It’s always difficult to make the decision to have a loved one relocate to a nursing home: whether they moved in willingly or preferred to stay in their own, familiar surroundings, the decision often involves a mix of realism with heartache. That paradox is made even harder when you start to suspect that they are not getting the care that they deserve. As nightmarish as that situation is, if you suspect that your loved one is the victim of nursing home negligence there are certain steps you need to take.

Nursing home negligence can become apparent in many different ways. Your suspicions might be raised by a change in your loved one’s mood or level of responsiveness, or in unexplained bruises or injuries. They may be losing weight, or you may find them in a constant state of poor hygiene, in unwashed clothes or unclean bed sheets. Whatever it is that activates your personal radar, you need to pay attention, as things can quickly go downhill, and your loved one’s health may be in jeopardy.

The first thing you need to know is that you have legal rights, and the nursing home likely has written policies regarding those rights. Review any documents that you received at the time that you signed your contract with the facility to see if there is a specific process you need to follow to register your concern.

When you see things that strike you as wrong, start with asking your loved one about the problem, keeping in mind that they may be afraid to speak with you out of fear of retribution or a misplaced sense of loyalty to a caregiver. If you want to speak to your loved one and don’t have the chance to do so because a staff member refuses to leave the room, you should immediately address the issue with a supervisor or the facility director. If they are not there, leave a note or call back when they are there to make sure that your concerns are registered and addressed. As tempting as it may be to call 911 or the police unless you believe that they are in immediate jeopardy it is probably best to remain calm and first give the administration a chance to respond to your concerns.

If the facility does not respond to your concerns immediately and does not show signs of true empathy and action, your next step may be to contact Adult Protective Services in your community and to contact an experienced legal representative who can advise you on your next steps.