In August, the federal government released the findings of a report that showed most nursing homes in America (54%) were dangerously understaffed. As many residents in nursing homes are dependent on the staff for most or all their needs such as food, water, medicine, toileting, grooming and turning; short staffing can dramatically affect the welfare of residents.

Given the study’s findings and the heavy reliance on staff for quality care, what you may have once dismissed as simply the signs of getting older, may be something more - abuse or neglect. If you find your loved one more listless, more agitated, or suffering more of the effects of dementia when you visit them, you need to be concerned. Here are some signs to look for:

Physical Abuse - Physical abuse can be the most obvious to detect. Take notice of any open wounds, cuts, bruises, welts, discoloration, or broken bones. If the caregiver cannot adequately explain what has happened, you need to take steps to investigate. Also, take note of any sudden change of behavior in your loved one. If he or she begins to cower when you approach, that could be a sign of physical abuse.

Emotional Abuse - Emotional abuse may be more difficult to recognize. Look for signs of your loved one being unusually upset or agitated, extremely withdrawn, or non-communicative. If you notice unusual behavior, like rocking in bed or sucking a thumb, you may be witnessing the aftershocks of serious emotional abuse.

Neglect - Detecting neglect can also be difficult to determine. If you notice your loved one losing weight and becoming listless he or she may not be getting the nourishment and food needed to maintain their health. Dry cracked lips and skin is a sign of inadequate hydration and the need for more fluids.

To detect other signs of neglect you have to familiarize yourself with some of your loved one’s more intimate details. You may need to discretely examine undergarments and skin to see if they are soiled with feces or urine. Residents who lie in their waste are much more likely to develop preventable bedsores.

If you recognize any of these situations, your loved one may be neglected or abused. There are steps you can take if suspect abuse or neglect.

You should first contact the administration at the home. Express your concerns and problems immediately and demand action be taken to improve the conditions. The majority of nursing home employees are caring and loving people who are eager to provide quality care.

If you do not get any response from the facility you should contact the state department that regulates nursing homes, the Division of Health Facilities Licensure and Certification within the Department of Health (800-227-7308). If you suspect possible abuse or neglect, contact the division and file a complaint. The state will visit the facility and investigate the situation. Be sure to follow-up with the investigator to see what actions are being taken to improve care.

You should also contact the Mississippi Long-Term Care Ombudsman (800-948-3090). The Ombudsman serves as a resident advocate and supports residents' highest possible quality of life and is responsible for investigating, and attempting to resolve concerns and complaints made by, or on behalf of, residents.

Abuse and neglect in any form should not be tolerated. When all is said and done, you should take any and all steps necessary to protect the safety of those you love. If they are not receiving adequate and appropriate care, you may need to take steps to enforce your legal rights. Don’t stand for abuse or neglect; take action.

Jim Wilkes is the co-founder of Wilkes & McHugh, a law firm that has been nationally recognized for its work on behalf of nursing home residents. Mr. Wilkes can be reached at (800) 255-5070.

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