Skilled nursing facility abuse is a problem that has caused a stigma on skilled nursing facilities, or 
nursing homes. Skilled nursing facilities are institutions that have been established with the purpose of providing care for patients that are unable to complete normal daily tasks without assistance. Skilled nursing facilities cater mostly to elderly patients, but there are cases of younger patients that require the assistance that can be provided by a skilled nursing facility. Often these are cases of brain or spinal trauma that has caused the patients to become paralyzed or impaired mentally.
Types of Skilled Nursing Facility Abuse
There are different types of skilled nursing facility abuse. Some types of abuse can be more difficult to spot than others. All types of skilled nursing facility abuse show some kind of sign, and loved ones should be vigilant for any signs of abuse.
Physical Abuse
Manhandling patients while changing clothing or diapers, hitting, or pinching patients are examples of physical abuse. This is the most obvious kind of skilled nursing facility abuse because patients will typically have unexplained bruises, cuts, or bloody clothes. Family members of patients should be on the lookout for these types of signs.
Sexual Abuse
Unfortunately, patients usually cannot defend against staff with poor intentions. Sexual abuse is a real concern, and has been on the rise in skilled nursing facilities. Sexual abuse takes many forms. There have been cases of rape of patients, improper touching while changing clothing or bathing, and gestures or jokes directed at patients.
The range of sexual abuse is wide, but it harms the patient in all cases. The signs of sexual abuse can be visible in some cases, such as bruising in sensitive areas. Sometimes sexual abuse occurs when the patient is sedated, so if a patient has bruising in private areas that cannot be sufficiently explained, it may be a warning flag that sexual abuse is happening. Even if there are no visible physical signs, patient withdrawal from activities or unwillingness to discuss daily life may be signs of sexual abuse.
Verbal Abuse
Talking down to patients, threatening patients, and verbally directing patients to perform demeaning activities are some examples of verbal abuse. Verbal abuse can manifest signs similar to certain types of sexual abuse. The patient may become increasingly withdrawn, or express fear when asked about daily occurrences. In some cases, the patient may develop more aggressive behaviors.
Neglect
Patients depend on the staff of skilled nursing facilities to provide medication on time, healthcare if needed, decent meals, clean clothing, clean bathing facilities, and clean clothing and bedding. When these things are not provided, or are improperly maintained, it is a case of skilled nursing facility abuse by neglect. This is the most common type of skilled nursing facility abuse. Neglect encompasses a wide range. Using food that has expired or has been held improperly is an example of neglect, and can result in patients getting sick. Leaving a patient unattended for days is another example of neglect, and signs may be harder to spot. Family members should ask the patient questions about how often the staff visits, changes bedding, and gives baths. If the patient is unable to communicate, family members should check patients for signs of bedsores, dirty clothing, or other telltale signs of neglect.
Issues Contributing to Skilled Nursing Facility Abuse
High patient to staff ratios contribute to poor care and especially neglect. If there are not enough nurses to care for all of the patients properly, neglect is unpreventable by the staff. The management at skilled nursing facilities must be proactive to prevent this from happening. Screening patients periodically to ensure proper care and interviewing employees to assess burnout levels is necessary. Management must be present in the main areas often to be completely aware of what is going on, hiring more staff as needed and watching general activity to maintain a high standard of care. Indifferent or over tasked management staff is another contributing factor to neglect, and family members should be sure to ask questions of the management staff that are specifically related to their knowledge of the daily activities of staff and patients.
High ratios of patients that are affected by dementia or Alzheimer’s disease to low levels of staff is a very dangerous and difficult combination. Dementia patients often try to leave and may need more individualized care than other patients in a skilled nursing facility. If there are not enough nurses to give the kind of care necessary, dementia patients are more prone to injuries. Patients that are not receiving proper care may also become angry and unwilling to cooperate, and this puts the staff at risk, creating further conflict.
How to Prevent or Handle Skilled Nursing Facility Abuse
Skilled nursing facility abuse can be prevented by the loved ones of patients. Family or friends must visit often and ask questions to be aware of daily events at the facility. Loved ones that visit frequently are much more likely to notice changes in behavior and appearance of patients than those who rarely visit.
If skilled nursing facility abuse is suspected, the patient should be taken out of the situation immediately. This can be accomplished in some cases by removing the patient from the skilled nursing facility. In other cases, a specific staff member is the abuser, and must be removed. After seeking medical treatment for any injuries or conditions sustained, an attorney should be contacted to assess the situation and possibly seek retribution for any skilled nursing facility abuse.
Sources:
“Advocacy Groups and Government Agencies.” Nursing home Abuse Center. Nursing Home Abuse Center, n.d. Web. 8 Sep 2013. <http://www.nursinghomeabusecenter.org/resources/advocacy-groups>.
“Nursing Home Abuse Risk Prevention Profile and Checklist .” National Center on Elder Abuse. U.S. Department of Health and Human Services, n.d. Web. 8 Sep 2013. <http://www.ncea.aoa.gov/Resources/Publication/docs/NursingHomeRisk.pdf>.
“Nursing Home Abuse.” The FBI Federal Bureau of Investigation. U.S. Department of justice, 08 May 2012. Web. 8 Sep 2013. <http://www.fbi.gov/news/stories/2012/may/nursing-home_050812>.