What Proposition 6 Means for Nursing Home Abuse in Texas

proposition 6 nursing homes

On November 3, 2021, Texans overwhelmingly approved eight proposed amendments to the Texas Constitution. Among them is Proposition 6, but what is it, and what does it mean for Texans and personal injury law at large?

What Is Proposition 6?

Proposition 6 is the Right to Designated Essential Caregiver Amendment, and it was approved by a huge margin of 88% in favor. It allows nursing home or assisted living facility residents to designate an “essential caregiver” to visit them in person. Under the amendment, this designated caregiver cannot be denied visitation rights except in the case of a declared public emergency.

It has also prompted a new state law —Senate Bill 25 — to create further guidelines for these essential caregivers, including that visits must be allowed for at least two hours per day and include “physical contact between the resident and essential caregiver.”

For the purpose of this new bill, an essential caregiver can be any family member, friend, guardian, or other individual selected by a resident, resident’s guardian, or resident’s legally authorized representative for in-person visits.

Proposition 6 is unique in that it is one of just two of the eight proposed amendments to respond to the COVID-19 pandemic.

The Impact of COVID-19 on Elderly Residents

At the height of the coronavirus pandemic in March 2020, Governor Greg Abbott imposed restrictions on assisted living and nursing home facilities to protect vulnerable residents.

In August of the same year, the state eased restrictions for nursing facilities with no active COVID-19 cases for the previous two weeks. However, touching was only permitted for essential caregivers and end-of-life visits. For the thousands of residents in COVID-positive areas, it wouldn’t be until March 2021 — a full year after restrictions were first implemented — that they could hug their loved ones again.

In a statement made when restrictions were finally lifted, Victoria Ford, chief policy and regulatory officer for the Texas Health and Human Services Commission, said, “Safely visiting with family and friends is vital to the mental health and well-being of long-term care residents.”

One report by Altarum, a nonprofit organization that helps federal and state health agencies improve outcomes and systems of care, found that COVID-19 restrictions had a huge impact on the lives of nursing home residents. Their findings included:

  • 76 percent of respondents reported that they felt lonelier under the restrictions
  • 64 percent of respondents said they didn’t even leave their rooms to socialize with other residents
  • Just 28 percent reported they went outside to enjoy fresh air at least once a week — compared to 83 percent before the outbreak.

With Proposition 6 not just set in statute but into the Texas Constitution itself, the state has made great strides to ensure that such restrictions on in-person visitation will never happen again.

The impact of this on the health and wellbeing of our elderly residents cannot be understated.

But this isn’t the only benefit of improved visitation rights for nursing home residents and their loved ones.

What Proposition 6 Means for Nursing Home Abuse

Nursing home abuse and negligence are shockingly common and can have serious repercussions. In 2021, the World Health Organization reported that two in three nursing home staff admitted to committing abuse in the past year, with around one in six residents aged 60 or older experiencing some form of abuse.

Unsurprisingly, rates of nursing home abuse increased during the pandemic, a time when many facilities were closed to visitors and abuse could occur without fear of visitors spotting the signs.

While the signs of abuse and neglect can be difficult to identify, especially as many residents feel intimidated by their caregivers and afraid to report this behavior, improved visitation rights in the event that care homes have to close again in the future can only be a good thing.

With essential caregivers able to see their loved ones every day, even the hidden signs of nursing home abuse may become easier to spot.

What Are the Signs of Nursing Home Abuse?

Abuse can take many forms, from physical injury and sexual assault to intimidation and confinement. Neglect — the failure to provide care that keeps residents safe from harm or pain — is equally devastating. But what signs should loved ones look out for?

Emotional Withdrawal

Emotional abuse doesn’t present visible injuries like cuts and bruises, but it can have just as deep an impact. If your loved one is usually chatty and bubbly, and they suddenly become withdrawn or easily upset, especially when care home employees are present, it could be a sign of emotional abuse.

Unexplained Marks

Injuries like cuts, bruises, and scars are common in the elderly because the skin is thinner and more vulnerable to tearing. A bruise on the wrist might be an innocent injury from a bump against a chair, but it could equally be a sign that your loved one has been hit or restrained.

If you notice that your loved one has frequent injuries that they can’t explain, or if they make an effort to disguise or hide these marks, it could mean that they’re being subjected to abuse.

Change in Condition

One of the common causes of nursing home neglect is mismanagement of medication. If your loved one is prescribed a specific medication and a caregiver fails to administer it correctly, it’s abusive behavior, and the consequences can be deadly. A member of staff may make errors by:

  • Overdosing residents
  • Underdosing residents
  • Administering the wrong type of medication
  • Failing to administer medication completely.

The signs of mismanaging medication aren’t always easy to identify, but if you notice your loved one acting fuzzy or spaced out, or if they’re deteriorating, it could be because they are receiving too much or too little medication, or that it isn’t being administered at all.


Bedsores are a completely preventable injury, but they’re common in cases of nursing home abuse. They happen when a resident needs assistance to move when lying down or after being seated for a long time. When they’ve been in the same position for hours at a time, the pressure causes a lack of blood flow, leading to painful ulcers. If left untreated, they can break the skin and get infected.

Abrupt Weight Loss

Malnourishment is a common sign of neglect, but weight loss isn’t the only symptom. Residents suffering from malnutrition may also lose their hair, struggle to concentrate, and be easily fatigued. While it’s often caused by residents not being provided adequate nutrition, it can also result from other abuse. For example, if a loved one is being intimidated by nursing home staff, they may lose interest in eating, causing rapid weight loss.

What to Do if You Think Your Loved One Is Being Abused or Neglected

For the first time in months, loved ones can once again hug loved ones living in nursing homes and assisted living facilities, but nursing home abuse is still increasingly prevalent. It doesn’t bear thinking that a family member won’t receive the most basic and necessary care, but it’s something all families should keep a watchful eye for.

If you suspect that your loved one is being abused, you should first report the incident and remove them to safety as quickly as possible. You should also contact a nursing home abuse lawyer in Texas to learn more about your legal rights and options, including your eligibility for compensation to get financial support for recovery and treatment.

Contact our compassionate personal injury lawyers at Patino Law Firm today if your loved one has suffered abuse or neglect in a nursing home.

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