When choosing a nursing home for a loved one, we often focus on what we can see: cleanliness, staff attitudes, visiting hours, and reputation. But there’s much that we don’t see, and what may not be immediately apparent could spell neglect. For families in West Virginia, knowing what to look for can mean the difference between a quick correction and long-lasting harm. Here are the most common “hidden” signs.

Quiet Withdrawal or Social Isolation

For residents who once participated in group activities, such as church services, happy hours, or other social gatherings, they may slowly become withdrawn. This can seem normal as people age, but it’s often not the case. Seemingly withdrawn residents can also point to neglect, as being kept apart or separated is part of a pattern rather than just one or two specific incidents.

Pro Tip: When the withdrawal and/or isolation is part of a larger pattern of neglect and separation, you may have grounds for a claim.

Minor Issues With Hygiene that Eventually Add Up

Grooming that Goes Unnoticed

• Hair gets brushed one morning, but doesn’t get brushed for days after that
• Nails are long and uncut, dirty, or broken
• Dentures are held in glasses instead of being brushed and worn

Many of these signs can be related to gaps in staffing and scheduling.

Smells and Soiled Clothing

• Musty odors or bed linens that have not been changed in several days
• Residents wear the same outfit day after day

These are often symptoms of basic hygiene failures, which are prevalent in understaffed homes.

Pro Tip: Ongoing hygiene problems are a cause for neglect claims, as they indicate that staff members are not providing basic care.

Unexplained Weight Loss or Gain

Weight loss isn’t always due to decreased appetite. Perhaps residents are missing meals, choking, or unable to eat because they are unable to chew their food. Alternatively, weight gain can be caused by overfeeding residents to mask a lack of nutrition or poor blood sugar control.

Pro Tip: Issues related to poor feeding can cause injuries to those with diabetes and those who require a modified food texture, so it helps to keep good records of such incidents to build a claim for medical neglect.

Skin Markings That Are More Than Sores

Itching or Spotted Skin

• Residents have dry or itchy skin that goes unchecked
• A soapy bath isn’t given to the resident, or soapy water is left on the skin
• Residents’ bedpans are not cleaned

These all contribute to skin irritation, yeast infections, and rashes.

Pro Tip: West Virginia’s regulations require regular observation and proper skin care. A violation can give rise to a claim for neglect.

Behavior Signals of Neglect

Fear of a Staff Member

• The resident becomes very shy around a particular nurse or aide
• Residents will say that someone is mean or that he or she pinched them

Even if there are no visible bruises, it can still be a sign of long-term physical and emotional abuse. Residents should have the right to complain and file a report.

Refusing to Bathe or Change Clothes

• Resident refuses to bathe or dress, or wants to stay in his or her room all day
• Residents have been touched roughly or left unattended during bathing 
• Residents don’t want to be naked or in the bathroom

These could be signs of abuse or emotional harm. Staff not following proper care standards could be considered neglect, and emotional abuse or injury could result.

Pro Tip: The grounds for a claim may come from negative behavior signals related to caregivers or care.

Hidden Signs You Can’t See, Until It’s Too Late

Sedation or Drowsiness

Residents are asleep more than usual. Their speech slows. They seem “spacy.” These can be a sign of residents who are overmedicated.

Missed Medications

There may be times when a resident’s medication was not administered as scheduled. This includes medicines for heart conditions, blood pressure, diabetes, or psychiatric conditions. This can lead to heart attacks, high blood pressure, loss of bladder control, or psychotic episodes.  

Pro Tip: Neglect, on its own, can be grounds for a claim, particularly when it leads to harm, injury, or even death, which are also grounds for a claim.

Environments That Tell You Something is Wrong

Too Many People at One Table

During mealtime, too many residents are trying to eat at once. There are not enough staff members to help. The residents are all left to eat their meals alone.

Pro Tip: Having more residents than staff may result in inadequate care, such as insufficient mealtime support.

Inadequate Number of Staff

Check if there are enough staff during peak care times (e.g., meal times or shift changes) or if an aide is responsible for caring for multiple residents simultaneously.

Pro Tip: Having too many residents assigned to a single staff member can indicate neglect.

Covering Up Mistakes

When inquiries are made, the nursing home’s explanations are vague and questionable. For example, when asked about specific issues, the response “We don’t know” is frequently repeated. There may be a pattern of negligence and evasion.

Limited Access to Records

By law, West Virginia residents have the right to see their care plan and records (W. Va. Code § 16-5-13). However, nursing homes often prefer that you do not see these records. Additionally, they’ll take months to return phone calls or produce the records. And once you finally get a response, they will often send records and documents that contradict what you see.

So, What Do You Do Next?

Take pictures of sores, bad skin, bad bath water, what your relative wears, etc. Be sure to gather the times and dates of injuries and/or signs of poor care. Make a list of what you’ve seen and heard, and let your attorney know right away.

Don’t Delay – Contact Our West Virginia Nursing Home Neglect Attorneys Right Away

If you’re noticing these hidden signs, don’t wait. A consultation with a West Virginia nursing home neglect attorney can help determine whether your loved one is a victim of neglect and what can be done next. You deserve accountability, justice, and the peace that comes when the person you care about is treated with dignity and thoroughness. Contact our office today for immediate assistance.