Doris Willett breezed in the door of the Waldorf nursing home with an armload of clean laundry for her mother, expecting to spend the September morning quietly keeping company at the bedside of the 92-year-old ailing woman. Instead, Willett was met at the door by the nursing director with a worried look on her face.

Willett's mother, who suffers from dementia, had been injured during the night, the supervisor said. This week authorities charged a nurse's aide at the home with hitting the elderly woman.

"I walked into her room and I was almost floored," Willett said. "I couldn't believe what I saw--her face, the nose and upper lip, were all swollen from bruising. Crusty blood was very visible on her nose. . . . I walked in and said, 'Mom, what happened to you?' "

Willett's mother couldn't say, and would only later tell a sheriff's investigator that "someone"--she could not say who--had hit her. But Charles County sheriff's investigators now believe they know the answer: Shenita Michelle Rice, one of the nurse's aides who took care of Alice Pickeral at Waldorf Health Care Center.

Rice, 23, of Waldorf, was charged this week with vulnerable adult abuse and two counts of second-degree assault in connection with the incident, which happened between 9:30 and 10:30 p.m. Sept. 22, after Rice went into Pickeral's room, repositioned her in bed and changed her adult diaper.

Rice denied any wrongdoing. "The night it happened I never touched the woman," Rice said yesterday. "I went in there and repositioned her and changed her and left the room."

Administrators from the nursing home did not return calls yesterday seeking comment.

Charles County officials said that incidents of nursing home abuse are rare in the county, but nationally such abuse is increasing, according to experts and a recent federal survey of advocates for the elderly.

Elder abuse "is an incredible concern," said Sarah Greene Burger, executive director of the National Citizens Coalition for Nursing Home Reform. "It's difficult to catch someone, and oftentimes the residents cannot speak for themselves."

According to a 1997 federal study of complaints to federal ombudsmen who serve as advocates for the elderly, 14,025 complaints out of 157,380 were related to abuse, gross neglect or exploitation, a 4 percent increase from 1996.

In Maryland, the increase was more dramatic, according to the study. The 678 complaints alleging abuse, gross neglect or exploitation in 1997 represented a 52 percent increase from 1996.

According to charging documents, one of Rice's co-workers told authorities she saw Rice strike Pickeral "hard . . . in the face" while Rice was preparing her for dinner earlier that day. The witness told police that Rice allegedly said to Pickeral: "You ugly [expletive]. If you put your hand in my face again, I'm going to pop you again like I just did," according to court documents.

The fellow nurse's aide told police that she had seen Rice strike the victim several times in the past and that "she has also seen the Defendant hold a pillow over the victim's face for a few seconds," charging documents said.

"You can imagine how I feel right now. This whole thing is ridiculous," Rice said. "I don't know why she is telling these lies. . . . Why would I lay my hands on an elderly person who can't defend themselves?"

Conviction of vulnerable adult abuse carries a sentence of up to five years in prison, and the penalty for second-degree assault is up to 10 years. The Maryland Office of Health Care Quality, which licenses nursing homes, has opened its own investigation.