ABSTRACT
An 81-year-old woman resides in a nursing home. She has mild dementia and suffers occasional spells of disorientation to time and place. While administering a shower, the woman’s caregiver notices contusions on her inner and outer thighs, and redness in her perineal area. She initially attributes the redness to irritation caused by the woman’s incontinence, but is puzzled by the bruise patterns. She searches the patient’s medical record, scanning for previous entries that document the bruises, but finds no explanation for the injuries or the redness. The caregiver decides that if no one else mentioned these findings, neither should she. How could she know that a male nurse on the night shift had been fired from his previous job for sexually fondling elderly female residents?
