If you or a loved one have been the victim of elder or nursing home abuse, you know how devastating its effects can be. Each year, as many as 5 million elders are abused. They suffer from having their dignity and self-respect robbed from them at a time in their lives when they should be free to enjoy well-deserved peace and comfort.
Because of the higher population of elderly citizens in Arizona, it is especially prudent that we be at the forefront of elder abuse prevention. With 145 nursing homes and 16,447 nursing home beds in the state, the law can unfortunately not reach all corners of care in the system. This is why it’s important for individual cases to be brought to light and heard with compassion and a commitment to restore the dignity and financial and physical well-being of elderly victims.
It is likely that 1 in 6 adults over the age of 60 will be affected by abuse. If you or a loved one have been hurt by elder abuse, you are aware of the long-term damage and debilitating effects of such acts. What you may not know is how to recognize the signs, report cases of abuse, and seek legal recourse. This guide will answer your basic questions. For more information, please seek professional assistance from an attorney or by contacting the resources at the bottom of this article.
What is Elder Abuse?
The World Health Organization defines elder abuse as “a single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person.” You can see how such a violation of human rights can exist in a variety of circumstances. When an elder is made to feel a loss of dignity or respect, a violation of the rights of the individual and a public health concern has occurred.
Many elders and family members believe that abuse must take place over a period of time for it to be reported, however, this is not the case. Even a single instance of abuse that causes undue distress and harm can and should be reported. The dignity of elders in our society is protected under the law and abuse against elders is punishable as a crime.
Elder abuse can occur in nursing homes, public and private care facilities, as well as in the home. Because elder abuse cases often go unreported, it is essential to treat each case with the care, attention, dignity, and respect it deserves.
What are the Different Types of Abuse Against Elders?
Verbal abuse is the most common type of abuse cited by elderly victims. This is a particularly dangerous type of abuse as the warning signs of abuse can easily go unrecognized by third parties. Elders are commonly mentally and emotionally abused with threats, intimidation, embarrassment, belittlement, yelling, and coercion. Because of the unmeasurable and invisible injuries, this causes to the victim’s well-being, such cases often go unreported. Similarly, the emotional and psychological damages may go unnoticed for months or years before loved ones begin to see a change in the victim and investigate its cause.
This mental and emotional abuse can be just as damaging as the other, more recognizable, types of abuse, such as:
Physical abuse. With this type of abuse, the evidence is typically physical in nature, suggesting the use of physical force against the victim. This can include medical evidence, such as an untreated infection or bedsores. Physical abuse may also result in bruising, broken bones, and cuts. Elderly physical abuse cases result in $5 billion in annual medical care costs. When an elderly victim is physically abused, it is often necessary to seek legal assistance for reparations to cover medical expenses and pain and suffering.
Neglect. Because an elder’s basic life necessities are largely entrusted to their caregiver or care facility, neglect often occurs when these basic needs for nutrition, medical care, or proper hygiene are unmet. Bedsores and untreated infections are often signs of neglect. Injuries can also result from improper dosing of medications or failure to administer medications. If nutritional needs are being neglected, the patient may exhibit signs of hunger and weight loss, and the deprivation of nutrition may also cause other serious medical complications.
Falls are one of the most common types of accident to happen in a nursing home and these are sometimes the result of neglect. Leaving a resident unattended or neglecting to provide proper ambulatory care can result in a falling injury.
With neglect, the signs of abuse can be difficult to detect. Often, neglect can have emotional consequences, such as when the elder is denied social interaction, or left without care for long periods of time.
Sexual abuse. Often perpetrated by other residents or sometimes by the caregiver themselves, sexual abuse can have long-term emotional and physical consequences. Such cases often go unreported due to the elder’s fear, embarrassment, or dependency upon the perpetrator.
Financial abuse. According to the National Council on Aging, it’s estimated that elder financial abuse and fraud account for anywhere from $3 billion to $36 billion annually. Financial abuse occurs when something of value is stolen from an elderly individual. There are many ways that financial exploitation can occur and often this type of abuse can be difficult to detect as the victim may be unaware that abuse has taken place. Such crimes often don’t surface until well after they have been committed. The property of value may consist of belongings, money, retirement or social security benefits, deeds, or other assets. Transferring titles, altering wills or life insurance policies, and forging signatures to falsify documents can also constitute financial abuse. Such thievery can occur through coercion, manipulation, or outright fraud.
Healthcare fraud is another common type of financial abuse and can be perpetrated by doctors, nursing home staff, or caregivers. This type of abuse includes overcharging or falsifying medical claims.
How Common is Elder and Nursing Home Abuse?
There is surprisingly little viable data on the prevalence of nursing home abuse as there have been few studies into the issue. However, nursing home abuse is estimated to be far more common than we are aware of. It’s estimated that only 1 in 5 cases of elder abuse or neglect are reported. Many elders do not report instances of abuse for fear of recrimination, retaliation, or out of embarrassment and feelings of inferiority or inadequacy. Others may be physically or mentally incapable of reporting abuse. Although elder abuse is more commonly reported today than ever before, there is still a presumption that abuses go disproportionately unreported.
Often, cases of elder abuse involve family members, and elders may be hesitant to make claims against the family for a variety of reasons. Other times, elders may not be fully aware of their rights or may doubt the fact that abuse is occurring and be hesitant to report it due to loss of mental faculties or loss of control of their situation.
What this means to our loved ones can be catastrophic. Our primary concern is to shepherd our elder relatives into comfort and ease with age. However, abuse is an intolerable fact that must be addressed and mitigated.
What are the Causes of Nursing Home Abuse?
In 2014, over 20% of nursing homes were cited for deficiencies causing potential or actual harm to patient residents. Where quality is lacking, so are proper resources, adequate training, and ongoing caregiver education. Understaffing in nursing homes is a nationwide problem and is the leading cause of abuse and neglect in facilities. It is such a glaring concern, that 95% of nursing home residents report having experienced some form of neglect. Over 50% of nursing home staff have admitted to abuse in some form. Stress on the caregiver can lead to abuse of the elder. Due to overstaffing, poor working conditions, and even personal problems, nursing home staff and caregivers often feel overwhelmed and resentful. Such feelings lead to the perpetration of abuse.
For-profit nursing homes tend to be the worst perpetrators of understaffing for the simple fact that many private enterprises cut staffing, training, and other costs to achieve a higher profit margin – to the detriment of the patient.
Who Is at Risk of Elder Abuse and Nursing Home Abuse?
Elder abuse doesn’t always occur in a care facility. In approximately 60% of elder abuse cases, the abuser is a relative of the victim. Such abuses occur when the elderly individual is being cared for in their home by a spouse, adult child, another relative, friend, neighbor, or in-home caregiver. In these situations, caregivers are more likely to commit abuse if they have mental illness or substance abuse problems or if they are emotionally or financially dependent upon the elder in their care.
Those who have mental or physical impairments are more likely to be victims of abuse. It’s estimated that 50% of elders with dementia are neglected or abused. Additionally, those with medical disabilities are also more likely to be abused. This raises many concerns for loved ones. Not only are physically or mentally impaired adults less likely to report incidences of abuse, but they are also more susceptible to harm caused by routine neglect or abuse. That these individuals tend to be more socially isolated is another factor contributing to their risk of harm.
While all elderly patients are at risk, those that are not in control of their finances, medical care, ability to care for their own bodies, and who are not socially connected to family, friends, or other groups are in a particularly vulnerable position. Additionally, elderly women are more likely to be victims of abuse than men, and socioeconomic status also appears to play a role in the likelihood of falling victim to elder abuse.
What is the Law Concerning Elder and Nursing Home Abuse?
In 1987, Congress passed the Nursing Home Reform Act to regulate the standard of care available in nursing homes with an eye toward establishing patients’ rights. The law specifies what services all nursing homes are to provide to residents and the standards by which they must perform these services, which include:
- Providing residents with pharmaceutical care
- Providing residents with dietary and nutritional care
- Periodically assessing each resident’s health
- Providing a comprehensive care plan for each resident
- Providing residents with nursing services
- Providing residents with rehabilitative services
- Providing residents with social services
Furthermore, the Act specifically lists the rights inherent to each resident of a nursing home:
- The right to communicate freely;
- The right to privacy;
- The right to be treated with dignity;
- The right to freedom from restraints;
- The right to exercise self-determination;
- The right to accommodation of medical, physical, psychological, and social needs;
- The right to voice grievances without discrimination or reprisal;
- The right to participate in resident and family groups; and
- The right to participate in the review of one’s care plan, and to be fully informed in advance about any changes in care, treatment, or change of status in the facility.
Arizona offers further rights to the residents of nursing homes in ARS §36-401, in which the licensing and operating requirements for adult foster care facilities, or nursing homes, are specified. Among these, state law adds provisions for the resident’s rights to have their money and possessions protected, to be notified clearly of their rights and entitlements to Medicaid benefits, and to be able to contact and receive information from patient advocates. These statutes also mandate certain requirements for health and safety that each nursing home must maintain.
The nursing home abuse statute of limitations in Arizona is 2 years. This means that from the moment of the violation, the victim has two years within which to file a claim against the offending party. However, in cases where the effect of the abuse has occurred or been discovered after the act of abuse itself, the statute of limitations begins at the moment when the victim should reasonably have been aware of the adverse effects.
What is a Long-Term Care Ombudsman and How Can They Help?
In addition to regulating nursing homes and specifying patient rights, Arizona, like many states, has adopted a Long-Term Care Ombudsman Program through the legislature. An Ombudsman is “an independent impartial dispute resolver.” The ombudsmen can investigate and make recommendations in response to complaints by elders in nursing homes or other care facilities.
Among those issues, an ombudsman can assist patients and family members with are the following:
- Knowing and interpreting the patient’s rights.
- Resolving billing or charge disputes.
- Resolving disputes involving changes in service or care.
- Investigating complaints regarding the quality of care.
- Investigating complaints regarding mistreatment by a caregiver.
This independent resource is provided by the state and the ombudsman makes every effort to hear complaints, advocate, and intervene on behalf of the nursing home resident. If you have a complaint and would like to see how an advocate can help you, please call the number for the Arizona Long Term Care Ombudsman at the bottom of this article.
How Can I Seek Financial Restitution for Myself or a Loved One?
Financial restitution is the compensation you or your loved one can receive as the victim of elder abuse by bringing a claim against the abuser. You may be entitled to a settlement from the nursing home or the individual perpetrator of the abuse. The perpetrator may also be held civilly or criminally liable for wrongdoing against the victim. Additionally, the perpetrator may be held liable whether the act of abuse was intentional or the result of negligence.
There are several different types of restitution you may be entitled to, including:
- A malpractice settlement
- An injury settlement
- Repayment of stolen or damaged property
- Reimbursement of medical expenses
- Reimbursement of mental health expenses
- Reimbursement of physical rehabilitation expenses
- Compensation for pain and suffering
- Compensation for loss of investment or profit value
- Repayment of legal fees
To find out what damages you or your loved one may be entitled to, you may need to seek the services of a qualified nursing home abuse attorney in your area. Your attorney will evaluate your case and advise you on how to seek restitution for your injuries or losses.
How Can I Prevent Elder and Nursing Home Abuse?
Awareness of the issues surrounding elder abuse is key to its prevention. More abuses are being reported than ever before. We have reason to believe that this is because awareness of elder abuse continues to grow. Patients are not only becoming more educated as to their rights as new laws crack down on nursing home abuse, but loved ones are learning how to identify warning signs and seek restitution for abuses.
Family members can do the following to help prevent elder abuse:
- Foster a culture of respect for the elderly in our homes and communities.
- Encourage elderly loved ones to participate in their own finances and remain socially active.
- Choose a nursing home wisely. Communication and transparency should be a top priority for any nursing home.
- Understand your relative’s care plan and ask questions if you don’t understand or see unexplained changes in it.
- Take an active role in the health and well-being of your elderly loved ones. Keep an eye out for bedsores, untreated infections, diminished spirits or depression, bruising, weight loss, trouble sleeping, violence or anger, poor hygiene, and withdrawal from social activities as these may be signs of abuse.
- Be on the lookout for signs of stress in caregivers and nursing home staff.
- Speak out when you see signs of elder abuse in your family or community.
Elderly individuals themselves can help prevent abuse by:
- Attending support groups.
- Having oversight over your own finances.
- Staying active and connected in your community.
- Using direct deposit for all checks.
- Being responsible for all of your own communications.
- Knowing your rights.
Where Can I Go for Help?
Individuals over 65 who are in abusive situations face dramatically increased rates of mortality. Elder abuse, as such, is an issue that has damaging long-term effects. It is our responsibility as a society to build and nurture a culture that respects our elderly citizens and help to limit the perpetuation of abuse.
Senior exploitation is a serious matter. If you or someone you know may be the victim of elder abuse, we encourage you to seek support.
National Center on Elder Abuse
National Adult Protective Services Association
Arizona Department of Economic Security – Aging and Adult Administration
Adult Protective Services
1-877-SOS-ADULT (877-767-2385) (toll-free)
Arizona State Long Term Care Ombudsman