Subtle Signs of Nursing Home Neglect that Families Often Overlook

When you place a relative in a nursing home, you entrust the facility with their care. It’s natural to presume that the facility is doing a good job and your loved one is well cared for. But we’ve seen over and over again the devastating consequences of nursing home neglect and abuse, and too often, the warning signs fly under the radar.

Facilities do their best to avoid liability for any harm they cause residents, so it’s important to be vigilant. Here’s what families need to know.

Early and easily overlooked warning signs of neglect

Gradual deterioration in your loved one’s condition

While relatives may notice rapid weight loss or sudden and severe symptoms, a mere gradual decline can be easily overlooked or explained away as a natural result of aging. The facility should be able to explain any change in your loved one’s condition, even if it’s small.

Limits on visitation

There are legitimate reasons a facility might need to restrict visitation, so it’s easy to write this one off. But new and poorly explained restrictions on visitation could be a cover for neglect or abuse.

High staff turnover

Families visiting their loved ones may not pay much attention to the staff, but it’s important to note who is caring for them. If you visit frequently and see different faces every time, that could indicate high turnover, which in turn may mean that staff are poorly vetted and/or overworked.

In Alabama, nursing homes have to meet specific staffing ratios, but these are often the bare minimum. If you're constantly seeing call lights flashing for long periods or find your loved one in the same position every time you visit, the facility's likely prioritizing profits over personnel. High turnover isn't just an HR issue; it's a safety risk that leads to missed medications and skipped safety checks.

Early-stage bedsores

Bedsores often go unnoticed, especially in the earlier stages, because they appear on parts of the body that are usually covered by clothing. But even an early bedsore could be a sign that the facility is failing to help your loved one turn over in bed or check their body for signs of disease.

Personality changes

Tiredness, irritability, and new complaints, such as feeling hot or cold, could all be warning signs that something is wrong. Watch out for frequent urinary tract infections (UTIs) or sudden confusion. Facilities often blame these on "old age," but they're frequently caused by dehydration or poor hygiene.

If your loved one's confused or lethargic, it might not be dementia. It could be a sign that they aren't getting enough water or that their catheter isn't being cleaned properly. We can review the intake logs to see whether the staff are actually tracking how much your relative drinks.

Lack of hygiene

If you notice lingering odors, stained or tattered clothing, dirty bedsheets, and other signs that your loved one isn’t being bathed or changed as frequently as they should be, that’s a warning sign of neglect.

What to do if you suspect nursing home neglect

Your first step if you suspect neglect is to inform the facility. Ask to speak with a director or administrator and explain exactly what you think is wrong and why. Make sure you have a written record of the conversation. That way, the facility can’t claim they were unaware afterward.

When you talk to the administrator, ask to see the "ADL" (Activities of Daily Living) flow sheets. These documents track exactly when your loved one was bathed, turned, and fed. If the charts are blank or look like they've been filled out all at once at the end of a shift, that's a red flag for "paper charting"—where staff records care that didn't actually happen. We'll use these records to build a timeline of neglect that the facility can't ignore.

You can also report the suspected abuse or neglect to the appropriate government authorities. In Alabama, the Long-Term Care Ombudsman investigates reports of abuse and neglect in nursing homes and other long-term care facilities. If you have any reason to suspect a crime has been committed, you can also contact the local police.

Finally, you need to talk to an experienced nursing home neglect attorney. While state officials play an important role in addressing nursing home neglect and abuse, ultimately, their job is to deal with the facilities, not to advocate for the victims. That’s our job. We will listen to your story and explain your family’s legal rights and options. And we have a winning track record in nursing home cases, including a $1 million settlement for the wrongful death of a nursing home resident who developed bedsores.

If you have any reason to suspect your loved one has been neglected in a nursing home, take action. Contact the experienced legal team at Shuttlesworth Law Firm, P.C. for a free consultation.