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What happens when a loved one is in a nursing home that you suspect is mistreating him or her? First of all, why are you suspicious that some neglect has taken place? Is your loved one appearing withdrawn during your visits? Has their personality changed, given that they are not suffering from a disease such as Alzheimer's? Other symptoms of mental or emotional abuse may surface in the forms of depression, passivity, guilt, fear, or hopelessness.

Abuse is a higher level of neglect that can include sexual battery, sexual assault, rape, assault, battery, or unreasonable physical restraint, deprivation of food and water, or unauthorized use of psychotropic drugs.

Sometimes an elderly patient may be unable to express themselves, symptoms of neglect or abuse in these situations may be evident with signs of malnutrition, soiled clothes, heavy sedation, unprescribed physical restraints, bed sores or outright lack of medical attention. The strongest indicators of physical abuse can be seen via unexplained bruises, swelling or pain, fractures or falls. Other indications of poor quality of care may be evident if there are bodily fluids on the floor of the room due to call lights not being responded to in a timely fashion.

While abuse is outright mistreatment of an individual, neglect is an insidious form of mistreatment that may not be as quick to identify. Forms of neglect are the failure to provide basic personal hygiene, failure to provide a safe and healthy environment, failure to prevent malnutrition or dehydration, and failure to provide adequate medical and mental health care needs of the patient.

Please be reminded that nursing homes are a business, which provide the service of caring for the elderly or individuals requiring further assistance in recovering from a debilitating illness or accident. Being a business, they are required to watch their finances and provide a profit for their shareholders. As a result, employees are not always paid well and the service they provide may not meet the standard of care.

All nursing homes are required to develop a plan of care for each patient housed in their facility. This plan of care should be discussed with the family member or guardian placing the patient in the nursing home. The family member or guardian is also supposed to be invited to the plan of care meeting where the plan is devised. More often than not, a nursing home does not meet the criteria it established in this plan of care, which can result in many of the neglectful situations mentioned above.

Unfortunately, this country's 1.5 million elderly that are housed in nursing homes often suffer from abuse and neglect. Sometimes, nursing home patients do not have any greater ability to defend themselves or speak for themselves than a small child or infant. Yet, nursing homes are held to a lower standard than daycare centers.

"If I detect symptoms of apparent neglect, what should I do?"

First, try to talk to your loved one to see if they can describe to you what's going on with their care. Try to visit the nursing home at different times and different days to prevent the caretakers from recognizing a pattern in your visitation. Keep a careful watch of what the caretakers do with regards to your loved one. If you see visible signs of neglect, take photographs and keep a diary of the dates of when the incidents took place. Be aware that the nursing home keeps a record of daily care in great detail.

"If after discussing my concerns with an attorney and he/she feels that I have a case against the nursing home, what do I need to be aware of regarding the care of my loved one?"

The threat of litigation is never welcomed by anyone. The process of holding a business accountable for poor treatment of a paying client/patient can lead to further disregard for the care of that person. Therefore, it is advisable that you remove your loved one from the nursing home in question and move them to a new one that meets with your approval.

"How much would it cost to pursue a case like this?"

Expenditures can range from $10,000 to $125,000 or greater depending on how the case gets resolved. (You will not be charged for this cost unless you receive an award.) Similar to medical malpractice cases, due diligence must be performed at the onset to determine if the abuse or neglect suffered by a loved one will result in a settlement or jury award that exceeds the cost of litigating the case.

"When you refer to the term settlement, what does that involve?"

A settlement results from arbitrating the case before a mediator. A mediator is typically a retired judge or attorney, who works to bring the parties together to settle the case prior to reaching a courtroom. Many nursing homes choose to settle out of court to avoid the bad publicity associated with alleged mistreatment of patients.

"How long could it take to resolve a nursing home abuse or neglect case?"

Timelines on cases vary according to the type of abuse or neglect and the severity of such. Oftentimes, proving abuse and neglect requires the testimony of experts and numerous depositions of the various parties involved. Also be aware that the Florida legislature, as a result of lobbying efforts, has enacted several laws making it more difficult to hold nursing homes accountable for poor care. These laws impose a greater effort on the part of the trial attorneys to prove their case.

"Should I receive payment for damages either via settlement or jury trial, what becomes of the money?"

Any monies received from litigation could be allocated for reimbursement to Medicare or Medicaid. Florida and federal law requires that these two government organizations receive their payments. Insurance companies may be entitled to reimbursement for medical expenses caused by negligence of nursing homes and health care providers based on Florida and federal laws similar to those mandating Medicare or Medicaid reimbursement. Also, the law firm you retain to pursue your case will receive its fee for the work performed on the case. Additionally, monies received from the litigation may be used to cover future losses and medical care.

"What happens when there are several family members involved in this process?"

Anyone entitled to an estate's assets as a part of intestacy succession or probate laws must be informed that a claim is being pursued. However, whether or not a beneficiary of an estate is entitled to proceeds from a lawsuit is dependent upon the specific claims pursued, the specific claims for which a verdict is awarded, and if a will exists.