Long-Term Care Survey Alert

Know what to look for and what not to do if you find it.

You can go a long way toward detecting a resident who has been sexually assaulted and take the right steps to help law enforcement nab the perpetrator.

The No. 1 critical step: Do regular assessments during bathtime or pericare to look for signs of sexual abuse. Consider suspicious any unexplained trauma to the labia, vaginal wall, clitoral area or bruising to the superior inner thighs -- especially circular, finger-tip sized bruises, advises nurse forensic expert Daniel Sheridan, PhD, RN, FNE-A, FAAN, associate professor at Johns Hopkins University School of Nursing. Even a relatively minor injury to the labia minora or vaginal area could be related to a sexual assault, he cautions.

Also suspect sexual assault in these scenarios:

1. When the resident has any bruising of the breast or unexplained vaginal discharge, especially if it's "consistent with semen" -- or if a resident who reportedly hasn't been sexually active in years develops an STD, advises Sheridan.

2. A resident complains about sexual abuse. "Even slightly confused patients have enough cognitive functioning to know they have been assaulted sexually," Sheridan points out. Also suspect abuse if a cognitively intact resident states he or she saw another resident, guest or staff touch another resident in a sexual way.