By Jeff Aidikoff, Founder and Managing Attorney, Bedsore.Law

Moving a loved one into a nursing home is one of the hardest decisions families make. Even after placement, caregiving and family support does not end, it changes.

Family caregivers remain the most important advocates for their loved ones in a long-term care setting. Understanding how to recognize risks early can help prevent your loved ones from suffering unnecessary harm.

While many facilities provide compassionate care, preventable injuries can still occur.  Some facilities have less than optimal staff, or fail to meet certain quality measures.  

Knowing what to look for can make a meaningful difference.

What Nursing Home Neglect Means for Families

Nursing home neglect occurs when a facility that is entrusted with caring for your loved one falls short. This may involve missed medications, lack of bathing, not providing enough food or water, or worse, causing serious injuries like bedsores or broken bones.

Neglect often develops gradually so family caregivers should stay on top of care plans, medications, repositioning and turning, as well as making sure your loved one is getting enough to eat and drink.

For caregivers, early awareness is key.

Why Neglect Happens

Neglect is often tied to larger systemic challenges within facilities, including:

• understaffing
• high staff turnover
• limited training or supervision
• reliance on temporary agency workers
• communication breakdowns between medical teams

These issues can make it difficult for staff to meet their residents’ needs.

Warning Signs Caregivers Should Watch For

Family members are often the first to notice changes.

Physical signs may include:

• unexplained bruises or injuries
• bedsores or untreated wounds
• sudden weight loss or dehydration
• poor hygiene or unchanged clothing
• frequent infection

Behavioral changes can also signal concern:

• increased confusion or withdrawal
• fearfulness around certain staff
• changes in sleep or appetite
• reduced engagement in activities

Other red flags may include unanswered call lights, rushed staff interactions, or dirty and unkempt rooms and common areas.

If something feels wrong, it is important to take that instinct seriously.  If you see something, say something.

How Caregivers Can Help Reduce Risk

Staying informed and involved is the most effective way to support a loved one in a long term care setting.  Practical caregiver support strategies include:

• attending care plan meetings
• documenting changes in health or behavior
• building relationships with care staff
• asking direct questions about care routines
• visiting at different times of day
• reviewing facility inspection reports

Families researching care options can benefit from structured guidance.

You can download a free resource on evaluating facilities here.

What to Do if You Suspect Neglect

If concerns arise, begin by documenting specific incidents and communicating with facility leadership. Many issues can be addressed informally if raised promptly.

If problems persist, caregivers may contact external support resources such as:

• Long Term Care Ombudsman Programs
• State Health Departments
• Adult Protective Services
• Local Law Enforcement

These agencies can investigate concerns and help ensure your loved one in a long term care facility is protected.

In situations involving serious harm, seeking legal guidance may also be appropriate and necessary.

Caregiver Support Through Knowledge and Advocacy

Family caregiving is often an ongoing journey that evolves as needs change. Having access to reliable information, practical tools, and supportive resources can help caregivers feel more confident in supporting their loved one in a long term care facility.  

The goal is not to create fear, but to empower families to ask informed questions, recognize risks early, and to best support the people they love.

Family caregiving often requires ongoing learning and advocacy. For more in depth information on recognizing risks and protecting a loved one in a care facility, you can continue reading here.

“Supporting a family member in a long term care setting is often stressful and difficult; but with the right tools, family caregivers can help ensure better outcomes for their loved ones.”