25 Nursing Home Red Flags You Need to Know

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A young person holds an older persons hands in a nursing home as they look for signs of nursing home red flags or abuse.

Choosing to put a member of the family in a nursing home is a difficult decision, but it is often the only option for many families. Most facilities have wonderful nurses, caregivers, and staff members who provide our aging parents and grandparents, and other family members with the quality care and quality of life they need and deserve. Yet, abuse and neglect can occur in facilities that do not meet industry standards.

In choosing a facility for your family member, it is important to keep the below 25 nursing home red flags in mind.

If you suspect abuse of a family member or loved one who is a nursing home resident in Kentucky, then a nursing home abuse attorney right away for a free consultation.

What Is Considered Senior Abuse in Nursing Homes?

Nursing home abuse is a broad term that encompasses a variety of types of abuse and neglect of nursing home residents. Both intentional and unintentional actions that cause harm fall under the broad notion of nursing home abuse. Specific types of abuse include:

  • Physical abuse which is the use of physical force against a resident causing injury. Examples include hitting, slapping, and improperly using bed or wheelchair restraints.
  • Sexual abuse is non-consensual sexual contact with or behavior toward a resident.
  • Emotional abuse consists of infliction of mental anguish on a resident by using threats, intimidation, isolation, or other actions.
  • Financial abuse in the context of abuse refers to the theft of cash, valuables or other personal property, as well as identity theft, fraud, forgery, and other abuse related to financial transactions.
  • Active neglect occurs when caregivers intentionally withhold care from a resident, affecting the well-being of a resident. Examples include withholding food, medication, water, hygiene, and medical care.
  • Passive neglect occurs when caregivers unintentionally fail to provide necessary care to a resident, often a result of inadequate training or understaffing.

Suffering from neglect devastates residents and their families. Not only does abuse cause massive emotional trauma for residents, but associated costs of injury and the need to transfer the resident to another facility can place an immense financial burden on families.

A frustrated nursing home resident holds their hands to their temples after suffering nursing home abuse.

The following red flags do not automatically mean your family member or loved one will suffer abuse at a nursing care facility. However, they should give you pause about trusting that facility to care for your family member or loved one.

1. Bad Reviews For the Nursing Home

Residents and their families typically have no motivation to make up bad reviews about a nursing home facility. If you perform an internet search about a particular facility and see multiple bad reviews, it is likely the comments are true or rooted in truth.

2. Dirty Facility

Check to see if a facility seems dirty, it is a strong clue that caregivers and staff might be ignoring other responsibilities in terms of care. Additionally, dirty facilities can become breeding grounds for disease and infection. This can sometimes be deadly for elderly residents with weakened immune systems.

3. Strong Odors

If you smell strong odors of urine and feces throughout the facility, it is likely that the residents are not getting bathed and may not have access to clean clothing.

4. Lack of Knowledge Among Staff

You should be able to ask nursing assistants and charge nurses questions about procedures, daily programs, and treatments and get a comprehensive answer.

If the staff cannot answer these types of questions, it suggests poor training and is also likely they aren’t following regular protocols and procedures for proper care. This could also mean the residents do not get the quality of care they deserve.

5. Residents of Nursing Home Look Unkempt

A Senior with messy hair, dirty clothes, no dentures, or bad breath suggest residents are not getting the assistance they need with their daily personal hygiene routine.

6. No Outdoor Activity for Residents

A nursing home staff member takes a resident for a walk outside. One red flag for nursing home abuse is when residents are not allowed to have outdoor activities.

Different facilities often incorporate outdoor activities and encourage their residents to get fresh air. Residents have the right to spend as much time outdoors as they would like. If you notice no outdoor activity and the facility doesn’t even have outdoor sitting areas, it’s possible caregivers and staff are isolating residents indoors.

7. No Evidence of Privacy

An older person has the right to privacy in regard to personal items and belongings. If rooms do not offer a safe or lockbox to protect a resident’s property, there is a risk of theft or financial abuse.

8. Staff Speaks Negatively About Residents

If the caregiver talks down to residents or regularly speaks badly about them, it’s a sign residents may suffer verbal abuse, which might even be worse when visitors are not around.

9. Restricted Visiting Services

A senior woman sits alone in her room at a nursing home. A big red flag for nursing homes is when residents are isolated and family members are not allowed to visit them.

The residents have the right to have visitors in their rooms whenever they want during normal visiting hours. If a facility restricts visiting hours and a family cannot visit anytime they want, there is a chance the nursing home facility might be hiding poor practices.

This is especially important to residents entering the end-of-life stage of their care and having families who want to visit them.

10. Loud Facility

Residents have the right to a peaceful environment in their rooms without excessively loud noises. If you regularly hear phones not being answered, pagers, and loud equipment, the facility is not providing a comfortable living environment for residents.

11. Poor Food Quality

One of the conditions that long-term care facilities have a responsibility to provide is healthy and nutritious meals to the senior citizens that live there, but they must also conform to special dietary needs. Poor food quality may also lead to your family member experiencing weight loss due to not wanting to eat the food they are served.

12. Residents Seem Agitated or Confused

Agitation, confusion, disorientation, anxiety, and depression are all symptoms of abuse and neglect. If you notice an increase in one or more of these behaviors from a resident, they might be suffering.

13. Rude and Dismissive Staff

A skilled nursing facility that provides above-standard care to the residents are willing to answer your questions and are not rude. This behavior can be an indication of how they talk to residents and address their concerns or requests.

14. Unsafe Conditions

Senior woman sitting alone in her bedroom at a nursing home in the middle of the afternoon.

Unsafe living arrangements such as beds that are kept too high off the ground, or wobbly rails in the bathroom, no shower chair, and poor access to a call button can lead to personal injuries for older adults in the facility.

15. Residents Still in Bed in Afternoon

If you visit an assisted living facility in afternoon hours and do not see any residents in the common areas watching television, chatting, or playing games, it is not a good sign of healthy social activity. Caregivers are leaving residents in their rooms, often still in bed, which can lead to dangerous and painful pressure sores.

16. Poor Lighting

Poorly-lighted assisted care facilities create dangerous spaces for injuries to occur. Residents can slip and fall or suffer physical abuse in these areas.

17. Refusal to Discuss Cost

Assisted living facilities that are not engaging in financial abuse or questionable financial transactions will be happy to discuss costs and fees related to putting a member of the family in a home.

18. Open Discussion of Resident Care

The Health Insurance Portability and Accountability Act (HIPAA) prohibits medical professionals, healthcare providers, and caregivers from discussing patient-specific information about care and medical records. If you overhear HIPAA violations, the staff is likely violating residents’ rights in other ways too.

19. Forced Activity

Residents have the right to refuse to participate in activities. Witnessing a staff member force a resident to do something is a warning sign for abuse.

20. Poor Staff Hygiene

A nursing home staff member washes their hands in a sink. Poor hygiene by staff members is a nursing home red flag.

All of the nursing home staff, and others who come in contact with residents have to follow Universal Precautions, which includes washing hands before and after assisting a resident. Staff who do not wash their hands can spread disease and bacteria among residents.

21. Family Members Cannot Eat with Loved One in Dining Room

If a facility won’t let you dine with your family member in the dining room, they might be hiding questionable mealtime practices that can lead to injury and illness among residents.

22. Poor Facility Location

Facilities located in unsafe areas or next to busy and loud roads put residents at risk for injuries, especially those who suffer from dementia, Alzheimer’s Disease, or similar conditions. If a resident wanders into the road because of poor supervision, it could lead to death.

23. Obvious Understaffing

When a long-term care facility is not properly staffed, it is impossible for short-handed caregivers to provide the level of care expected for each resident which can lead to a high staff turnover. This often results in nursing home neglect and injuries to residents.

24. Unclean Resident Rooms

Residents deserve to live in a clean environment. Unmade beds, unemptied trash, uncleared food trays, and other cleanliness issues suggest the resident might not be getting the care they deserve.

25. Injured Residents

Injuries do happen in the facilities and some are truly accidents. Yet, many injuries can be a result of physical abuse or neglect, and they are preventable. If you notice any injuries such as unexplained bruising or bed sores, or even if your family or loved one has sustained a broken bone, it could mean elder abuse is occurring regularly.

Your Best Options Regarding Nursing Home Abuse

If you know or suspect an elderly person you love has been abused while staying in an assisted living facility or nursing home, you may have the right to take legal action on their behalf.

Contact David Bryant Law today using the form on this page to learn more about how a nursing home abuse attorney can help you stop the abuse and hold the facility accountable for its actions.

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David G. Bryant is certified to practice in all state courts in Kentucky, and federal courts in the Eastern and Western districts of Kentucky, Southern District of New York, Southern District of West Virginia, Northern District of Ohio, Middle District of Tennessee, and Western District of Pennsylvania. He is licensed to practice before the United States Supreme Court and the Sixth Circuit Court of Appeals.