Nursing home abuse cases are often against elders who are unable to speak up and advocate for themselves. This might include people with dementia or other cognitive disabilities. Other times, victims of nursing home abuse are simply too afraid to speak up or are made to believe nobody will believe them. 

When we think of abuse, we often think primarily of physical abuse, but elder abuse in nursing homes can include sexual abuse, financial abuse, abandonment, neglect, and emotional abuse as well. This means the signs of nursing home abuse and neglect can vary widely, and the signs may not be what you think. 

Because there are many potential signs of nursing home abuse, the presence of one sign does not necessarily mean abuse is happening. In fact, many of the signs of abuse can also be a normal part of aging or a sign of an illness. Nonetheless, if you have a hunch, it is always better to investigate and contact the nursing home abuse hotline in your state.

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If you suspect abuse or just want to know what signs to look out for, here are some common signs of abuse. 

Dehydration and malnutrition: These are signs that your loved one is not being fed regular meals or is not being given nutritious food. You might notice these signs if they are losing weight, seem unusually thirsty, or become very weak. 

Mood changes: Mood changes might include depression, anxiety, anger, or aggression. 

Behavior changes: Behavior changes, such as avoiding social situations, can be a sign your loved one is being abused. They might try to avoid their abuser or withdraw to hide their abuse. They might also feel self conscious about their abuse and turn inward. 

Bruises, broken bones, or other injuries: As people age, falls and injuries unfortunately become more common. However, a healthcare provider can usually determine if an injury is due to abuse. Similarly, if you see injuries that the nursing home staff is attempting to conceal, that is cause for concern. 

Poor hygiene: Poor hygiene is another sign a resident is being neglected. He or she should be bathed and cleaned regularly, and the staff should also make sure their room is clean. 

Broken belongings: This might include accessories like watches or eyeglasses. It also might include possessions in the resident’s room, such as lamps or decorations. 

New or unexplained fears: Abuse can make people feel on edge and fear things they didn’t fear before. This may manifest as startling easily, being afraid of specific places, being afraid of specific people, or being afraid to be alone. 

Bleeding, bruises, or sores on genitals: This can be a sign of sexual abuse. Understandably, it might be difficult to notice these signs. If you suspect sexual abuse, consider asking an independent healthcare provider to examine the resident. 

Torn or stained underwear: You might notice this when helping your loved one put away laundry or go to the bathroom. 

Contracting new sexual transmitted diseases: If your loved one is not having consenual sex, this is concerning sign of sexual abuse.  

Unexplained spending: Your loved one might have a higher credit card bill than normal, or you might notice charges at stores they don’t normally buy from. 

Confusion about finances: An abuser might take advantage of a resident who doesn't keep a close eye on their spending or who easily gets confused. If they can’t remember where their money went or doesn’t understand why their bank account balance is lower than it should be, this is a sign of financial abuse. 

Missing financial documents: This might include checkbooks, debit cards, credit cards, or bank statements. 

Unexplained bills: Unexplained bills might include bills for unnecessary medications, therapy, or nursing home charges.  

Bed sores: Bed sores can be a sign that your loved one is neglected or abandoned. 

Unreported and/or frequent illness: When a nursing home is not reporting illness, it is a concerning sign that they are careless or that they are trying to cover something up

It is very understandable if you are hesitant to report suspected abuse or take your suspicions beyond just that… a suspicion. Many of the signs of abuse can also be completely normal parts of growing older and living in a nursing home. Even if you end up being wrong and there is no abuse happening, it is far better to advocate for your loved one and make sure he or she is safe than to find out later your hunch was right and you did nothing.