Table of Contents

About This Course

1. Introduction to Elder Abuse
2. The Basics of Elder Abuse
3. Substance Use and Other Risk Factors
4. Screening and Assessment
5. Intervention and Treatment
6. Preventing Elder Abuse

Supplements
Case Studies
References
Resources

Out of the Shadows
Uncovering Substance Use and Elder Abuse

Warning Signs of Poor Care

These warning signs may indicate poor care in a nursing home.

Atmosphere:

• Unclean residents and sanitation problems
• Unpleasant odors
• Hurried staff
• Slow response to nurse call lights

Dehydration:

• Sunken eyes
• Dry lips
• Change in mental status
• Strong urine odor
• Swallowing problems
• Constipation

Declining Nutrition:

• Weight loss
• Ill-fitting clothes
• Loose dentures
• Swallowing problems
• Lack of meal variety
• Lack of assistance with meals
• Rushed mealtimes
• Difficulty eating

Decline in Mobility:

• Difficulty getting up from a chair or using a cane, walker, or wheelchair
• Loss of balance/falls
• Being physically or chemically restrained
• Bladder and Bowel Problems:
• Complaints or moaning
• Odors
• Wet and soiled clothing
• Lack of assistance getting to the bathroom
• Slow responses to call lights
• Slow responses changing wet or soiled clothes
• No toilet program
• No monitoring of intake and outflow

Pressure Sores:

• Discolored, swollen, or torn skin over bony areas
• Poor eating
• Lack of assistance to move or change positions every 2 hours (minimum)

Mediation Problems:

• Change in mental status
• Drowsiness
• Dizziness
• Weakness
• Rashes
• Medication interactions
• Poor appetite

Loss of Dignity:

• Dirty, untrimmed nails
• Crusty eyes
• Body odor
• Unkempt hair
• Unshaven
• Soiled clothing
• Lack of staff for daily grooming

Special Needs:

• Medical equipment such as oxygen or tube feeding turned off
• Lack of transportation for outside appointments and trips
• Lack of supplies including soap, toothpaste, and denture cleaners

Boredom and Depression:

• Crying
• Withdrawn attitude
• Apathy
• Aggression
• Poor appetite
• Lack of planned activities (especially during nights and weekends)
• Lack of staff interaction with residents

Source: A Perfect Cause. (n.d.). Warning signs of poor care. Retrieved June 24, 2004, from http://aperfectcause.org/122602-apc-warningsignsofpoorcare.htm