Potential Signs of Nursing Home Abuse in a Loved One

A bruise that does not quite match the explanation given for it. A sudden reluctance to talk during a visit when one particular aide is in the room. Small changes like these do not necessarily mean abuse has occurred, but unexplained injuries or changes in a resident’s behavior can be reasons to pay closer attention.

Signs of nursing home abuse can be physical, emotional, financial, or related to the care a resident receives. Some have innocent medical explanations, while others may warrant further investigation. Knowing what to watch for can help families recognize concerning patterns and ask questions when something does not seem right.

Physical Signs of Nursing Home Abuse

Physical abuse and neglect can sometimes result in visible injuries or changes in a resident’s condition. However, older adults may also bruise easily, fall, lose weight, or develop medical complications for reasons unrelated to abuse. The circumstances surrounding an injury are often just as important as the injury itself.

Potential warning signs include:

• Unexplained bruises, burns, cuts, fractures, or other injuries
• Repeated falls or injuries without a clear explanation
• New pressure injuries or existing wounds that continue to worsen
• Sudden, unexplained weight loss or signs of dehydration
• Poor hygiene, unwashed hair, soiled clothing, or soiled bedding
• Injuries that appear inconsistent with the explanation provided
• Delays in obtaining medical attention after an injury or significant change in condition

Any one of these signs could have a reasonable explanation. A recurring pattern, conflicting explanations, or significant changes in a resident’s condition may provide more reason to investigate what is happening.

Pressure injuries, commonly called bedsores, deserve particular attention because residents with limited mobility can be especially vulnerable to them. A pressure injury does not automatically mean a nursing home was negligent. Age, circulation, nutrition, moisture, serious illness, and other medical factors can all affect a resident’s risk.

The more important question is whether the facility recognized that risk and provided appropriate preventive and wound care. Depending on the resident’s condition, that may include regular skin assessments, repositioning, pressure-relieving equipment, nutrition and hydration support, wound treatment, and monitoring for signs that an existing injury is getting worse.

Emotional Signs of Nursing Home Abuse

Emotional abuse can be harder to recognize than physical mistreatment because it may not leave a visible injury. Changes in a resident’s behavior can be important to notice, particularly when they appear suddenly or cannot be readily explained by a change in health, medication, or living circumstances.

Potential warning signs can include:

• Becoming unusually withdrawn or reluctant to communicate
• Increased anxiety, agitation, or fearfulness
• Sudden changes in mood or behavior
• Avoiding eye contact or appearing hesitant to answer questions
• Becoming noticeably quiet, tense, or fearful around a particular staff member
• Changes in sleeping or eating habits
• Statements about being threatened, humiliated, isolated, or treated poorly

A behavioral change does not necessarily mean emotional abuse has occurred. Dementia, depression, medication changes, illness, and the transition to a new living environment can also affect a resident’s mood and behavior. However, a sudden or recurring change, particularly one associated with a specific person or situation, can be a reason to ask more questions about the resident’s care.

Financial Signs of Elder Abuse in a Care Setting

Financial exploitation may be more difficult to recognize because it does not leave a physical injury. It can also go unnoticed when family members are not directly involved in managing a resident’s finances.

Potential warning signs include:

• Unexplained withdrawals, transfers, or other unusual account activity
• Missing cash, jewelry, or personal belongings
• Unexpected changes to a will, power of attorney, beneficiary designation, or other financial documents
• Unpaid bills despite the resident having sufficient funds
• New names added to bank accounts or other financial accounts
• Unexplained purchases, checks, or payments benefiting another person
• A staff member or another person taking an unusual interest in the resident’s money or property

Not every unexpected financial decision is evidence of exploitation. However, unusual transactions or sudden changes may deserve closer attention when a resident has cognitive or communication impairments, depends heavily on another person for financial assistance, or appears confused or uncomfortable when asked about the changes.

Nursing Home Abuse Signs That Involve Medication

Medication-related concerns can be difficult to recognize because drowsiness, confusion, and changes in behavior may also result from a resident’s medical condition or appropriately prescribed treatment. A sudden or unexplained change can still be a reason to ask questions about the resident’s medications and care.

Potential warning signs include:

• Unexplained or unusually heavy sedation
• Sudden increases in confusion, lethargy, or difficulty staying awake
• Significant behavioral changes after a medication is started or the dosage changes
• Medication records that do not appear to match the medications the resident is receiving
• Frequent use of medications without a clear explanation of why they are needed
• Significant changes in alertness that appear after medication is administered

Federal nursing home regulations protect residents from chemical restraints used for discipline or staff convenience when the medication is not required to treat the resident’s medical symptoms. They also require residents’ medication regimens to be free from unnecessary drugs, including medications given in excessive doses, for excessive durations, without adequate monitoring, or without an appropriate indication.

A change in alertness or behavior does not necessarily mean a resident has been improperly medicated. Families with concerns can ask what medications the resident is receiving, why they were prescribed, whether dosages have recently changed, and how the resident is being monitored for side effects.

How to Report Nursing Home Abuse in South Carolina

South Carolina has several ways to report concerns involving a nursing home resident, depending on the nature and urgency of the situation.

For suspected abuse, neglect, or exploitation occurring in a long-term care facility, the South Carolina Long Term Care Ombudsman Program can receive complaints and assist residents and their families. The South Carolina Department on Aging directs people who suspect abuse or neglect in a long-term care facility to call the Long Term Care Ombudsman at 1-800-868-9095. The program handles concerns involving abuse, neglect, exploitation, residents’ rights, quality of care, and quality of life.

Complaints involving nursing homes and other regulated healthcare facilities can also be filed with the South Carolina Department of Public Health (DPH). DPH investigates complaints against healthcare facilities it regulates, and complaints can be submitted through its online Health Facility Complaint Form or by calling 1-800-922-6735.

When a resident is in immediate danger, or a suspected crime has occurred, contacting 911 or local law enforcement may also be appropriate.

Nursing homes have their own reporting requirements when allegations or incidents occur. South Carolina DPH states that abuse of any kind must be reported by the facility within two hours. Certain alleged violations that do not involve abuse or serious bodily injury are subject to a 24-hour reporting timeframe. Facility allegations must then be investigated and reported to the Bureau of Certification within five working days of the initial report.

What to Do After Noticing Signs of Nursing Home Abuse

If you notice signs that may indicate nursing home abuse or neglect, the resident’s immediate safety comes first. If your loved one appears to be in immediate danger or has a serious injury or medical emergency, call 911 or seek appropriate medical attention.

When there is no immediate emergency, families can take several steps to document their concerns and learn more about what happened:

• Photograph visible injuries or concerning conditions when appropriate.
• Keep dated notes describing what you observed, when you noticed it, and any explanations provided by staff.
• Save relevant communications with the facility, including emails, text messages, and written notices.
• Ask questions about unexplained changes, including injuries, falls, medications, wounds, weight loss, or changes in behavior.
• Request available medical and care records rather than relying only on verbal explanations.
• Report suspected abuse or neglect to the appropriate South Carolina agency when necessary.
• Consider speaking with a nursing home abuse lawyer if a resident has been seriously injured or you have concerns about whether abuse or neglect contributed to their condition.

A single bruise, behavioral change, or medication concern does not necessarily establish that abuse occurred. What matters is whether there is a concerning pattern, an unexplained injury or decline, conflicting information, or other reason to question the care a resident received. Families do not need to determine exactly what happened before raising concerns or asking for help.

If you are concerned that a loved one has been injured because of abuse or neglect, you do not need to determine exactly what happened before asking questions. Hite Law Firm helps families investigate concerns about nursing home abuse in Laurens and throughout the surrounding area. We also represent families dealing with suspected nursing home abuse in Greenwood or nursing home abuse in McCormick. Our nursing home abuse attorneys can review what happened and explain the legal options that may be available.