What You Don’t Know Won’t Kill You, But it Can Kill Your Patient: Negligence in Nursing Homes

“Neglect” is often an abuse term associated with children, and rightly so, but there is another group of individuals that can face negligence with equivalent severity: the elderly. Unable to physically or mentally care for themselves alone, 1.4 million Americans reside in nursing homes, where they trust they will be attended to.[1]  However, elder abuse has become an increasing concern for families and individuals over the past twenty years; in 2001, a division of the House Government Reform Committee found that 30% of the nursing homes in the United States were cited for abuse.[2] Furthermore, a 2010 study reported that an older person who experienced abuse of any degree or type had a 300% higher risk of death than other elderly people.[3] Whether you’re representing a victim of neglect, defending a nurse charged with it, or attempting to discern if abuse factors into a client’s situation or not, knowing the details of this issue is critical. Following is a profile of nursing home negligence to help you better understand it:


The Facts:

Negligence is not intentional abuse, but rather a breach of duty or form of sub-standard care that results in harm to a patient.[4] Neglect in nursing homes can take the form of social and emotional abandon, where the elderly person is repeatedly ignored or left alone, or it can pertain to a lack of attention to hygiene or other basic needs (no adequate help with bathing, unclean environment, poor nourishment, etc.).[5] There are also cases of medical negligence – patients who fail to receive the proper prescriptions or dosages, or aren’t able to see doctors or RNs when they require it.[6]

The Effects:

The consequences of negligence are often minor at first, but can have serious repercussions long term. Patients who have been neglected often suffer more infections, bed sores, falls, dehydration, malnutrition, poor hygiene, and withdrawn or unusual changes in behavior.[7] These unnecessary ills can worsen the patient’s condition while adding new concerns to their health. When long-term health concerns – like diabetes, heart disease, or cognitive diseases – are not treated due to neglect, the damage can be irreparable; patients may need to be admitted to a hospital, or may die before that is even an option.

The Solutions:

In order to decrease cases of neglect, training staff properly and lowering the patient-to-nurse ratio is essential, not surprisingly, as it’s been mentioned on several occasions in our posts. Beyond that, however, there are other preventative measures that can be taken. This spring, CMS added 6 new quality measures to Nursing Home Compare that include hospital data-based measures, making sure data is not solely self-reported by nursing homes.[8] This will now make it easier for families and caregivers to chose quality care for patients, while keeping nursing homes accountable. Furthermore, nurses can pay closer attention to environment to prevent injuries, identify and check in with high-risk fall patients, and engage in positive communication with patients and their families to recognize mood changes.[9]

Thousands of elder abuse cases go unreported every year – know what to look for and know how best to help your clients!