Residents in a negligent nursing home are at a greater risk for serious diseases, infections, injuries, and death. While some forms of neglect are obvious, many go unnoticed and unreported. It is important to recognize that often times neglect does not show any signs and that the absence of signs does not mean the home is free of neglect. Neglect can be covered up by the home or even the resident. It is best to be observant.

Small violations or hints of problems can be the start of bigger issues. Take them as clues that you may want to consider contracting a monitoring service. Below are just a few subtle signs of neglect you can watch for when visiting your loved one in their nursing home.

1. Bruises: Although older people tend to bruise more easily, bruises or cuts, regardless of their severity, should never be ignored. They require both medical attention and an evaluation to determine cause. When you see a bruise or cut, ask questions.

2. Urinary Tract Infections: A urinary tract infection usually results from bacteria getting into the urinary tract. This can occur from the nursing home’s failure to keep the resident clean and dry. U.T.I.s can prove very dangerous, especially when nursing homes fail to provide proper and prompt treatment. They cause tremendous suffering in the patient including a persistent urge to urinate, burning, blood in urine, and more. Additionally, they can lead to falls if residents try to find their way to the bathroom.

3. Slow Response to Call Button: If nursing home caregivers are habitually slow in responding to a call button, it could due to understaffing, but leads to neglect. Call buttons should be responded to within 5 minutes, not 30 minutes. Read Call lights signal urgent need, but response time often slow.

4. High Staff Turnover: A strong indicator of problems and increased likelihood of neglect is the high turnover rates among caregivers in nursing homes. Turnover rates have been persistently high for decades in most states. A recent study found turnover rates among CNAs to be as high as 43% while other studies have found turnover rates to be more than 100% in many facilities.1

5. No Water in Room: Elderly individuals are at a heightened risk for dehydration because their bodies have a lower water content than younger people. Practitioners in the field know that dehydration can happen very rapidly, in less than an eight-hour shift. The consequences of dehydration among the elderly can be life threatening and the symptoms are alarmingly swift. Therefore, safe, fresh, and palatable drinking water must be accessible for residents at all times.

1.Castle, N.G., & Engber, J. 2005. Staff turnover and quality in nursing homes. Medical Care, 43, 616-626. Castle, N.G., et al. 2007. Nursing Home Staff Turnover: Impact on Nursing Home Compare Quality Measures. The Gerontologist. Vol 7, No. 5. 2007.