If you have ever had to make the difficult decision of placing someone you love into a nursing home then you know how agonizing the decision making process and its implementation can be. Sometimes it seems, though, that you really have no other choice.

If someone close to you has become very ill and cannot adequately perform many of the simple acts of daily life then your options are quite limited.

If they are ill, or cannot easily move around perhaps you may have considered caring for them in your own home. But if you work, or if the nature of their challenges are just too much for you to handle you often are left with few if any other options other than placing them into what you believe would be a caring environment.

Right now there are approximately 17,000 nursing homes in the United States that house about 1.6 million people. And with the baby boomer generation getting older those numbers will probably grow by leaps and bounds. Current estimates predict that by 2020 twelve million aging Americans will need long term care.

Nursing home abuse was and still is a widespread problem. A study done by the Special Investigations Division of the House Government Reform Committee in 2001 showed that there were close to 9,000 incidents of nursing home abuse from January 1999 through January 2001; 5,283 facilities - roughly 30% of all nursing homes - were cited for abuse within that timeframe.

So what can you do to protect the ones you love if the nursing home that they are in does not provide the necessary care and attention they need? What can you do to ensure that their safety is not neglected? And what could you do if you suspect that there are any problems?

First, you should regularly visit your loved ones. Be attentive to these signs of abuse:

- Any sign of neglect. It could be poor hygiene, unusual loss of weight, dehydration, or bedsores.

- Are the living conditions unsafe, hazardous, or unsanitary?

- Is your loved one exhibiting either a sudden behavioral and/or emotional change?

- Are there any unexplained physical injuries?

- Are there unexplained financial discrepancies?

The law provides protection for nursing home residents. The Nursing Home Reform Act (NHRA) was passed in 1987. Intended to protect the residents' quality of life and improve the quality of care that is provided by their caregivers, the act includes the Nursing Home Residents' Bill of Rights.

If you suspect abuse first visit the National Long Term Care Ombudsman Resource Center website and find out how to contact your state's Ombudsman Program.