The defendant/appellant, Crystal Robinson, was charged by indictment with one count of emotionally abusing Jane Roe, 1 a resident of a long-term care facility under the patient abuse statute, 16 Del.C. § 1136(a), and with one count of conspiring with a co-worker to commit such offense under 11 Del.C. § 511. Both offenses are class A misdemeanors. On May 16, 1990, as a result of a jury trial in the Superior Court, Robinson was found guilty as charged. She was sentenced to pay the costs of prosecution and a fine of $101.00 for each offense. She was also sentenced to 31 days of incarceration for each offense to be served consecutively. However, the prison sentences were suspended for three months of probation, as to each charge. Robinson now appeals those convictions.
Robinson has raised five issues on this appeal. She contends that: 1) the Superior Court erred as a matter of law by permitting the State to amend the indictment to add the mens rea element of “knowingly” as specified in 16 Del.C. § 1136(a); 2) the Superior Court abused its discretion by admitting evidence of the physical and mental condition of Roe at the time of the offense; 3) the Superior Court abused its discretion by denying Robinson’s motions for a mis *358 trial based on the fact that the State had improperly elicited testimony that Robinson’s codefendant, Yvette Jones, had entered a plea of guilty; 4) the Superior Court erred as a matter of law when it did not include the recitals made in the bill of particulars as elements of the offense in the court’s instructions to the jury; and 5) the patient abuse statute, 16 Del.C. 1136(a), is unconstitutionally vague and overbroad under due process principles with regard to prosecutions predicated on the “emotional abuse” element, 16 Del C. § 1131(l)(b), of the statute. We find each of these contentions to be without merit and, therefore, affirm the judgment of the Superior Court.
FACTS BASED ON TESTIMONY OF STATE’S WITNESSES
The charges against Robinson arose out of an incident occurring on a Sunday morning at approximately 7:30 a.m. on August 13, 1989 in Room 400 at the nursing home facility known as the Layton Home. At the time of this incident, Robinson had been employed at the Layton Home for over two years as a nurse’s aide. Room 400, which was the home for four elderly residents, was 14 feet by 14 feet in dimension. In this room, Jane Roe, eighty-five years of age, had been quietly sitting in her wheelchair. Meanwhile, two housekeepers were doing the daily housecleaning and bringing fresh linen to Roe and her roommates. While the two housekeepers were working, defendant Robinson and code-fendant Jones, both of whom were employed at the Layton Home, came into Room 400. Ignoring the two housekeepers and the other residents in the room, Robinson approached Roe and allegedly stated in an “insincere” tone of voice that someone had been stealing some of Roe’s clothes. This statement was not true. Roe, who was very possessive of her belongings, immediately became very upset. While the record is unclear on the exact sequence of the subsequent events, the Court will relate them as they could have been found to have occurred. Throughout this incident, the defendants and Roe maintained an abusive dialogue, which sometimes became quite loud. A total of six towels (as many as three at one time) were thrown at Roe by codefendant Yvette Jones as Roe sat confined to her wheelchair. Meanwhile, Robinson took a cup of water and, out of Roe’s sight, used her fingers to throw drops of water on Roe. At the same time, Robinson mimicked the sound of spitting which further upset Roe. Roe cried out for Robinson to stop spitting on her and for the two defendants to get away from her. Apparently in response to Roe telling Robinson to “Get away from me you bitch”, Robinson told her “It takes one to know one.” Robinson also admitted that she had called Roe “mean” and had told her to “shut up” and had argued briefly with Roe. In the meantime, Robinson had also placed a small artificial flowerpot on Roe’s head. When the flowerpot fell to the floor a second later, the defendants laughed. With Roe now yelling “bloody murder”, Robinson told her to “kiss [my] butt” which prompted Roe to respond with an identical suggestion. Not to be outdone, Robinson repeated the statement a second time, stood in front of Roe, lifted her nurse’s uniform, shook her rear end, and placed it on the meal table of Roe’s wheelchair. Roe managed to push Robinson away and yelled that God would punish the defendants for their conduct. The entire incident lasted approximately fifteen to twenty minutes. Additional facts will be presented as necessary to address Robinson’s contentions on appeal.
The defendant testified that there was a relatively brief verbal exchange and some laughter. Then she left the room without having taken part in any of the other actions outlined above. She also testified that she had none of the various intentions required by the statute.
A.
Robinson’s first contention on appeal is that the Superior Court erred as a matter of law by permitting the State to file an amended indictment which added the essential
mens rea
element of “knowingly” to the patient abuse charge which was omitted from the original indictment. Robinson
*359
contends that this constituted a prejudicial amendment of “substance” thus requiring the reversal of both of her convictions.
See Keller v. State,
Del.Supr.,
This Court has held on several occasions that a trial court has the power to amend an indictment as to matters of form, but not as to matters of substance, so long as no new, additional, or different charge is made thereby and the accused will not suffer prejudice to substantial rights.
Keller,
B.
Robinson’s second contention on appeal is that the Superior Court abused its discretion by admitting evidence of Roe’s physical and mental condition as it existed at the time of and after the time of the offense. Robinson contends that such evidence was irrelevant and inadmissible because the patient abuse offense focuses on the defendant’s alleged actions rather than on Roe’s characteristics. Even if such evidence was relevant, Robinson contends that its probative value was substantially outweighed by the danger of unfair prejudice, confusion of the issues, or misleading the jury. D.R.E. 401, 402, and 403. We find these contentions to be without merit. When reviewing evidentiary rulings of this type, this Court recognizes that the trial court is in the best position to make informed rulings after considering all of the factors involved, and this Court will reverse only if there is a clear abuse of discretion.
See, e.g., Lynch v. State,
Del.Supr.,
Evidence of Roe’s physical and mental condition is highly relevant to the material issue of whether Robinson knew that her conduct towards Roe and dialogue with Roe would be demeaning to Roe. The facts show that Roe was generally confined to a wheelchair and unable to move out of her room, that she was easily agitated and often disoriented as to time and place, and that her memory was impaired. Since Robinson was aware of these facts, a reasonable jury could easily infer that Robinson’s actions (the abusive dialogue, the false statement that Roe’s clothes had been stolen, the mock spitting incident, the flower pot incident, and the incident where she lifted her nurse’s uniform to shake her buttocks and to tell Roe to “kiss her butt”) were done with knowledge that such conduct would likely cause others to scornfully laugh at Roe. Moreover, although the introduction of evidence of Roe’s physical and mental condition when viewed along with Robinson’s actions might engender “undue sympathy” for Roe, it cannot be said that the Superior Court erred in its balancing of the probative value of the evidence against the potential for unfair prejudice to Robinson. D.R.E. 403. We conclude that the Superior Court did not abuse its discretion by admitting evidence of Roe’s physical and mental condition as it existed at the time of and after the incident.
C.
Robinson’s third contention on appeal is that the Superior Court abused its discretion by denying Robinson’s motions for a mistrial because the prosecution had elicited hearsay testimony that the code-fendant Yvette Jones had “pled guilty to her [patient abuse] charge”. Such evidence was presented through a witness from whom such testimony could not properly have been elicited without first showing that Jones was not available to testify. See D.R.E. 804(b)(3). The testimony was erroneously elicited before defense counsel had the chance to object. It is manifest, however, that not every error in admitting testimony warrants a reversal or new trial. In many instances where inadmissible evi
*361
dence is placed before the jury, the appropriate remedy is a curative instruction to the jury to disregard the evidence.
Diaz v. State,
Del.Supr.,
D.
Robinson’s fourth contention on appeal is that the Superior Court erred as a matter of law when it failed to include in its instruction to the jury, as requested by defense counsel, that the State was required to prove the alleged acts set forth in its bill of particulars 5 as to each of the offenses charged. Defense counsel noted an exception to that omission and now contends that the failure of the trial court to give the requested charge constituted reversible error. We find this contention to be without merit.
In the case of
Taylor v. State,
Del.Supr.,
*362 E.
Robinson’s final contention on appeal is that the Superior Court erred as a matter of law by denying her pretrial motion to dismiss the indictment because the patient abuse statute is unconstitutionally vague and. overbroad on its face as to prosecutions predicated on the emotional abuse element. The Superior Court found that the patient abuse statute was not unconstitutionally vague especially in light of the requirement that the offender must act “knowingly” with respect to the act(s) of abuse. 6 We agree with the Superior Court's ruling that the patient abuse statute is not unconstitutionally vague or over-broad.
An approach to this issue is suggested by the following statement of the United States Supreme Court: “In a facial challenge to the overbreadth and vagueness of a law, a court’s first task is to determine whether the enactment reaches a
substantial
amount of constitutionally protected conduct. If it does not, then the over-breadth challenge must fail. The court should then examine the facial vagueness challenge, and assuming the enactment implicates no constitutionally protected conduct, should uphold the challenge only if the enactment is impermissibly vague in all of its applications.”
Village of Hoffman Estates v. Flipside, Hoffman Est.,
1. Overbreadth
We first examine the legislative purpose of the patient abuse statute. Concerned that patients and residents of long-term care facilities are sometimes subjected to conduct not fully covered by traditional criminal statutes, the General Assembly, in 1986, enacted the patient abuse statute which prohibits the abuse, neglect, and mistreatment of patients and residents of long-term care facilities. 65 Del. Laws ch. 442 (July 7, 1986) (synopsis); codified at 16 Del. C. § 1136(a) (Supp.1990). The patient abuse statute is consistent with earlier legislation which also sought to protect the essential dignity of patients and residents of nursing homes and long-term care facilities. See 16 Del. C. § 1121(1) (“Every patient and resident shall be treated with consideration, respect, and full recognition of his or her dignity and individuality.”).
Specifically, the patient abuse statute is “designed to protect one of the most vulnerable segments of our society.... The victims of patient abuse are often at the mercy of the[ir] tormentors, are dependent upon them for daily needs, and are therefor, reluctant to report incidents committed against them. Many times, victims are unable because of physical or mental disabilities, to effectively communicate what is being done to them.” 65 Del. Laws ch. 442 (July 7, 1986) (synopsis). Thus, when confronted with offensive, insulting, or abusive language, patients and residents may have “no choice but to sit and listen, or perhaps to sit and try
not
to listen.”
Lehman v. City of Shaker Heights,
Therefore, in addition to enacting a specific, mandatory system for reporting incidents of patient abuse, the patient abuse statute made it a criminal offense for any person to knowingly abuse, mistreat, or neglect a patient or resident of a private or state-owned facility. 7 16 Del.C. § 1136(a). 8 *363 The proscribed “abuse” covers not only physical abuse, 16 Del. C. § 1131(l)(a), but also emotional abuse “which includes, but is not limited to, ridiculing or demeaning a patient or resident, making derogatory remarks to a patient or resident or cursing directed towards a patient or resident, or threatening to inflict physical or emotional harm on a patient.” 16 Del. C. § 1131(l)(b).
With this legislative purpose in mind, we next consider whether the patient abuse statute reaches a
substantial
amount of constitutionally protected speech or is over-broad because it inhibits the First Amendment rights of other parties. Although the First Amendment generally protects speech from content-based regulations, the First Amendment does not protect all speech.
See, e.g., F.C.C. v. Pacifica Foundation,
In cases dealing with captive audiences, the United States Supreme Court has balanced the First Amendment rights of the speaker against the State’s interest in protecting the privacy rights of the captive audience.
See, F.C.C. v. Pacifica Foundation,
In the case of
Frisby v. Schultz,
Although in many locations, we expect individuals simply to avoid speech they do not want to hear, cf. Erznoznik v. Jacksonville, supra, 422 U.S. [205] at 210-211, 95 S.Ct. [2268], at 2273-74 [45 L.Ed.2d 125 (1975)]; Cohen v. California,403 U.S. 15 , 21-22,91 S.Ct. 1780 , 1786-1787,29 L.Ed.2d 284 (1971), the home is different. “That we are often ‘captives’ outside the sanctuary of the home and subject to objectionable speech ... does not mean we must be captives everywhere.” Rowan v. Post Office Dept.,397 U.S. 728 , 738,90 S.Ct. 1484 , 1491,25 L.Ed.2d 736 (1970). Instead, a special benefit of the privacy all citizens enjoy within their own walls, which the State may legislate to protect, is an ability to avoid intrusions. Thus, we have repeatedly held that individuals are not required to welcome unwanted speech into their own homes and that the government may protect this freedom. See, e.g., FCC v. Pacifica Foundation,438 U.S. 726 , 748-749,98 S.Ct. 3026 , 3039-3040,57 L.Ed.2d 1073 (1978) (offensive radio broadcasts); id., at 759-760,98 S.Ct. at 3045-3047 (Powell, J., concurring in part and concurring in judgment) (same); Rowan, supra (offensive mailings); Kovacs v. Cooper,336 U.S. 77 , 86-87,69 S.Ct. 448 , 453-54,93 L.Ed. 513 (1949) (sound trucks).
Frisby,
We recognize that the patient abuse statute is a content-based regulation as to offenses predicated on the emotional abuse element, and it reaches speech which would be protected from government restriction if it occurred in a public setting. However, after carefully weighing the First Amendment rights of a person charged with emotional abuse under 16 Del. C. § 1136(a) against the significant State interest in protecting the residential privacy rights of a “captive” patient or resident of a long-term care facility, we conclude that the patient abuse statute does not reach a substantial amount of constitutionally protected speech as required by Flipside in order to justify a facial overbreadth challenge. Therefore, Robinson’s facial overbreadth challenge fails. ■
2. Vagueness
We next examine whether the patient abuse statute is unconstitutionally vague on its face as to prosecutions predicated on the emotional abuse element. At the out
*365
set, we first examine the parameters for criminal liability for emotional abuse under sections 1136(a) and 1131(l)(b). First, the patient abuse statute only grants protection to patients and residents present within a “facility”. Second, “ridiculing” or “demeaning” speech or conduct directed at a patient or resident or “derogatory remarks” made about a patient or resident or “cursing” directed towards a patient or resident are not subject to criminal sanction unless: 1) the prohibited act(s) occur within a facility
9
; 2) the prohibited act(s) were targeted at or directed towards a patient or resident of the facility; and 3) the defendant performed the prohibited act(s) “knowingly”. Furthermore, the standard of liability is an objective one; a defendant’s speech or conduct must be of the kind that reasonable people would recognize, in the
context
that they were done or spoken, as being ridiculing, demeaning, or derogatory in nature or as constituting cursing.
See, F.C.C. v. Pacifica Foundation,
With the foregoing parameters in mind, we continue with our examination of Robinson’s facial vagueness challenge. “As generally stated, the void for vagueness doctrine requires that a penal statute define the criminal offense with sufficient definiteness that ordinary people can understand what conduct is prohibited and in a manner that does not encourage arbitrary and discriminatory enforcement.
10
Where the legislature fails to provide minimal guidelines [for government law enforcement], a criminal statute may permit ‘a standardless sweep that ailows policemen, prosecutors, and juries to pursue their personal predilections.’ ”
Kolender v. Lawson,
In view of the parameters of the patient abuse statute and the particular facts of this case, we are satisfied that any reasonable person would recognize that Robinson’s speech and conduct (the abusive dialogue, the false statement that Roe’s clothes had been stolen, the mock spitting incident, the flower pot incident, and the incident where Robinson lifted her nurse’s uniform to shake her buttocks and to tell Roe to “kiss her butt”) directed towards Jane Roe, an elderly patient confined to a wheelchair in a facility, clearly fell within the common understanding of the statutory terms “ridiculing” and “demeaning”.
11
See Grayned v. City of Rockford,
Having carefully examined the reach of the patient abuse statute, we rule that the patient abuse statute defines the criminal offense of emotional abuse with sufficient definiteness such that ordinary people can understand what conduct is prohibited. We also rule that the parameters of the patient abuse statute provide sufficient law enforcement guidelines or standards which foreclose the risk of arbitrary or discriminatory enforcement of this statute. Therefore, Robinson’s facial vagueness challenge fails.
Conclusion
For the reasons stated, the judgment of the Superior Court is AFFIRMED.
Notes
. The name Jane Roe is a pseudonym selected by the Court.
. The original indictment stated in pertinent part:
COUNT II. MISDEMEANOR
PATIENT ABUSE in violation of Title 16, Section 1131(a)(2), of the Delaware Code of 1974, as amended.
CRYSTAL ROBINSON on or about the 13th day of August, 1989, in the County of New Castle, State of Delaware, did emotionally abuse [Jane Roe], a patient at Layton Home by ridiculing, demeaning, and making derogatory remarks directed toward [Jane Roe].
. The Superior Court declined to dismiss the indictment and stated:
Denied. Charge is not vague, esp. in light of state of mind requirement. State may file amended indictment to correct citation and to allege state of mind. This is over defense objection. There is no prejudice, because the State would be required to prove the appropriate state of mind, even if the statute did not expressly so provide. See 11 DelC. §§ 103(b), 251.
. See, Webster’s Ninth New Collegiate Dictionary (1987) defining ridiculing at p. 1014, demeaning at p. 337, and derogatory at p. 342.
. In response to Robinson's request for a bill of particulars, the State’s answer stated in pertinent part:
The defendant put a flower pot over the victim’s head, pulled up her dress and said "kiss my butt.” She also pretended to spit on the victim.
The defendant along with the codefendant threw towels at the victim. They teased her and called her names using words to the effect of "old hag,” “bitch,” etc.
. See supra note 3.
. 16 Del.C. § 1131 states in pertinent part:
(4) “Facility" shall include any facility required to be licensed under this chapter. It shall also include any facility operated by or for the State which provides long-term care residential services.
. 16 Del.C. § 1136(a) states:
Any person who knowingly abuses, mistreats or neglects a patient or resident of a facility shall be guilty of a class A misdemean- *363 or. Where the abuse, mistreatment or neglect results in serious physical injury when such person shall be guilty of a class D felony.
Where the abuse, mistreatment or neglect results in death then such person shall be guilty of a class A felony.
. See supra note 7.
. The United States Supreme Court has indicated that a more stringent vagueness test should apply where a law interferes with the right of free speech.
Village of Hoffman Estates
v.
Flipside, Hoffman Est.,
. We find that legislatures routinely use synonymous words in criminal statutes without constitutional difficulty.
See, e.g.,
11
DeLC.
§ 1311(1) (person commits “harassment" when he "insults, taunts or challenges another person or engages in any other course of alarming or distressing conduct”); Model Penal Code § 250.-4(2) (P.O.D.1962) (same).
Cf. City of Seattle v. Huff,