Elder Abuse in Institutions

What is elder abuse?

The great majority of reported acts are physical abuse. Other types of elder abuse that have been reported in institutions include sexual abuse, monetary abuse, or acts where an employees perform work routines improperly, e.g. cutting off a bandage with a sharp instrument. Sometimes, patient abuse can cause irreparable damage, as in a case where a punch by a nurse’s aid resulted in permanent blindness for the elderly resident.

Abuse can be subtle or covert, including harassing elderly residents or controlling them with drugs or restraints. Restricting the personal choices of residents (e.g. in regard to bathing or feeding times, or what to wear) can also be abusive. Sometimes residents are placed in isolation, especially if they are aggressive or hard to care for.

Who abuses elders in nursing homes and why?

In the United States, nurses’ aides (equivalent to nursing assistants in Canada) are the most frequent abusers. This is likely because they are the largest group of employees working in institutions for the elderly. Male workers, although outnumbered by females, are more likely to be overtly abusive, such as assaulting residents physically.

Oftentimes staff are overworked and underpaid. In addition, residents can be aggressive or difficult to manage. In insitutions, routines are seen as important, and residents who do not cooperate may cause frustration in workers, who react with anger.

What can be done about it?

Elders need to understand what elder abuse is, and to be informed of their basic rights. Such knowledge protects against the risk of abuse. It can also be useful to educate staff about elder abuse, particularly covert abuse, which they often do not consider to be harmful. Staff need to know that elder abuse is a crime and that offenders can be punished.

In addition, workers should be trained in conflict resolution, so that violent responses to difficult situations can be reduced. When residents object to procedures (like being forced to take a shower), staff should be encouraged to seek alternatives, such as providing a bath instead, or a different time to shower. In many cases, staff themselves feel powerless and the pressures of the job are overwhelming.

Finally, as with any crime, the presence of witnesses tends to deter potential offenders, and to increase the chances of successful prosecution. It is important that managers of institutions and families of residents keep this in mind. Residents who are visited regularly by vigilant family members are less likely to become victims of elder abuse.

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