Nursing Home Injury & Assisted Living Injury Attorneys Serving Prince George's County, Anne Arundel County, Charles County, Baltimore, and in the Maryland, Washington, DC, Metro area.


As individuals age, the human body becomes more susceptible to both accidental and intentional injury. Not all physical injuries in a nursing home are cause for immediate concern, but it’s the responsibility of nursing home caregivers to ensure nursing home injuries and abuse are prevented. Recurring or excessive physical injuries—in any form—must be observed and recognized and many of these cases should be represented by skilled and experienced nursing home abuse attorneys.

Types of Nursing Home Injury and Assisted Living Injuries

Physical Abuse in Nursing Homes and Assisted Living Facilities

Elder physical abuse and injury is the result of direct physical force, either from someone intentionally causing harm or from being careless in actions. Following are typical examples of physical elder abuse injuries:

  • Bruises: Bruises, including black eyes, are among the most common visual indicators of abuse. Newer bruises appear as dark blue or purple marks on the skin, which change to yellow during healing. In elder patients, bruises can take several weeks to turn yellow, making it difficult to determine the exact time and cause of bruises.
  • Burns: Skin burns are usually a symptom of active abuse or neglect. Characterized by damaged tissue as the direct result of extreme heat such as cooking burns, or friction, such as rope burns.
  • Welts: Welts appear on the skin as red, raised bumps. There are many different causes of welts, some of which can be indicative of elder abuse.
  • Bedsores / Pressure Sores / Ulcers: Although commonly associated with neglect, bedsores can be a significant sign of physical abuse if the caregiver knowingly allows them to occur and does not take adequate steps to prevent or heal these sores. A bedsore is an open wound on the body, often occurring in bony areas such as the elder’s back, ankles, hips or butt.
  • Cuts & Lacerations: These types of injuries are identified by cuts or scars, and can appear anywhere on the body.
  • Skin Tears: As humans age, skin becomes more susceptible to tearing as it becomes very thin. Skin tears look like rips, flaps or tissue loss, and usually vary in severity and sensitivity. Skin tears can be an indicator that the elder’s handling is too rough—whether intentional or not.
  • Broken Bones & Fractures: The bones of elderly people can be more porous, which provides for an increase in fractures or breaks. A broken bone in a nursing home is almost always the result of negligent care. Nursing homes are required to have safety measures in place to protect residents from fractures.
  • Dental Injuries: A sudden damage to the appearance of the teeth or surrounding bone can be a certain indicator of trauma.
  • Head Injuries: Injuries to the head resulting in mild traumatic brain injury (TBI) signify a sign of physical abuse—a further indicator that there may be additional causes as well.
  • Malnutrition & Dehydration: A lack of proper nutrition and hydration occurs when elders aren’t receiving proper care. Sometimes, if the individual has experienced a trauma, they will then lose their appetite.
  • Insomnia & Sleep Issues: The inability or unwillingness to sleep may indicate physical abuse, particularly if the elder’s pain is causing the sleep disturbances, or if the elder fears their abuser will return while they sleep at night.
  • Chronic Pain: On-going or recurrent pain—in any form—can be a symptom of continued physical abuse.
  • New Illnesses: Physical and mental strain on the elder’s body may also cause the same physical abuse victims to catch new related diseases or illnesses.
  • Worsened Existing Conditions: Physical trauma, in addition to new injuries or illness, can also worsen pre-existing health issues; it prevents the body from properly repairing itself naturally.

Nursing Home Neglect vs Nursing Home Abuse

The difference between physical elderly abuse and neglect is usually found by looking at the intent, although both may provide equally devastating impacts. Many symptoms of neglect overlap with the physical abuse symptoms previously discussed. In addition to physical abuse symptoms, indications of elder neglect may also include:

Inadequate Hygiene

An elder who does not receive adequate hygiene will appear dirty or exhibit a strong body odor. They might experience dental decay, persistent infections or other indicators relating to poor hygiene. This is a common issue in understaffed nursing homes where bath quotas may be overlooked.

Unexplained Odors and Excessive Weight Loss

Sudden weight loss or unexplained odors in nursing home residents can be a cause for concern and sadly, this problem is very prevalent in nursing homes. Nursing facility residents often have chronic diseases and functional impairments that impair proper nutrition and hydration and require interventions by facility staff. However, when facility staff fails to intervene or assist, this can be considered a case of nursing home neglect.

Elderly individuals with weight loss are at higher risk for functional decline, hip fractures, and mortality. The consequences of weight loss also may include muscle wasting, infections, and increased risk of pressure ulcers.

Malnutrition & Dehydration

If your loved one is showing signs that he or she is suffering from malnutrition or dehydration, they may not be receiving the appropriate attention and care at their nursing facility. Signs of malnutrition and dehydration include unintentional weight loss, dry skin, loss of muscle mass, dizziness, bedsores, or a sore mouth. Inadequate nutrition and lack of continued hydration can be significant indicators that an elder is not eating properly. In most cases, these are symptoms of self-neglect and may need direct intervention from family and loved ones.

Improper Medication

Neglected individuals may not be encouraged or directed to take their medications, may have ineffective or even harmful prescriptions, or they may be given improper doses. In some cases, medications may also be used when alternative medical or pharmaceutical solutions would be more ideal. Healthcare professionals, family, and caregivers need to be very diligent to ensure elders are receiving proper medications.

Emotional Abuse & Psychological Injuries

Emotional or psychological abuse is any form of abuse that impacts the emotional wellbeing of an individual. Elderly emotional abuse can be particularly hard to diagnose due to a lack of evidence or physical symptoms. The following are a few common indicators of psychological trauma:

  • Anxiety / Fear: Elders who have been emotionally abused typically become anxious or fearful, possibly to the extent of hyper-vigilance.
  • Aggression: Unexpected or unexplained aggression can be an indicator of abuse, used by the elder as a defense mechanism. This can be particularly apparent if elders are aggressive only towards one or two individuals, either caregivers or family members.
  • Depression: Symptoms of depression, including withdrawal from social interaction, over-sleeping and lack of interest in activities, can be significant signs of emotional abuse.
  • Learned Helplessness: Emotionally abused elders may become helpless, expecting others to do tasks that are within their abilities.
  • Low Self-Esteem: A noticeable decline in self-esteem or self-worth can be an indicator of prior or ongoing emotional abuse. Elders may exhibit emotions that indicate they are feeling undesirable, stupid, or helpless.
  • PTSD: Previously abused individuals may show other signs of Post-Traumatic Stress Disorder, including panic attacks.
  • Substance Abuse: Ongoing elder abuse may lead to substance abuse as a coping or escape mechanism.
  • Suicidal Thoughts / Attempts: Long-term emotional abuse can contribute to suicidal thoughts or attempts in the elder, further leading to nursing home deaths.

This list is not all-inclusive. Emotional abuse tends to impact the personality and mental health of an individual and can manifest itself in many unexpected ways. If you suspect emotional abuse may be occurring, take immediate action.

Elder Sexual Abuse in Nursing Homes and Assisted Living Facilites

Nursing home sexual abuse—one of the hardest to identify and least reported—can be one of the most devastating forms of elder abuse. Sexual abuse occurs when an individual participates in any form of sexual activity without their explicit consent, or without the ability to consent.

Sexual abuse symptoms can mimic physical and emotional abuse, considering these types of abuse often overlap. Following are additional indicators of sexual abuse:

  • Genital Injury: Unexplained bruising, swelling or physical injury to the vagina, penis or anus can be indicative of sexual abuse.
  • Breast Injury: Bruising or injury to the breasts or chest is a common symptom of sexual abuse.
  • Mouth Injuries: Bruising on the top of the mouth or to the uvula can be symptoms of forced oral sex.
  • Urinary Tract Infections: Recurrent UTIs can indicate sexual abuse, as sexual activity can cause these infections. This can also be a sign that someone with incontinence is not being changed regularly.
  • New STIs: A new sexually transmitted infection is a strong indicator that an individual is involved in sexual activity and can be a symptom of sexual abuse.
  • Increased Interest in Sex: A sudden interest or obsession with sex or sexual content can occur when individuals are sexually abused. They may suddenly say sexually suggestive things or want to access more sexual content, or they may become sexually aggressive towards other individuals.
  • Inappropriate Relationships: A change in relationship or behavior between a caregiver and elder may be a sign of sexual abuse. This change could be perceived as negative, such as a sudden fear, or it could appear to be “positive,” like a new infatuation.

It’s important to take any of these symptoms seriously when observed. If you suspect sexual abuse is occurring to you or your loved one, report it immediately.

The following are important resources to consider when choosing an assisted living facility for your loved one, as well as reporting suspected incidents of nursing home abuse:

Fear of a Caregiver

A nursing home patient who is the victim of any form of injury will likely grow fearful of a caregiver. If your loved one is showing signs that indicate fear such as acting disconnected from family and friends or acting out in a different way, they may be receiving poor and unlawful treatment related to nursing home injuries.

If you believe your loved one has been injured in the care of a nursing home or suffered some form of injury while under the care of a long-term care facility, contact Potter Burnett Law today to discuss your case.


Personal Injury and Medical Malpractice Attorneys Serving the Prince George's County, Anne Arundel County, Charles County, and the Maryland/DC/Metro Area.
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