Nursing home residents have a legal and moral right to be safe. Nevertheless, several studies have revealed that abuse and neglect of nursing home residents occurs with appalling regularity. One of the most unforgivable forms of abuse – sexual abuse – is difficult to quantify. Victims may be afraid or unable to protest or report the abuse. They may have been selected by the perpetrator because of their vulnerability. Whether the predator is a staff member or a resident, investigations of sexual abuse against nursing home residents generally uncovers failures management of the facility.

A few highly publicized cases brought belated attention to the prevalence of sexual assaults in nursing homes. Several years ago in a Florida nursing home, a 77 year-old woman with dementia was raped by an 83 year-old male. It turned out that the man had a 13-page long criminal file that included sexual assault and child molestation. The victim's daughter, who sued the home, was never informed that sex offenders would be sharing a floor of unlocked rooms with her vulnerable mother – of course, she would never have placed her mother in the home had the disclosure been made. In a Florida case, a 36 year-old woman with severe mental and physical disabilities who was living in a nursing home was raped by a staff member. The rape was not discovered until she gave birth, the pregnancy undetected until a nurse found the baby in the woman’s bed sheets.

The practice of placing convicted sex offenders unrestrained amidst the general population of residents unable to protect themselves is completely unacceptable. Even if no statute prohibits the practice, common sense and the duty to keep all residents safe should prevent it. While the issue of where to place sexual predators who become elderly and unable to care for themselves is problematic, it cannot be with frail elderly nursing home residents. And management has an absolute obligation to conduct adequate background checks and to properly train and supervise all staff.

A sexual assault on a nursing home resident, in addition to the physical harm it may cause, can destroy the resident's remaining ability to trust others and to enjoy their lives to the extent their condition allows. Family members are limited in their ability to stop abuse, but can keep some simple measures in mind which may lessen the risk. A family member who is uneasy about a staff member even if they have not witnessed anything specifically, should not be afraid to voice their concern to the nursing home administrator. If they see any signs of inappropriate conduct by a staff member toward a resident, they should report it immediately. If their loved one shows signs of unexplained withdrawal, depression, or anxiety, they should report it and insist that a cause for the change be determined. Any signs of physical trauma or genital rashes or discharge should be reported and immediately investigated.

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