Elder abuse, which may be physical, emotional, sexual, financial, or negligent in nature, is among the most underreported types of violence in the United States. It is estimated that only 1 in 14 cases of elder abuse are reported to authorities, even though incidences of mistreatment occur in most nursing home facilities.
Nursing homes may not be openly hostile, but understaffing, lax hiring practices, and the implicit power imbalance between caregiver and dependent may contribute toward the high rates of elder abuse. Nursing home occupancy will stretch further past capacity as the American population over the age of 65 continues to grow, increasing the likelihood of abusive situations and decreasing opportunities to report them. The following statistics are intended to shed light on the mistreatments that can result from mounting pressures and a lack of scrutiny within the eldercare industry. We think they are stunning.
1 in 10 elder Americans, aged 60+, have experienced abuse, and as many as 5 million elders are abused each year. The rates of abuse in nursing homes are even worse. Out of the 2,000 nursing home residents who were interviewed for a study, 44% had been abused and 95% had been or had seen another resident neglected. Although negligence is by far the most common mistreatment, resident-on-resident abuse is also recognized as a frequent problem in nursing homes.
Ten percent of nursing home residents have had a pressure ulcer. Thirty-five percent of nursing home residents with stage II or higher pressure ulcers needed wound care to treat the bed sore.
Urinary tract infection (UTI) is the second most frequent infection in long-term care (LTC) facilities and the most common cause of hospitalization for bacterial infection.
More than half of nursing home staff admitted to abusing a patient within the prior year. Two-thirds of those admitted abuses involved neglect, but an additional survey found that 17% of certified nursing aids had physically assaulted a resident, 51% had yelled at a resident, and 23% had insulted or cursed at a resident. Some of these mistreatments must result from the nursing aids pent-up stresses from being stretched too thin. Although the recommended ratio of aids to residents is 1:6, nursing aids are commonly responsible for 15-30 patients. As many as 90% of U.S. nursing homes do not have enough staff to provide adequate care. The pressure on nursing homes to hire more nursing aids for less money can lead to irresponsible hiring practices. 92% of American nursing homes employ convicted criminals, and there are no federal background check requirements for nursing home staff.
Abused elders are 300% more likely to suffer a premature death. "Negligence" is never listed directly on death certificates, so it may be difficult to ascertain whether an elderly nursing home patient's death was a result of abuse. Recorded causes of death such as starvation, dehydration, or bedsores should always raise red flags, but the link between death and the more subtle abuses, isolation, for example, is just as significant. In 2001, one out of every four nursing homes was cited for causing death or serious injury to a resident.
Rates of abuse are even higher for elders with dementia, ranging from 27.5% to 55% depending on the study. People over 85 years of age make up the fastest-growing segment of the American population, close to half of whom have dementia. With symptoms including memory loss and a decline of other mental skills, dementia makes it difficult for elderly sufferers to speak up about any mistreatment they experience. One of the most prevalent abuses for dementia patients is overmedication, a cheaper option for understaffed nursing homes than giving residents the TLC they really need.
Antipsychotic drugs are often overprescribed to nursing home patients in order to reduce agitation and outbursts, to the point where approximately 1 in 3 nursing home patients have been administered antipsychotic drugs. Sometimes antipsychotics can help to keep self-destructive, violent, or extremely paranoid patients safe, but the drugs have serious side-effects and should only be prescribed in small dosages as a last resort. For most Alzheimer's patients, antipsychotics are no more effective than a placebo for treating aggression and delusions. In randomized trials of antipsychotic drugs, between 30 and 60 percent of dementia patients who were administered a placebo showed signs of improvement. In other words, nursing home patients with dementia respond more positively to the care and attention they get from simply participating in a clinical trial than they do to the actual drug. But insurers are more likely to compensate nursing homes for pharmaceutical intervention than for attentive medical care. It's much easier for overworked nursing aids to administer antipsychotic drugs, even though side effects can include movement disorders, sedation, and weight gain.
Financial exploitation, frauds, and scams cost older adults $36 billion annually, afflicting a population that is already disproportionately impoverished. 40% of Americans over the age of 60 are economically insecure and struggle to meet their monthly expenses, which may include the steadily increasing cost of elder care. In 2003 the average cost for a private room in a nursing home was $66,000. The cost is projected to reach $175,000 by 2021, at more than double the rate of real estate inflation.
African American and Latinx demographics are at greater risk for elder abuse. 23% of African Americans reported experiencing financial exploitation since turning 60, and 24% reported psychological abuse. In comparison, only 8.4% and 13.2% of Non-African Americans over 60 reported financial or psychological abuse, respectively. A study found that 40% of Latino elders experience at least one type of abuse, with half of those victims experiencing multiple types of abuse. Like any other social institution, nursing homes are not immune from institutional discrimination against people of color.
LGBTQ+ elders are also disproportionately targeted for elder abuse. Surveys show that 65% of gay, lesbian, and bisexual people over the age of 60 are victimized because of their sexual orientation. 8.3% are abused by a homophobic caretaker, and 8.9% are blackmailed or financially extorted. The experiences of transgender elders are not as well documented, but they are predicted to suffer even greater abuses as a result of transphobic prejudices. Nursing home staff may not permit same-sex couples to share rooms or refuse to dress transgender elders in clothing that match their gender identity.
Approximately one-third of U.S. nursing homes had been cited for federal standard violations with 10% of those violations causing serious harm to their residents. And this statistic is likely underrepresentation, since the General Accountability Office estimates that 70% of state surveys miss at least one health violation, and 15% miss violations that put residents in immediate danger. Considering that each nursing home averages 20 complaints per year, it's disturbing that so many state inspections are incomprehensive.
Nursing home falls are stunningly common. The average nursing home resident falls 2.5 times a year. Between 50 and 75 percent of nursing home residents fall each year. If the resident cannot ambulate, the number is even higher.
If you have witnessed or experienced elder abuse of any kind, the first step is to seek medical aid if necessary, and contact law enforcement. In addition, allegations of abuse or neglect within facilities that receive Medicaid Funds can be reported to the Office of the Attorney General's Medicaid Fraud Control Unit (410-576-6521). Marylanders are fortunate to have an Attorney General's Office that responds quickly and seriously to reports of elder abuse in nursing homes.
Most of the nursing home negligence cases we handle are in the Baltimore-Washington area, but we handle significant injury cases throughout the entire country. If you or a loved one have been harmed as a result of nursing home abuse, mistreatment or neglect and want to consider a lawsuit or a claim for an out-of-court settlement, call one of our lawyers at 800-553-8082 or click here for a free no obligation Internet consultation.
- The National Council on Aging's Elder Abuse Facts and Economic Security for Seniors Facts
- National Center on Elder Abuse (NCEA) research statistics and fact sheets for African American, Latino, and LGBTQ+ elders living in long-term care facilities
- "Doctors Say Medication Is Overused in Dementia" from the New York Times
- A list of nursing home abuse statistics from Masters In Health Care
- The Center for Disease Control "Understanding Elder Abuse" Fact Sheet