Abuse of People with Paralysis in Long-Term Care Facilities - Blog - Reeve Foundation

Abuse of the elderly and vulnerable/dependent adults is a huge issue as it affects millions of people in the United States, particularly disabled individuals who live in long-term care (LTC) facilities, including nursing homes and board and care homes/assisted living communities. To put that number into perspective, a study on abuse from the National Center on Elder Abuse calls out alarming statistics. From 1999 – 2001, nearly one in three U.S. nursing homes received citations for violations of federal standards for causing harm to a resident or having the potential to do so. And almost “one of 10 had violations that caused residents harm, serious injury, or placed them in jeopardy of death (2001 U.S. House of Representatives Report).” Therefore, if you or a loved-one is in a long-term care facility, it’s imperative to recognize the frequency, causes and signs of abuse so you can address the issues and ensure one’s safety.

Before we can identify the indications of abuse, you must realize how often it occurs in these facilities. Researchers interviewed 2,000 nursing home residents, where 44 percent reported abuse and 95 percent claimed or witnessed neglect (Broyles, 2000). Additionally, seven percent of all complaints reported to Ombudsmen – or advocates for residents in long-term care facilities – were concerning abuse, neglect or exploitation. (NORS Data 2010). As the findings show, abuse of residents in these homes cannot be ignored.

So why is abuse so prevalent? Significant factors include the quality of the staff, lack of facility resources and the residents’ care requirements. Experts from Nursing Home Abuse Justice believe the most common causes stem from shortages of staff, lack of experience and training to care for specific disabilities, illnesses and needs, underpaid employees, poor supervision and accountability, and the type of residents as well as their health issues. Sadly, patients who are the most vulnerable are often the ones who are abused the most. For instance, patients with a high level of need, women, veterans, and LGBTQ residents as well as those with severe intellectual, developmental and physical disabilities are more susceptible. And since residents with physical disabilities pose more challenges and require additional care, attendants often become frustrated – especially if they aren’t properly trained.

Many instances of abuse and neglect take place in subtle ways and over a long period of time making it especially difficult to detect and report any wrong behavior. Therefore, it’s essential to be aware of what constitutes abuse. Unfortunately, there are multiple forms of abuse, including physical, sexual, mental/emotional, financial, neglect and even among residents. The most common type is physical abuse which can be identified in numerous ways. Evidence often includes bruises, burns and welts, cuts, broken or fractured bones, dental and head injuries, persistent pain, infections or gangrene as well as new illnesses or worsening conditions.

Gross neglect is equally as damaging and is often the result of inadequate staff who fail to execute their duties. These claims are also challenging to prove as they often rely on witnesses coming forward versus finding evidence of something that is not being fulfilled. Common signs of neglect are bedsores/pressure sores and ulcers, malnutrition, dehydration and weight loss, insomnia and sleep issues as well as improper medication.

Warning signs and red flags can also be recognized by studying the residents’ demeanor and the caregivers’ actions – or lack thereof – as well as the overall environment. Some significant indications include patients who are physically restrained and/or appear to be over medicated, have body odors or appear unclean, and are missing money or personal items as well as poor or insufficient response for care, residents’ requests, complaints and their rights.

Patients in long-term care facilities deserve quality care. If you suspect that abuse is occurring, be vigilant and record your concerns, complaints and any activity you witnessed so you can prepare a report to the proper supervisors, agencies, advocates and authorities.

Part Two of this blog series will focus on addressing abuse that occurs in long-term care facilities while Part Three will pertain to preventing abuse.

We will also be hosting a free webinar on September 18 with presenter Amity Overall-Laib, Director of the National Long-Term Care Ombudsman Resource Center (NORC). Click here to register.








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About the Author - Reeve Staff

This blog was written by the Reeve Foundation for educational purposes. For more information please reach out to information@christopherreeve.org

Reeve Staff

The opinions expressed in these blogs are the author's own and do not necessarily reflect the views of the Christopher & Dana Reeve Foundation.