Physical Abuse

Under the law, nursing home residents have the right to be free from physical abuse. This right, however, is often violated by nursing home staff members. Physical abuse is the intentional use of physical force that may result in bodily injury or pain. The injuries that a nursing home resident may suffer as a result of physical abuse can be very serious because most older people are fragile. For example, many older people have brittle bones that can break easily. An elderly person's skin is also more susceptible to bruises, cuts, and tears because aging causes the skin to lose elasticity.

The following are examples of the types of physical abuse that can be inflicted by nursing home staff members on elderly nursing home residents:

• Striking or beating the resident with an object or with a hand
• Pushing or shoving the resident
• Shaking, slapping, kicking, or pinching the resident
• burning the resident
• Force feeding the resident
• Using chemical or physical restraints that are unnecessary
• Mishandling the resident during ambulation (for example, throwing the resident into bed, or pushing the resident in an attempt to get him or her to hurry up)
• Pulling the resident's hair

Physical abuse in nursing homes occurs for a variety of reasons. When physical abuse occurs for any of the following reasons, the nursing home may be liable for negligence:

• Failure of the nursing home to conduct background investigations on employees who have a history of physical abuse
• Failure of the nursing home to properly supervise staff members
• Failure of the nursing home to hire a sufficient amount of supervisory staff
• Failure of the nursing home to properly train employees on how to spot physical abuse
• Failure to provide the proper ratio of staff to patients means that some caregivers may snap under the pressure and take their stress out on the patients

Tips to prevent physical abuse

The following signs may indicate that your loved one is the victim of physical abuse in a nursing home:

• Broken bones
• Sprains
• Black eyes
• Rope marks or belt marks, particularly around the wrists, ankles, and neck
• Cuts and bruises
• Internal injuries or bleeding
• Unexplained loss of hair
• A nursing home staff member's refusal to permit the resident to have private visitors
• Any unexplained change in the resident's behavior, particularly any showing of fear, stress, anxiety, or a combative reaction when a certain staff member approaches
• When the resident offers implausible stories to explain any of the above signs of physical abuse

If your loved one exhibits any signs of physical abuse in a nursing home, you should:

• Calmly but firmly express your concerns to your loved one. If your loved one tells you that he or she was the victim of physical abuse, immediately report the incident to the police and get emergency medical help. Oftentimes, however, elderly people are afraid or embarrassed to admit that they were the victim of physical abuse; and others may be too physically or mentally impaired to communicate the incident. In these situations, if you believe the warning signs are severe enough, call police and get your loved one to the emergency room of a hospital as soon as possible, if necessary.
• If your suspicions don't warrant immediate police intervention or emergency medical treatment, report the incident to the nursing home administrator and discuss your observations with your loved one's doctor. Then monitor the situation. If the warning signs persist, you should contact authorities.

Legal evaluation of physical, mental, or sexual abuse claims

Neglect is defined as failure to provide goods and services necessary to avoid physical harm, mental anguish, or mental illness. Neglect occurs on an individual basis when a resident does not receive appropriate care based on their individualized needs.

Abuse is defined as the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm or pain or mental anguish, or deprivation by an individual, including a care taker, of goods or services that are necessary to attain or maintain physical, mental, and psycho-social well-being.

Federal and state law have regulations that set forth that a resident in a nursing home has the right to be free from verbal, sexual, physical and mental abuse as well as involuntary seclusion.

There are also federal and state regulations that are aimed to prevent employment of individuals who have been convicted of abusing, neglecting, or mistreating individuals in a health care related setting. Nursing homes have a duty to be thorough in their investigations of the past histories of individuals they are considering hiring. The facility should do a record check with the Pennsylvania State Licensing Division and also check the State Nurse's Aide Registry.

In evaluating a claim of abuse or neglect, we will investigate the nursing home to see if:

• A proper background check was performed.
• The home was aware of any previous incident of neglect or abuse by the nurses aide, staff member, or even another resident of the home.

When a nursing home becomes aware of a violation of the law involving mistreatment, neglect or abuse, the incident must be reported to the administrator of the nursing home and to the Pennsylvania Department of Health. The nursing home must have evidence that all alleged violations are thoroughly investigated and that the home has policies and procedures regarding investigation of injuries suffered by residents.