The details about John R. Riems' alleged assaults against nursing home residents seem grimly familiar to social workers. They say assaults against mute and helpless victims fit a pattern.
The victims of sexual abuse in nursing homes tend to be people who "are just not able to defend themselves because of physical disabilities or cognitive impairments or just general frailty," said Sharon Merriman-Nai, co-manager of the National Center on Elder Abuse.
"We do typically see if we have those kinds of complaints, the victim is someone who is not generally a good reporter," echoed Beverley Laubert, Ohio's Long-Term Care Ombudsman. Laubert's office investigates complaints about nursing home care in Ohio.
Riems, recently fired from his position as a nurse at Concord Care and Rehabilitation Center, is accused of raping a 55-year-old man unable to talk or see because of a stroke.
A fact sheet on elder sexual abuse from the Maryland Coalition Against Sexual Assault says perpetrators are most likely to be male, and victims most often are women older than 70 who are "totally dependent or functioning at a poor level."
It's difficult to know how often sexual abuse of the elderly occurs, Merriman-Nai said. Sexual abuse in general is underreported, she said, and institutional abuse is even more difficult to find out about.
Experts who have tried to study the incidence of elderly sexual abuse have offered a wide range of estimates of how often such cases are actually reported. These range from 1 in 5-6 instances of sexual abuse to 1 in 14, Merriman-Nai said.
Common sense suggests that if criminals tend to select victims who cannot communicate, "that would certainly go into the mix as to why they go undetected," she said.
The Ohio Department of Health does not keep separate statistics on sexual abuse of nursing home residents, but lumps it in with verbal, physical and mental abuse, corporal punishment and involuntary seclusion, said department spokeswoman Sara Morman.
She said 31 cases of all types of abuse were recorded last year in Ohio.
Laubert said loved ones of nursing home residents should be alert for changes in behavior that signal possible sexual abuse.
"People just need to be alert to anything that's different, trust their instincts, just like the loved one you reported about (in the Riems case)," she said.
A resident becoming withdrawn, less expressive or tearful could be a sign of trouble, Laubert said.
"We've seen people who, if someone reaches out to hug them, might jerk back," she said.
Sexual abuse cases in Ohio verified by the Ohio Long-Term Care Ombudsman office: