident’s health changes suddenly.

Changes in Behavior

Some seniors show changes in behavior when they are the subject of neglect. These can include:

  • Withdrawal
  • Refusal to speak or answer questions
  • Anger
  • Sadness and crying
  • Anxiety
  • Loss of normal skills or social function
  • Changes in habits

Falls, Bruises, or Broken Bones

Falls and other injuries are common in nursing homes where neglect is taking place. This may happen when seniors aren’t accompanied to the bathroom or when environmental hazards aren’t remedied. If your loved one has had an unexplained fall or they have mysterious bruises or broken bones, it could be a sign of abuse or neglect.

Unsupervised Wandering

Like bedsores, unsupervised wandering is another common problem in neglectful nursing home situations. This can result in seniors with dementia wandering the facility or worse, leaving the premises and going missing. Some seniors wander looking for a bathroom or for a nurse, which is doubly indicative of neglect. Another aspect of neglect that contributes to wandering is the failure of the facility to secure doors, to use door alarms, or to employ security cameras.

Illnesses or Injuries Not Reported to Medical Professionals

Appropriate care in a nursing home means caregivers report any injuries or illnesses to the proper medical professionals. If your loved one’s medical problems are going unreported, this could constitute neglect. This can happen if the nursing home is aware they are being neglectful and don’t want a doctor to report them.

Unexplained Changes in Appearance

A nursing home resident who has unexplained changes in appearance could be neglected. Basic hygiene should be provided, so a senior in soiled clothing, for example, is not receiving proper care.

Visible Environmental Dangers at the Nursing Home Facility

If you observe environmental hazards at a nursing home, report them at once to the staff. This could be things that cause seniors to trip or sharp objects that could cause injury. It could also include unsanitary living conditions. If the staff refuse to fix the problem, document the issue and report it as neglect.

Observed Neglectful Behavior by Caregivers

Of course, if you directly observe a senior in a nursing home being neglected, you do not have to look for the signs above. Document any incidents and consult the management. Write down when the incident took place and who was involved. Be sure to get the names of caregivers involved, and photograph any physical evidence.  If they do not remedy the situation immediately, it’s time to think about consulting legal counsel.

How Does Nursing Home Neglect Happen?

Neglect of nursing home residents can happen for a multitude of reasons, many often overlapping:

  • Understaffing of nursing homes
  • Burned out or stressed nursing home caregivers
  • Poorly trained nursing home staff
  • Unresponsive attending physicians affiliated with nursing homes
  • Poor facility system for dealing with medical or behavioral issues
  • Inadequate or absent hand washing and infection control
  • Lack of charting and documenting of health issues
  • Lack of ability or fear on the part of the senior resident to speak up
  • Inability on the part of the facility to recognize neglect
  • Poor supervision of the nursing home facility
  • Facility trying to save money in the wrong ways

Can You Prevent Nursing Home Neglect?

If your loved one must live in a nursing home, there are ways to prevent neglect. Follow these tips to minimize their chance of being neglected:

  • Select the best nursing home that you and your loved one can afford. Look at how much care each resident receives and what the ratio of staff to residents is. Ask about their staff training.
  • Spend time in the nursing home before your loved one moves in, so you can observe social interactions and care ahead of time.
  • Ask about the credentials for the nursing home, which may vary by geography. Any nursing home should be able to provide you with required certifications and licensing on a moment’s notice or even have them posted in prominent areas.
  • Inquire about medical care at the home. Does a physician come by regularly? Can your loved one’s personal physician visit them there?
  • If possible, arrange for an outside physician to visit the nursing home periodically.
  • Try to visit the nursing home frequently for direct observation, or arrange for someone close to you to check in on your loved one. Go at different times of the day and different days of the week, including weekends.
  • When at the nursing home, check for hazardous environmental elements, like bad lighting, lack of handrails, and slippery mats. Make sure there are no suffocation risks with the senior’s bed and mattress or cords where the resident could become tangled. If something is dangerous, make note of it, take a photograph if possible, and report it.
  • Move senior citizens out of hazardous rooms into a safer area.
  • Make sure any medical conditions are disclosed and charted, so there can be no mistake about care your senior’s needs.
  • Double check that you have the right level of care selected for your loved one in situations where tiered care is provided. It’s always better to err on the side of too much care than not enough.
  • Check to see that seniors in a nursing home have adequate stimulation and social interaction. Do they have group activities or outings? Game nights or entertainment?
  • Advocate for senior and nursing home rights in your location.
  • Contact an attorney experienced with nursing home neglect cases.

If a senior citizen in your life is the object of nursing home neglect, and if you have tried and failed to address the neglect with the home caregivers, it may be time to take legal action.

Sadly, there are many instances where attorneys need to get involved in nursing home neglect, including filing lawsuits because of illness, injury, or even death to a nursing home resident.

A legal case involving a nursing home may necessitate an attorney who is skilled in one or more of these practice areas:

  • Accidents
  • Personal injury
  • Medical malpractice
  • Premises liability

If you think your loved one in a nursing home has been the victim of neglect, don’t hesitate to get in touch with Ingerman and Horwitz today. We are attorneys experienced in nursing home neglect and similar cases, and we can advise you on how to proceed. A lawsuit may not undo the neglect of your loved one, but it may help recoup the expenses resulting from neglect and keep the same thing from happening to another senior in the future.