Abuse, Neglect, Exploitation and Misappropriation: Prevent It and Report It
Learn what abuse, neglect, exploitation and misappropriation look like, how fast to report, and how to keep people safe while it is checked.
ForNursing home, Home health, Hospice staff
TimeAbout 66–74 minutes
Lessons10, each with a quick check
FinishA quiz (80% to pass) and a printable certificate of completion
What you will learn
Name the four main kinds of abuse: physical, verbal and mental, sexual, and abuse using phones or cameras.
Explain neglect in your own words.
Define exploitation and misappropriation in your own words.
Name signs of abuse and neglect in a resident's body and behavior.
Report every allegation right away to the person your facility names.
Know that you personally are a 'covered individual' with a duty to report a suspected crime.
Keep the resident safe right after an incident.
Name stress signs in yourself that can lead to rough care.
Know your federal duty to report right away in home health or hospice.
Spot signs of money abuse in a patient's home.
Written by Pact Compliance from federal rules and CDC, CMS, OSHA and NIH guidance (sources under each lesson), checked October 2026. Where your facility's policy is different, follow your facility's policy.
Lesson 1: What Abuse Is
In this lesson you will:
Name the four main kinds of abuse: physical, verbal and mental, sexual, and abuse using phones or cameras.
Explain that abuse can happen even if the person did not mean to cause harm.
Know that abuse of a resident with dementia is still abuse.
Freedom from abuse
Every resident
Every person you care for has the right to be free from abuse. The rule also covers neglect, exploitation, and taking their things. It also bans physical punishment. It bans locking someone away from others against their will. And it bans restraints used to make work easier, when the person does not need them for a medical reason. This lesson is about abuse. Later lessons cover the others. You will learn what abuse looks like, so you can stop it and report it.
Deliberate act
Harm, pain, fear
Here is what the federal rule says. Abuse is on purpose. It is hurting someone, holding them in a way that is not reasonable, scaring them, or punishing them. It causes physical harm, pain, or mental anguish. Mental anguish means deep fear or upset. Now listen closely to one word: willful. Willful means the person acted on purpose. It does not mean they wanted to hurt anyone. So an aide who grabs a resident's arm hard to hurry them along may say, 'I didn't mean to hurt her.' If the grab was done on purpose, it can still be abuse.
Show the answer
It can still be abuse, because the act was on purpose. Right. Willful means the act was deliberate. The person does not have to mean to cause harm.
Physical abuse
Punishment
Physical abuse includes hitting, slapping, punching, biting, and kicking. Punishment is also abuse. Punishment means hurting someone to control or correct how they act. Examples are pinching, spanking, slapping a hand, or flicking someone. A quick flick on the hand when a resident grabs at you is not a small thing. It is physical punishment, and it is not allowed.
Verbal abuse
Mental abuse
Mental abuse is words or actions that make a resident feel shamed, scared, put down, or upset. Verbal abuse is a kind of mental abuse. It can be spoken, written, or a gesture. It counts even if the resident cannot understand it. Examples are mocking, insulting, or making fun of a resident. Yelling at them, or standing over them to scare them. Threatening them, like saying, 'If you don't stop, you won't get your shower,' or, 'Your daughter isn't coming back.' Keeping a resident away from others or from activities can be mental abuse too.
Sexual abuse
Phones and cameras
Sexual abuse is any sexual contact the resident did not agree to. Any type at all. Abuse can also happen with technology. Taking a photo or video of a resident in a way that shames them, and sharing it, is abuse. That includes a text, a group chat, or social media, even if it is meant as a joke. Last, remember this. The rule says abuse harms every resident, no matter their mind or body. A resident with dementia who may not remember is still harmed. Abuse is abuse.
Put it together
Report it
Let's put it together. Abuse can be a hit, a pinch, or a flick. It can be a threat, yelling, or a joke that shames. It can be sexual contact without consent. It can be a photo in a group chat. It does not have to leave a mark. The person does not have to mean harm. And the resident does not have to understand or remember. If you see any of these, you must report it. The next lessons show you how to spot the signs and how fast to report.
Tell the difference between a busy shift and choosing not to give care.
Know what to do when you cannot give care that a resident needs.
Neglect
Care not given
Neglect is when the facility, its staff, or its service providers do not give a resident the goods or services they need. That is, what they need to avoid harm, pain, mental anguish, or emotional distress. Goods and services means things like food, water, turning, toileting, clean briefs, pain medicine, glasses, hearing aids, and help to eat. Neglect is about what does not happen. It is often quiet. Nobody hits anyone. But a resident can still be badly hurt.
Show the answer
It can be abuse, because care is being kept from her on purpose. CMS says staff who can give care but choose not to, or ignore requests for help, deprive the resident of services. That is abuse.
Choosing not to
Ignored requests
CMS describes a kind of abuse that looks like neglect. It is when staff know how to give care and are able to give it, but choose not to. It also covers staff who choose not to answer a resident who asks for help. CMS calls this deprivation of goods and services. Think about a call light. A busy hall can mean a wait. That is a problem to fix. Walking past a call light again and again, on purpose, because the resident 'calls too much' is different. That can be abuse.
What it looks like
Signs
Signs of neglect can include a resident who has not been changed for a long time. Or someone left in a wet bed. Others are sores that could have been prevented, like bedsores. Or a resident who is dirty, with unwashed hair or dirty clothes. Missing glasses, dentures, a walker, or a hearing aid can also be signs. Watch for a pattern. One thing alone may have a reason. Several things, or the same thing again and again, need to be reported.
Can't get to it?
Tell the nurse
Here is what to do when you cannot give care in time. Maybe you are short staffed. Maybe you have two residents who need help at once. Tell your charge nurse right away. Say what is not done and who is waiting. Ask for help. Do not chart care you did not give. Do not leave it for the next shift without saying so. Speaking up protects the resident. It also shows you did not choose to leave care undone.
Report a pattern
No proof needed
If you see signs that someone else is neglecting a resident, report it. You do not need proof. The National Institute on Aging says you do not have to prove abuse is happening. Professionals will look into it. Your job is to notice, keep the resident safe, and tell the right person. The reporting lessons in this course show who to tell and how fast.
On your shift
Speak up early
Here is a real-life example. Mrs. Jones needs two people to help her get up. Your partner is on break, so she stays in bed all morning and misses breakfast. That is a care gap. The fix is to tell your nurse right away and ask for help. Now think about this. If staff leave her in bed every day because getting her up is 'too much work,' that is choosing not to give care. That is neglect, and it can be abuse. Speak up early. Ask for help. Report patterns you see.
Lesson 3: Exploitation and Taking Residents' Things
In this lesson you will:
Define exploitation and misappropriation in your own words.
Spot common examples, including taking medicine.
Know how to answer when a resident offers you money or gifts.
Exploitation
Personal gain
Exploitation means taking advantage of a resident to get something for yourself. It happens through tricks, scaring, threats, or pressure. For example, an aide tells a resident she cannot pay her rent, so the resident gives her money. CMS uses this exact kind of example. The resident gave money because staff made her believe there was a money crisis. Even if the resident said yes, this is exploitation.
Show the answer
Yes. Using a resident's things without their OK counts, even for a short time. The definition includes wrongful temporary use of a resident's belongings without consent.
Misappropriation
Without consent
Misappropriation is a long word. It means using or taking a resident's things or money without their OK. It can be on purpose or for a short time. It counts even if you plan to give it back. Resident property is anything they own, no matter what it seems worth to you. That includes jewelry, clothes, money, phones and tablets, credit cards, bank cards, and their personal information, like their name, ID, and Social Security card.
Medicine is property
Drug diversion
A resident's medicine is their property. Taking a resident's medicine for yourself or for someone else is misappropriation. CMS names this, including controlled drugs like pain pills. If you see someone pocket a resident's pills, or see pill counts that do not add up, report it. It harms the resident twice. They lose their medicine, and they may be left in pain.
Gifts and money
Say no kindly
Sometimes a resident offers you money or a gift. CMS says a gift is misappropriation when a resident gives it to get good care, because staff talked them into it. Consent is not real if the resident cannot understand, or if they agreed out of fear or pressure. Check your facility's gift policy. A safe answer is: 'Thank you, that is so kind. I can't take it, but I'm happy to help you.' Then tell your nurse about the offer.
Protect belongings
Report missing items
The facility must use reasonable care to protect residents' things from loss or theft. You help with that every day. Label things the way your facility says to. Do not throw out a resident's things without asking. If a resident says something is missing, take it seriously and tell your nurse. Even if the resident is confused. Theft of a resident's things is one of the situations CMS says staff must be trained to spot.
Good habits
Protect yourself
Some simple habits protect residents and protect you. Do not borrow anything from a resident, even for a minute. Never use a resident's credit card, bank card, or cash unless the resident has agreed and your facility's process allows it. CMS lists purchases made without a resident's OK, or under pressure, as misappropriation. Keep residents' personal information private. CMS lists identity theft as misappropriation too. Never ask residents for money or favors. A resident's things matter to them, even if they look worthless to you. Treat them that way. If something feels off about a resident's money or things, report it. You do not need proof.
Lesson 4: Spotting the Signs, Including Injuries of Unknown Source
In this lesson you will:
Name signs of abuse and neglect in a resident's body and behavior.
Know the three things that make an injury an 'injury of unknown source.'
Remember that you report a suspicion; you do not need proof.
Body signs
Look and ask
You see residents up close every day. That makes you one of the best people to spot abuse. Body signs include bruises, burns, cuts, or scars that nobody can explain. Watch for marks that look like a hand or a grip. Watch for fractures, sprains, or burns on the hands or the chest and belly. Bedsores and other sores that could have been prevented can be a sign of neglect.
Behavior signs
Sudden change
Signs can also show in how a resident acts. A resident who becomes quiet and withdrawn. Or one who gets upset or violent. Some rock back and forth. Some flinch or get scared when a certain person walks in. Others will not talk when a certain staff member is in the room. Any of these can have other causes too. But you should not ignore them. Tell your nurse what you saw.
Show the answer
A possible injury of unknown source that must be reported. Not seen, not explained, and in an odd spot. That meets the CMS criteria.
Unknown source
Three checks
CMS uses the words 'injury of unknown source.' These injuries must be reported, just like abuse. An injury is from an unknown source when all three of these are true. One. Nobody saw how it happened. Two. The resident cannot explain it. Three. The injury is suspicious. That could be because of how bad it is. It could be the place on the body, like a spot that does not usually get bumped. Or it could be the number of injuries at one time, or injuries that keep happening over time.
Report suspicion
No proof needed
You do not need to know who did it. You do not need to prove it. You only need to report what you saw or what you were told. Investigating is the facility's job, and sometimes the state's. CMS found that some staff knew about an incident but did not report it. They thought it did not meet the definition. If you are not sure, report it. Let the people who investigate decide.
What they tell you
Believe and report
Sometimes a resident or family member tells you something happened. Report it, even if the resident is confused. Report it even if they have said things before that were not true. CMS lists not believing a resident because of past false reports as a reason staff fail to report. Listen. Stay calm. Do not promise to keep it a secret. Say, 'Thank you for telling me. I need to tell my supervisor so we can keep you safe.' Then report it right away.
On your shift
Notice, then report
Here is how this can look on a real shift. During evening care, you notice Mr. Diaz has a scratch on his back and two small bruises on his upper arm. Yesterday he had none. He cannot tell you what happened, and nobody saw anything. You stop. You make sure he is comfortable. You tell your nurse right away and show her. Then you write down what you saw and when. You did not decide what caused it. You did not need to. You noticed, and you reported. That is exactly your job.
Lesson 5: Report Right Away: The 2-Hour and 24-Hour Rules
For: Nursing home
In this lesson you will:
Report every allegation right away to the person your facility names.
Know the time limits: 2 hours if abuse or serious bodily injury, otherwise 24 hours.
Know that time limits are clock hours, not business hours.
Report right away
Every allegation
In a nursing home, every alleged violation must be reported right away. An alleged violation is something seen or reported that has not been checked yet. If it is true, it could be abuse, neglect, exploitation, mistreatment, an injury of unknown source, or taking a resident's things. It can come from staff, a resident, a family member, a visitor, or anyone else. Your part is simple. Report it right away to the person your facility names. That is often the administrator or the abuse coordinator.
Show the answer
Right away, no later than 2 hours, because it involves abuse. Allegations involving abuse must be reported within 2 hours, using clock time.
2 hours
Abuse or serious injury
Federal rules set time limits. If the allegation involves abuse, or the resident has a serious bodily injury, the report must be made right away. And no later than 2 hours after the allegation is made. Serious bodily injury means an injury with extreme pain or a big risk of death. It also means an injury that causes long-lasting loss of use of a body part, an organ, or the mind. Or an injury that needs medical help like surgery, a hospital stay, or rehab. Certain sexual abuse always counts as serious bodily injury.
24 hours
Everything else
If it does not involve abuse and there is no serious bodily injury, the limit is 24 hours. That covers things like neglect, exploitation, mistreatment, or taking a resident's things, when nobody was seriously hurt. But do not wait just because you have 24 hours. Report right away. The 24 hours is the latest time, not the goal. The facility must report to the administrator and to state officials, like the State Survey Agency, as state law says.
Clock time
Nights and weekends
These time limits are real clock hours. They are not business hours. That means 2 hours at 3 in the morning on a Sunday is still 2 hours. So know how to reach the right person at night, on weekends, and on holidays. Your facility should have a phone number for this. Write it down. Keep it on your badge or in your phone.
When in doubt
Report
Sometimes you will not know if it is abuse, or how bad an injury is. Do not let that slow you down. If you are not sure which time limit applies, use the 2-hour limit. Report right away. After the report, the facility must look into it, keep residents safe while it does, and send its results to the state within 5 working days. You do not do the investigation. You start it by speaking up.
Know your contact
Before you need it
Do these three things today, before you need them. First, learn the name of the person you report to at your facility. Second, save the reporting phone number in your phone, including the after-hours number. Third, ask your nurse what your state requires. State law can add steps, like reporting to adult protective services. Then, when something happens, you will not lose time looking for a number. Remember: report right away. The 2 hours and 24 hours are the latest limits, not targets.
Your facility's policy (ask your supervisor):
Name and title of the person staff report to (administrator / abuse coordinator)
24/7 phone number for reporting, including nights and weekends
State-specific rules (state survey agency, adult protective services) if your state requires more
Lesson 6: Suspicion of a Crime: Your Own Duty to Report
For: Nursing home, Hospice
In this lesson you will:
Know that you personally are a 'covered individual' with a duty to report a suspected crime.
Report a suspected crime to the State Survey Agency and to law enforcement within the time limits.
Know that you are protected from retaliation for reporting.
Elder Justice Act
Covered individual
A federal law called the Elder Justice Act added section 1150B to the Social Security Act. It covers long-term care facilities that get federal funds. It gives a personal duty to every covered individual. That means every owner, operator, employee, manager, agent, or contractor. That includes you. CMS says it also applies to hospices that serve residents in nursing homes. Your facility must remind you of this duty every year.
Suspected crime
State and police
If you have a reasonable suspicion that a crime was committed against a resident, you must report it. You report to two places. One is the State Survey Agency. The other is at least one local law enforcement agency, like the police or sheriff. What counts as a crime depends on your local law. Many kinds of abuse, neglect, and theft can be crimes. Your facility will tell you how to make these reports.
Show the answer
The State Survey Agency and local law enforcement, within 2 hours. A suspected crime goes to both. Criminal sexual abuse counts as serious bodily injury, so the 2-hour limit applies.
2 hours
24 hours
The time limits are like the ones you already learned. But the clock starts when you form the suspicion. If the events caused serious bodily injury, report right away, and no later than 2 hours after you form the suspicion. If there was no serious bodily injury, report no later than 24 hours after you form the suspicion. Again, these are clock hours. Nights and weekends count.
Report together
Your own duty
Several staff can file one report together, if it names everyone who is reporting. But each person is still responsible for making sure their own duty is met. Your facility can set up an easy process, but it cannot stop you from reporting directly yourself. Covered individuals who do not report can face large fines. They can also be barred from working in health care paid for by Medicare and Medicaid.
No retaliation
Know your rights
The law protects you. Your employer cannot fire, demote, suspend, threaten, or harass you for making a lawful report. It cannot deny you a promotion or other job benefit for it either. Your facility must post a notice of your rights where staff can see it. The notice tells you how to file a complaint with the state if someone retaliates. Fear of losing your job is one reason CMS says staff fail to report. You are protected. Speak up.
On your shift
Do both
Here is an example. On night shift, you see a coworker take cash from a resident's wallet. Nobody is hurt. Theft can be a crime, so you now have a reasonable suspicion of a crime. You tell your facility right away, as its policy says. You also make sure a report goes to the State Survey Agency and local law enforcement within 24 hours, because nobody was seriously hurt. Use your facility's process if it has one, and make sure your name is on the report. If no one will help you, you can report yourself. Your facility's yearly notice and the posted notice tell you how.
Your facility's policy (ask your supervisor):
How to reach the State Survey Agency complaint/incident line
Local law enforcement non-emergency number for your city or county
Lesson 7: Right After You Report: Keep the Person Safe
In this lesson you will:
Keep the resident safe right after an incident.
Protect possible evidence until you are told what to do.
Know your part in the investigation.
Safety first
Stay with them
If a resident is in danger right now, make them safe first. Call for help. If it is an emergency, call 911 or follow your emergency process. Stay with the resident, or make sure someone safe is with them. Keep the person who may have done it away from the resident. The rules say the facility must stop more abuse while it investigates. Often that means the staff member who is accused does not work with residents during the investigation.
Show the answer
Leave them as they are until your nurse tells you what to do. CMS says washing linens or clothing before an exam has hurt criminal investigations.
Protect evidence
Don't clean up yet
If you think a crime happened, be careful with things that could be evidence. CMS says some investigations were hurt because staff washed linens or clothes. Or they destroyed papers. Or they bathed or cleaned the resident before the resident was checked. So unless the resident needs care right now for their health, do not wash, bathe, or change linens until your nurse says it is OK. Leave the room as it is if you can. Ask your nurse what to do next.
Write it down
Just the facts
Write down what you saw and heard as soon as you can. Write the date and time. Use the person's own words if they told you something. Put them in quotes. Write facts, not guesses. Write 'I saw a red mark on her left wrist,' not 'Someone grabbed her.' Follow your facility's form. Your notes help the people who investigate.
Don't investigate
Don't tip off
Do not try to solve it yourself. Do not question the accused person. Do not tell coworkers what you reported. Talking about it can scare the resident, change what witnesses remember, or warn someone who did wrong. Answer the investigator's questions honestly. That is your part. Your facility must look into every allegation. It must send its results to the state within 5 working days.
Care for the resident
And yourself
Abuse can leave a resident feeling scared and sad. Some think it was their fault. Be calm, kind, and steady. Tell them they did the right thing by telling. Tell your nurse if the resident seems scared, sad, or not like themselves in the days after. Seeing or reporting abuse can be hard for you too. Ask your supervisor about support if you need it.
Report again
If it continues
Sometimes after a report, things do not seem to change. Maybe the problem keeps happening, or the resident tells you it happened again. Report again, right away. Each new allegation is its own report with its own time limit. Each report should include what you saw, when, and who you told. In a nursing home, if you suspect a crime, you also have your own duty to report it to the state and to law enforcement. Never let worry about being a 'snitch' stop you. CMS says sympathy for coworkers is one reason staff fail to report. Your loyalty belongs to the resident.
Lesson 8: Preventing Abuse: Stress, Triggers and Walking Away
In this lesson you will:
Name stress signs in yourself that can lead to rough care.
Use a safe 'step away' plan when you feel angry.
See a resident's distress as a message, not an attack.
Burnout is a risk
Know your signs
CMS says abuse training must cover what can lead to abuse. That includes staff burnout, frustration, and stress. Caregivers under stress may not even notice they are being rough or careless. Know your own signs. Maybe you are short with people. Maybe you rush, or your jaw is tight, or you feel like you are about to snap. Those are signs to slow down and get help. They are not signs you are a bad person.
Show the answer
Make the resident safe, step back, and get a coworker to help. Pausing safely and getting help prevents rough care.
Step away safely
Get a coworker
If you feel anger rising during care, stop. Make sure the resident is safe. Put the bed down, lock the wheelchair, and put the call light in reach. Then step away for a moment and take a few deep breaths. Ask a coworker to take over or to help. Tell your nurse. Coming back calm is always better than finishing the task angry. Walking away to cool off is not neglect when you make the resident safe and get help.
Distress is a message
Unmet need
Residents with dementia may hit, yell, grab, or wander. CMS says these are often attempts to tell us about a need, pain, or a thought they can no longer put into words. If staff see these acts as 'bad behavior,' the risk of abuse and neglect goes up. So ask yourself: Is he in pain? Hungry? Does he need the bathroom? Is he scared, or is it too loud? The dementia course goes deeper on this.
Our own biases
Respect for all
CMS also lists staff prejudice as a risk. That includes bias about age, culture, race, religion, and sexual orientation. It also includes gender differences and negative attitudes toward people with disabilities. Everyone has some bias. Notice yours. Treat every resident with the same respect and the same care. If you hear coworkers mock a resident for who they are, speak up and report it. It can be mental abuse.
Calm conflicts
Resident to resident
Conflicts happen. They can be between staff and residents, visitors and residents, or two residents. Stay calm. Use a low, slow voice. Separate people who are upset, and keep everyone safe. Do not take sides or argue. Get your nurse. If one resident hurts another, report it like any other allegation. Residents are protected from abuse by anyone.
Ask for help
It is strength
Asking for help is a strength, not a weakness. Tell your nurse when a resident's care is hard for you. Maybe the resident needs two people, or a different time for a shower, or a different approach. CMS asks facilities how they encourage staff to raise concerns and ask for training in hard situations. So your facility wants to hear from you. Speak up about short staffing, about residents you are struggling with, and about coworkers who seem burned out. The National Institute on Aging says caregivers need rest and time to care for their own needs too. Preventing abuse is a team job.
Know your federal duty to report right away in home health or hospice.
Know who you report to.
Know the extra rules when hospice patients live in a nursing home.
Same harm
Different rules
Abuse, neglect, and theft can happen in a patient's home too. It can be done by family, friends, strangers, or caregivers. Home health and hospice patients have the same right to be free from abuse, neglect, and misappropriation of their property. That includes injuries of unknown source. The federal reporting rules for home health and hospice are a little different from nursing homes. This lesson covers them.
Show the answer
Immediately, to the agency and as state law requires. Home health staff must report possible abuse and injuries of unknown source immediately.
Home health
Report immediately
In home health, any staff member who sees or learns of possible mistreatment, neglect, abuse, an injury of unknown source, or misuse of a patient's property must report it immediately. That applies whether you are hired by the agency or work under a contract. You report to the agency and to other authorities as your state's law requires. Immediately means as soon as you can. Do not wait until your next visit or the next team meeting.
Hospice
Tell the administrator
In hospice, employees and contracted staff must report alleged violations by anyone working for the hospice immediately to the hospice administrator. That covers mistreatment, neglect, verbal, mental, sexual, and physical abuse. It also covers injuries of unknown source and misuse of a patient's property. The hospice must look into it right away and act to prevent more harm. It must report verified violations to state and local bodies within 5 working days.
Hospice in nursing homes
Extra duties
Some hospice patients live in nursing homes. Then more rules apply. If someone outside the hospice may have mistreated the patient, the hospice must tell the nursing home administrator within 24 hours of learning about it. And CMS says the Elder Justice Act duty to report a suspected crime applies to hospices that serve people in long-term care facilities. So tell your hospice right away, and follow the suspected-crime steps your hospice gives you.
In the home
Safety and 911
In a home, you may be the only staff member who sees what is going on. If the patient is in danger right now, call 911. Then call your agency. Do not argue with or accuse a family member. That can put the patient or you at risk. If you suspect a family member or someone else, tell your agency right away. Your agency follows state law, which may mean a report to adult protective services. Write down what you saw and heard, with times, and report it. You do not need proof. Trained people will look into it.
Your state
Your agency
Every state has its own rules too. Many states have adult protective services, which help protect adults from abuse, neglect, and exploitation. Your agency will tell you if your state wants you to call them directly, or if the agency makes the call. Learn your agency's process before you need it. Save the agency's 24-hour number in your phone. Ask your supervisor which rules apply where you work. And if you ever think a patient is in danger right now, call 911 first. Then follow your agency's steps and write down what happened.
Your facility's policy (ask your supervisor):
Agency phone number to report, 24/7
Your state's adult protective services number and any state reporting law
Lesson 10: Signs in the Home: Money Abuse and Self-Neglect
For: Home health, Hospice
In this lesson you will:
Spot signs of money abuse in a patient's home.
Explain self-neglect in your own words.
Keep your own visit notes true and report health care fraud.
Money abuse
In the home
In a patient's home, you may see things no one else sees. One of them is money abuse. The National Institute on Aging says financial abuse is when money or belongings are misused or stolen. Examples are forging checks, or taking someone's retirement or Social Security money. Others are using their credit cards or bank accounts without permission. It also includes changing names on a will, a bank account, a life insurance policy, or a house title without permission.
Warning signs
Bills and losses
Watch for signs. A patient may suddenly lose money, or have unpaid bills, even though they have enough money. The home may be unsafe or dirty. The patient may not have glasses, a walker, dentures, or a hearing aid. People who depend on others for daily help are at higher risk. So are people with memory problems or dementia, and people without family or friends nearby. Watch for a pattern, and report what you see.
Show the answer
Self-neglect, which you should report to your agency. Self-neglect is when an adult cannot do key self-care tasks like getting food or medical care.
Self-neglect
Can't care for self
Sometimes nobody else is causing harm. The patient just cannot take care of themselves anymore. This is called self-neglect. The Elder Justice Act describes it as an adult who, because of a physical or mental problem, cannot do key self-care tasks. That includes getting food, clothing, shelter, and medical care. It includes getting what they need to stay safe and healthy. It also includes managing their own money. Tell your agency what you see. Your agency can work with the patient and family, and with adult protective services when state law calls for it.
Caregiver stress
Report, don't judge
Family caregivers carry a heavy load. NIA says a caregiver under stress might not even realize they are being neglectful or abusive. So stay kind. Do not blame or lecture. But do not let kindness stop you from reporting. Report what you see to your agency. The care team can help the family find support, like respite care, which gives caregivers a break. Reporting is how the patient and the family both get help.
Health care fraud
True visit notes
NIA lists health care fraud as a form of financial abuse. It includes charging for care that was not given, billing twice for the same service, or false Medicare or Medicaid claims. You protect patients by keeping your own records true. Home health records must be accurate. Every entry must be dated, timed, and signed by the person who wrote it. Never sign for a visit you did not make, or for a task you did not do. If anyone asks you to, say no and report it.
Hands off money
Report concerns
Keep yourself safe too. Do not handle a patient's cash, checks, or cards unless your agency's policy says you may, and says how. Do not accept money or gifts in return for care. Do not sign anything for a patient. If something about a patient's money feels wrong, tell your agency right away. You do not need proof. Trained people will look into it, and the patient gets the help they need.
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This certifies that
completed the online in-service course
Abuse, Neglect, Exploitation and Misappropriation: Prevent It and Report It
Setting
Completed
Seat time
Quiz score
Certificate ID
This free course gives you a certificate of completion from Pact Compliance. It is not continuing education (CE) credit and is not approved by any state. Your employer decides whether it counts toward required in-service hours. Home health and hospice aide training must be given or supervised by the agency's registered nurse. California: it does not count toward CNA or HHA renewal hours.
Part of this topic needs a hands-on check with your supervisor; this online course does not cover that part.
Pact does not keep a record of this certificate. Print it or save it as a PDF and give a copy to your supervisor. pactcompliance.com/free-training/abuse-neglect-prevention/
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