Families ask us, almost always: "Was there something we should have seen?" The honest answer is yes, usually — but the signs of nursing home neglect are easy to miss when you're visiting a parent or grandparent during normal daytime hours and staff are putting their best foot forward.
1. Bedsores at any stage
Stage 1 and 2 pressure injuries are usually treatable. Stage 3 and 4 are catastrophic — the wound has reached muscle or bone — and they almost never appear in a properly-staffed facility. Bedsores indicate a resident hasn't been turned often enough. Check skin during visits. Ask staff directly if there are any pressure injuries currently being treated.
2. Falls without medical workup
One fall is bad luck. Three falls is a pattern. After any fall, the resident should be examined by a physician, and the facility should produce an incident report and updated care plan documenting how they're preventing recurrence. If the facility shrugs it off as "she just falls sometimes," that's the warning.
3. Weight loss or dehydration
Unintentional weight loss in elderly residents is a leading indicator of inadequate feeding assistance. Many residents need help eating — they hold the fork but can't coordinate the motion. Understaffed facilities skip the help. Watch the resident's weight chart at care conferences. A 5%+ unintentional drop in three months is reportable.
What to do
Document with photos. Request the care plan, recent incident reports, and state survey reports. Talk to other families. And call us — confidentially — for a free review.
— DiLeonardo & Shaw · Nursing Home