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Risk Factors for Elder Abuse in Nursing Homes

Elder abuse in nursing homes has been a phenomenon that's difficult to track, though its frequency is worrying enough to publicize steps for prevention. Indeed, according to the National Center on Elder Abuse, 95% of care facility residents have felt neglected or seen a fellow resident neglected, while 44% reported some type of abuse.

While abuse in nursing homes has recently been found to be most frequently perpetrated by other patients, it's still necessary to check on any risk factors that might be present in a facility. Trusting such an institution to care for our loved ones full-time - a difficult and emotionally taxing decision in itself - means doing our homework to ensure their well-being and safety from harm. The National Center on Elder Abuse's Nursing Home Abuse Risk Prevention Profile and Checklist is meant to help you be aware of any danger signals. Let's cover the key risk factors:

  1. Abuse Prevention Policy: Elder abuse is more likely to occur in nursing homes that haven't instituted a clear abuse prevention policy. Are employees at the facility trained to spot signs of elder abuse and prevent it in the first place? Can they report elder abuse without fear of punishment? Does management promptly and thoroughly investigate reports of elder abuse?
  2. Staff Education and Training: Is training for staff at a level that aims for excellence? Major issues to address include communication and anger management, cultural and ethnic differences, caring for patients with dementia and mental illness, and policies and procedures, most importantly detection and prevention of elder abuse and exploitation.
  3. Staff Screening: In addition to proper background checks, potential hires at a nursing home should be evaluated according to their attitude toward the elderly, their approach to conflict, how they would handle anger and stress, drug and alcohol history, and reaction to situation of abuse.
  4. Staff Stresses/Burnout: Working in a nursing home can be stressful enough, and long hours, low pay, low morale, and potential abusive behaviors by patients can all increase the possibility of elder abuse in a facility. Solutions include better pay and training, regulating shifts to avoid burnout, the presence of registered, licensed nurses and nurse's aids on staff, and communicating a strong ethic of care and leadership that values both patients and staff.
  5. Staff Ratio/Turnover: What is the rate of turnover at the nursing facility? Labor shortages are bad for both staff and residents. If a care home is inadequately staffed, the risk for elder abuse rises accordingly. The more employees are set on permanent shifts and know their patients well, the less the likelihood of abusive behavior.
  6. Complaint History: Is there a history of complaints about a prospective nursing home? Have there even been past incidents of abuse reported there? Is the facility known to skirt safety rules, policies, and procedures? If any of these questions can be answered with "yes," then you should keep looking and seek out a better nursing home.
  7. Culture and Management: What are the goals, values, traditions, shared attitudes, and sanctions at the care facility? Is the leadership of the facility on hand to deal with potential problems? Studies have established that if management is removed from the day-to-day care work of the staff, elder abuse is more likely. Seek out a nursing home where the leadership takes a hands-on, balanced approach to elder care with an emphasis on communication and compassion.

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