Nursing Home Negligence and Elder Abuse: The Often Hidden Crime

Senior with bruises begging for mercy

As young children, we look up to our parents and elders with great admiration. In them we see symbols of strength, wisdom, authority, compassion and love. As we grow older, so do they. And, in time, some of what we sought from them they begin to seek from us.

Aging and elderly people can and do live happy and healthy lives, but the aging process does eventually begin to weaken bodies (and sometimes minds) in ways that can leave them quite vulnerable. This state of vulnerability is especially present when older people depend on others for some, or all, of their personal care, such as at a nursing home.

In this blog post, I outline the major types of elder abuse, highlight symptoms that may indicate abuse, and explain legal options you can take if you or an elderly loved one has been victimized by the actions or lack of actions of nursing home staff and caregivers.

Types of Elder Abuse

Any form of mistreatment of an older person that harms them or causes a loss is considered elder abuse. This catch-all term consists of several major types of abuse:

  • Financial abuse: The most common form of elder abuse in general, financial abuse occurs when a perpetrator engages in improper conduct against an older person. Without obtaining informed consent for an action, the perpetrator either enriches him/herself through monetary or personal gain at the expense of an elder person, or acts in a way which mismanages their finances. Financial abuse can be caused by theft, forgery of signatures on forms, using a senior’s belongings or property without compensating them, or pressuring them to act in a way contrary to their best financial interests.
  • Physical abuse: Any physical action, including inappropriate restraint, that causes bodily injury, physical impairment, discomfort or pain constitutes physical abuse. Examples of physically abusive actions include: grabbing, hitting, shaking, pushing, kicking, slapping, poking, pinching, biting, arm twisting, hair pulling or spitting.
  • Emotional and Psychological abuse: Any verbal or non-verbal conduct that intentionally inflicts mental or emotional anguish on an elderly person can be considered emotional or psychological abuse. This conduct can include threats and intimidation, forms of humiliation, acting in a hurtful or disrespectful manner, withholding affection, or isolating an older person from social settings.
  • Sexual abuse: Various forms of non-consensual sexual contact with an older person are classified as sexual abuse. These actions can range from rape, to sexual assault, to molestation, to fondling or coerced nudity. Although many older people continue to have active sexual lives with consenting sexual partners, some elderly people may suffer from diminished cognitive capacity that requires particular sensitivity in terms of establishing consent.
  • Neglect: Active or passive neglect of an older person results when they are denied basic needs and care. Deliberate (active) neglect occurs when a person withholds basic needs or care, while unintentional (passive) neglect occurs when a person lacks the knowledge or training to provide proper care. Any caregiver (whether a familial relation, paid attendant, or medical staff) may actively or passively neglect an elderly person’s basic needs and care – from failing to provide adequate food and water, to improper administration of medication, to denying medical attention, to abandonment or leaving an older person in an unsafe environment.

What Are Some Signs of Elder Abuse?

The wide variety of types of elder abuse mean there is no simple checklist of indicators. The context of each situation may lead to different signs. It’s also essential to remember that an older person who is suffering from abuse may attempt to hide evidence of the abuse out of fear, shame, or embarrassment.

Generally, the following signs may point towards one or more forms of abuse listed above:

  • Financial irregularities (unexplained bills, bank transactions, unexpected disappearance or sale of belongings)
  • Withdrawal from contact from others (by choice or by coercion)
  • Fearfulness, anxiety, nervousness, or reluctance to make eye-contact with certain individuals
  • Reluctance to talk openly about certain topics or visible unease when certain matters are addressed
  • Unexplained injuries, patterns of injuries or aggravated medical conditions

Nursing Homes and Elder Abuse

It’s difficult to estimate the prevalence of elder abuse in long-term care settings. However, one College of Nurses of Ontario study from the 1990s revealed that 20% of nurses in these settings reported witnessing abuse of residents. This included observing rough handling of residents (31%), yelling and swearing (28%) or making embarrassing comments (28%) towards them, or seeing other staff hitting or shoving them. Investigations by media have also revealed troubling examples of abuse.

Many long-term care facilities and nursing organizations have instituted best practices to minimize these incidents and increase rates of reporting among caregivers who witness this abuse, but much work remains to be done and any elder abuse is too much.

How Can You Help?

Sadly, the vulnerability of older persons – particularly those with diminished cognitive or physical abilities – means victims of elder abuse are unlikely to self-report. However, if a loved one or a person under your care confides about an abusive act or situation it is extremely important acknowledge you are taking the matter seriously. A local support service agency can help answer your questions about how the older person, or you as their advocate, might best proceed. The Seniors Safety Line (1-866-299-1011) is one example of these types of resources.

Preventative strategies to combat elder abuse include proactively educating older people about their rights and how to recognize and report mistreatment. However, older individuals who have the mental capability to understand they have been or are victims of elder abuse also have the right to refuse to take action. As frustrating as this may feel, acting against the wishes of a mentally capable older person by escalating the situation is itself a form of elder abuse that diminishes their independence. You can show support by staying in contact with them, providing them with information about options they may choose to take later, and offering to help them maintain their independence through outings (if possible) that may remove them from the abusive environment for a period of time.

If you witness a crime relating to elder abuse, or suspect elder abuse is being committed against a person who is not mentally capable to self-report, you should call the police to report the incident. While police will investigate the matter and may make criminal charges, if the older person has suffered a loss or harm, they or their loved ones may also be eligible to pursue civil action to claim damages. Consider contacting a personal injury lawyer to learn more about these options.

Honouring our elders means respecting them as individuals who, when mentally capable, are free to make informed decisions about their lives and care. Regardless of whether we agree with these choices, we can show them respect by offering our strength, wisdom, love and compassion – particularly to vulnerable elderly people at risk of abuse from family members or caregivers, or within assisted living facilities.

If you or a loved one has sustained a personal injury as the result of elder abuse, please contact personal injury lawyer Melissa Miller to learn more about what options are available to you as you seek justice and restitution. You can reach Melissa at 416-847-1063 or by email at

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