Texas Guide to Nursing Home Abuse and Neglect

How to spot nursing home abuse or neglect and what to do if you suspect it’s happening

“My children put me in a home.”

Not what you want your elderly parents telling their friends after you put thought, effort, love, and money into finding the perfect place for them to spend their final days, right? And for the most part, nursing home staff are prepared, skilled, kind, caring, and competent. 

Once in a while, though, Texas nursing home residents could be subject to neglect or worse... nursing home abuse. If you have a loved one in a Texas nursing home, it’s important to be able to spot the signs of nursing home abuse or neglect and know what to do if you suspect your family member is being harmed.

Signs of Texas nursing home abuse

Sometimes, what looks like it could be nursing home abuse is actually the normal process of aging. But not always. It’s important to be able to distinguish between the types of nursing home abuse—physical, emotional or psychological, sexual, and financial—and to be able to know what behaviors or signs could indicate a problem.

Physical abuse

• Unexplained injuries like bruises, cuts, burns, fractures, or welts;
• Frequent hospitalizations, including repeated trips to the emergency room or frequent medical treatments (aside from any preexisting medical conditions);
• Signs of restraint like marks on wrists or ankles that indicate the use of restraints;
• Broken eyeglasses or frames could indicate physical altercations; or
• Overmedication or under-medication might be signs of drug misuse, including lethargy or unusual behavior changes.

Emotional and psychological abuse

• Behavioral changes like withdrawal from activities, depression, or unusual levels of agitation or anger;
• Fearfulness or displaying fear around certain staff members or other residents;
• Isolation or being kept away from other residents or social activities; or
• Changes in sleep patterns, such as insomnia or excessive sleep.

Sexual abuse

• Unexplained STDs or infections, like the sudden appearance of sexually transmitted diseases or infections; 
• Bruising or bleeding, particularly in the genital or anal areas; or
• Torn or stained underwear could be indications of sexual assault.

Financial exploitation

• Unusual financial transactions include sudden changes in bank accounts, unexplained withdrawals, or new credit cards;
• Changes in legal documents like unexpected changes in wills, powers of attorney, or other financial documents; or
• Missing personal belongings that include items such as jewelry, cash, or valuables.

Behavioral signs of abuse

• Sudden changes in personality, for instance, noticeable shifts in behavior or mood;
• Unexplained fear or anxiety, particularly around certain individuals or in specific situations;
• Refusal to speak and reluctance to communicate or share experiences;
• Communication and interaction issues, or suddenly becoming non-verbal or having trouble communicating.
• Residence staff behavior, such as staff members refusing to allow private visits or conversations with the resident.

Signs of Texas nursing home neglect

• Poor hygiene, including unwashed bodies, dirty clothes, or unkempt appearance;
• Malnutrition or dehydration could manifest as sudden weight loss, dry skin, or other signs of insufficient nutrition or fluids;
• Unsanitary living conditions include dirty bedding, rooms, or common areas;
• Untreated medical conditions like bedsores, infections, or other health issues that are not being addressed;
• Inadequate supervision involves residents being left unsupervised for long periods, leading to falls or wandering.

What to do if you suspect Texas nursing home abuse

Act immediately. 

Your loved one has been through a lot in their years—decades!—and they deserve to be cared for properly as they transition into their end of life.

1. Ensure they are safe. If the resident is in immediate danger, call 911 to get emergency assistance.
2. Seek medical attention if necessary. If the abuse or neglect led to injuries or health complications from a pre-existing problem, contact a physician or case manager who coordinates their care and make sure they are receiving the intervention or treatment they need. 
3. Document the abuse (or suspected abuse). Keep detailed notes on dates, times, specific incidents, and any visible injuries or changes in behavior. Take photographs if there are visible signs of abuse.
4. Make a complaint or report to the facility’s management or operator. Notify the nursing home administration or management about your concerns. They are required by law to investigate abuse allegations and take appropriate action.
5. Report it to the Texas Department of Family and Protective Services (DFPS). You can report suspected abuse, neglect, or exploitation to the DFPS through its toll-free hotline at 1-800-252-5400 or online. The agency is responsible for investigating complaints.
6. File a complaint with the Texas Health and Human Services (HHS) agency. The HHS regulates and oversees nursing homes. You can call the complaint hotline at 1-800-458-9858 or submit a complaint online. 
7. Follow up. If you’ve made a report or complaint, follow up after a reasonable time to make sure that any appropriate investigation or action is taking place. 
8. Provide support to your loved one. Even if you live far away, stay in contact through phone calls or other means so that the resident knows they’re not alone. You might be able to find local support and resources, as well.

What is your legal recourse for a Texas nursing home abuse case?

If you believe your loved one is a victim of Texas nursing home abuse, you have several legal options:

• Report to Texas DFPS or HHS, as discussed above. 
• Contact a Texas lawyer who specializes in elder law or nursing home abuse cases. 
• File a civil personal injury or wrongful death lawsuit. This would be to receive damages from injuries or death caused by the abuse or neglect. 
• Pursue criminal charges, depending on the severity of the offense. 
• Contact the Texas Long-term Care Ombudsman program for assistance, advocacy, and support for the victim. 
• Transfer the resident to a different facility.

How might nursing homes try to cover up instances of abuse?

Nursing homes may try to cover up abuse to avoid legal consequences, financial losses, or damage to their reputation. Here are some common tactics they might use:

• Intimidation. This could be by staff or administrators against residents or even other staff to prevent them from reporting abuse. It might include threats of retaliation, eviction, or job loss.
• Falsifying or altering medical records. A staff member might modify a resident’s medical records to hide signs of abuse or neglect by changing or omitting entries or falsifying data to make it appear that there was proper care.
• Delaying medical care. Delaying or avoiding medical care for injuries resulting from abuse can prevent documentation and reduce the likelihood of the abuse being detected by external medical professionals.
• Isolation. Abusive staff might isolate residents from their families, friends, or other visitors who might notice signs of abuse. This can include restricting visits, moving the resident to a different room, or limiting social interactions.
• Providing false information. Administrators or staff might provide false or misleading information to families, regulators, or investigators about the resident's condition or the care they are receiving.
• Concealing or destroying evidence. Nursing home staff might destroy physical evidence of abuse, such as bloody clothing, damaged medical equipment, or surveillance footage that captures incidents of abuse.
• Misleading inspectors. Nursing homes might present a false image of compliance by temporarily improving conditions, hiding problematic staff members, or coaching residents and staff on what to say.
• Retaliation against whistleblowers. A staff member who reports abuse could face retaliation, such as demotion, job loss, harassment, or other issues, to discourage other staff from coming forward. 
• Failure to report incidents. The facility might underreport or fail to report an incidence of abuse or might call it an accident to downplay its severity and avoid scrutiny from authorities and families. 
• Inadequate training. A facility might claim that an incident resulted from an unintentional mistake or accident because of a lack of training, which is a lesser offense than abuse. This minimizes the perception of abuse and avoids accountability. 
• Making claims “disappear.” The administrator or owner of a nursing home facility could offer a financial settlement to a resident victim or their family in exchange for a non-disclosure agreement. In other words, the family agrees not to discuss the abuse or incident and are essentially “paid off” for remaining quiet.

If you believe your loved one is the victim of Texas nursing home abuse or neglect, or if you suspect these things are happening in the facility where they live, you can contact one of the agencies above or you can seek the guidance of a Texas personal injury lawyer.