WASHINGTON, Jan. 3, 2016 — In many instances, if what is happening in our nation’s nursing homes today were to occur anywhere outside such facilities, those individuals responsible would be charged with felony crimes.

Despite the fact that many of us today are blessed having our parents and grandparents alive and reaching older and older ages, one in 10 elderly people is abused each year. This outrageous conduct takes the form of financial, sexual, mental and physical abuse. It occurs too often because there is no one stepping up to care for our elders when they cannot care for themselves. In nursing homes, where our elders are supposed to be cared for properly, this often means those responsible for that care are aware they are not being watched.

This author’s mother-in-law is in an excellent assisted living facility. At age 90 she is in constant arthritic pain. Her fingers are permanently contorted, and, while she can still hold things and feed herself, every act involving the use of her hands is painful. Twice every month she is taken to a doctor so fluid that has built up in her knees can be drained. Getting up and sitting down for her is painful. Walking is very difficult and she needs a walker to do so. She actually needs a wheelchair, but she resists.

She is at the beginning stages of dementia. While her long-term memory is excellent, she needs to be reminded every day, often multiple times per day, of things that will occur later or tomorrow. She watches television most days or reads. She knows more about the world and the presidential candidates than almost everybody. She misses only one or two questions on “Jeopardy” each night. She is “old school” and will not speak up for herself.

Because she has an attentive and loving daughter — meaning her daughter is “on top” of the staff continuously, as an advocate — the likelihood of abuse, negligent though it may be, is almost zero.

Hers is a success story.

I have handled numerous “elder abuse” cases during my career as an attorney. One in particular stands out as being “off the charts” egregious.

A woman age 88, mentally alert but physically unable to talk or in any way care for herself, was put into a nursing home’s intensive care unit. The day after she was admitted, she was raped with an object like a broom handle. During the investigation, a letter from the lead physical therapist for that unit and addressed to the facility’s administrator was uncovered. It was dated three weeks prior to the attack.

The letter was addressed to the facility’s administrator. The therapist wrote that he was resigning because “despite over one year’s repeated communications to you (the administrator) about increasing the number of staff assigned to the unit, there remains an inadequate number of people to properly care for the residents.” The letter continued and advised the administrator “I (the therapist) can no longer work in an environment that is a disaster waiting to happen, risking my professional reputation and by design being part of not delivering the basic needs of care these fine people deserve as human beings.”

We do not want to believe that people we trust to care for our elder loved ones want to harm them. In fact, the people working in nursing homes are almost universally wonderful, kind and caring. The truth of the matter, however, is that there are not enough people employed in nursing homes to properly care for the residents.

This sad fact means a choice. Owners of nursing homes place profits above care. Thus, hiring more aides and nurses to care for the residents is all too often not considered, even though doing so would still allow for a profitable business, just less so.

A typical nursing home will task an aide to feed 15 (or more) residents during mealtime. That is easily twice the number that is reasonable. Consider how long it takes to properly feed someone, meaning they get both the food and hydration needed to keep them healthy. Each resident requiring help can take up to 20 minutes to be properly fed. If there are too many residents to feed, the result is that all will suffer, being given less nutrition and less hydration, resulting in malnutrition, dehydration and weight loss.

Falls take place when people are not receiving the nutriments needed to make them strong and able to stand and walk. Falls cause injuries, fractures and death.

Our skin is our biggest organ. Without the proper nutriments it will not thrive. Thin skin, common in the elderly, easily bruises, cracks and bleeds. Bedsores can develop more easily and, untreated, can eat through muscle and even bone and can become highly infected. Bedsores, you can imagine, are extremely painful. When infected, they can kill.

Alarming as it may be, neglect and abuse regularly occur in nursing facilities. Below is a list of signs that can  help you spot when elder care has gone wrong. Knowing what to watch out for is helpful. If you see many of these signs manifesting, it may be time to do more than just question the staff and call for help.

  • Sudden weight loss
  • Bedsores (redness on skin surface, usually on the back or buttocks), or pressure ulcers
  • Injuries from falls
  • Dehydration
  • Malnutrition
  • Withdrawal or changes in behavior
  • Lack of personal hygiene or changes to appearance
  • Limited exchange with staff
  • Limited socialization with other residents
  • Environmental hazards, including poor lighting, slippery floors, unsafe equipment or furniture

Regarding falls: how do you know if your mother just slipped and fell because she is old and frail or if the nursing home has really neglected its duties? Most often, falls are preventable. Check with the staff to make sure the “care plan” identifies the resident as a fall risk, and make sure a plan is in place to prevent falls. This means that the resident is assisted, always, when he or she goes from point A to point B.

Speak to the staff and don’t accuse. Insist, politely, that you are kept up to date on what is happening and that you are immediately alerted about any health problems. Make it known that you are engaged and show this by your frequent presence. Make it clear that someone cares what happens to this elderly person. If all else fails, speak to authorities.


Paul A. Samakow is an attorney licensed in Maryland and Virginia and has been practicing since 1980.  He represents injury victims and routinely battles insurance companies and big businesses that will not accept full responsibility for the harms and losses they cause. He can be reached at any time by calling 1-866-SAMAKOW (1-866-726-2569), via email, or through his website.  

His book “The 8 Critical Things Your Auto Accident Attorney Won’t Tell You” can be instantly downloaded, for free, on his website: https://www.samakowlaw.com/book.

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