Nursing Home Abuse

Understanding Nursing Home Abuse

nursing home abuse

According to the 2010 US Census (1), there is a greater number of people over the age of 65 than in any other time in which the census was taken.

This figure amounts to 40.2 million individuals, or about 13 percent, of Americans that are over the age of 65. Much of this is due to the “Baby Boomer Effect”; and this relationship is not expected to change any time soon.

By the year 2050, it is estimated that 20 percent of all Americans will be at least 65 years of age, with the most growth occurring among Americans aged 85 and older. According to 2010 the census, about 5.8 million Americans were over the age of 85, and this number is expected to reach 19 million people by 2050.

The Problem of Elder Abuse

The mistreatment of the elderly is defined as engaging in actions that intentionally harm or create a risk of some type of harm to an elderly person by a trusted individual or caregiver (2).

Researchers do not know exactly how many elderly individuals are being abused or neglected. However, the problem of elder abuse seems to be worse among women who are 65 years and older.

Overall, the older the person is, the more likely it is that the person will be abused.

Evidence of abuse of the elderly may be overlooked by healthcare professionals because there is little training available in this area. The elder may be reluctant to report that they have been abused because they fear retribution or lack of continued care if they were to report it.

The individual may also be unable to speak of the abuse due to language or communication barriers. Because 90 percent of abusers come from within the family, the senior citizen may not want to get their loved one in trouble, and fail to report their actions as abuse.

What is Known About Elder Abuse and Neglect

The information from the Adult Protective Services (APS) indicates that there are more reported cases of elder abuse than in the past.

  • About 4-10 percent of older people experienced some type of abuse within the previous year. This amounts to about 1 in 10 older individuals. These statistics do not involve abuse of the elderly person’s finances.
  • In spite of the accessibility of Adult Protective Services in every state and mandatory reporting laws, there are many unreported cases of neglect, abuse and exploitation every year.
  • Exploitation of the elderly person’s finances occurs at a rate of about 41 per 1,000 people surveyed.  This is a greater number when compared to those who suffer from neglect, sexual abuse, physical abuse or emotional abuse.
  • Only about 1 out of every 14 cases of elder abuse ever reaches authorities. For every case that is known to APS and other programs, 24 cases were undiscovered (2).

Who are the Abusers?

According to national studies on elder abuse, most abuses of elderly individuals were family members, with a rate of about 90 percent. Other perpetrators of abuse can be partners, spouses, adult children or in-home caregivers.

Family members or caretakers who also abuse alcohol or drugs on a daily basis, or who have an emotional or mental illness, tend to be at a greater risk of being an abuser. Those who feel burdened by caring for an elderly person are also more likely to be abusers.

Elder Abuse in Nursing Facilities

While elder abuse occurs within the community, such as in private homes, there is elder abuse in nursing facilities and other types of facilities where the client stays for a long time.

About 3.2 million people in the U.S. live in nursing homes and are subject to abuse and/or neglect.

Some facts about abuse occurring in nursing facilities:

  • In the year 2000, 2,000 residents of a nursing home were surveyed as to whether or not they were abused. About 44 percent indicated that they had suffered from abuse, and more than 95 percent indicated that they had been neglected by their caregivers (4).
  • About 7 percent of nursing facility complaints were regarding long term care facilities. The main complaints were exploitation, neglect and abuse.
  • A total of 7 percent of nursing home residents surveyed miss deficiencies and 15 percent of these miss the immediate jeopardy and outright harm to the nursing facility resident (5).

The Impact of Abuse to the Elderly

Older people who suffer from abuse have a 300 percent greater risk of death when compared to non-abused individuals (6). Studies have shown that victims of elder abuse suffer from elevated levels of stress and psychological distress than non-abused individuals. They also suffer from a decreased perception of self-efficacy.

The elderly who are at the greatest risk of elder abuse are those who have concomitant health problems, such as depression, anxiety, bone problems, joint problems, chronic pain, digestive problems and cardiovascular problems.

The total cost of these problem is vast. In fact, the medical costs of caring for violent injuries against the elderly are believed to be more than $5 billion USD per year. Victims of financial exploitation report losses of $2.9 billion USD (7).

The Prevalence of Elder Abuse

About 33 percent of nursing facilities were cited for healthcare violations that carried the risk of harm, or had already caused harm to the resident (3). About ten percent of nursing facilities had healthcare violations that resulted in serious injury, harm or risk of death among their residents.

More than half of skilled nursing staff admitted to engaging in mental abuse, neglect or physical violence to residents in the past year. Most of the cases were those involving neglect.

In a survey of certified nursing assistants (CNAs), about 17 percent reported that they had grabbed, pushed or shoved a person in their care, and half reported yelling at the elderly person. A total of 23 percent of CNAs had engaged in insulting the elderly person, or had sworn at them at one point in the recent past (3).

References:

  1. US Department of Census. US Census Bureau (2011).  The Older Population: 2010.
  2. National Center on Elder Abuse. www.ncea.aoa.gov/library/data/. Accessed 3/15/2016.
  3. Abuse of Residents of Long Term Care Facilities. www.ncea.aoa.gov/Resources/Publications/docs/LTCF_ResearchBrief_web508.pdf.
  4. Broyles, K. (2000). The silenced voice speaks out: A study of abuse and neglect of nursing home residents. A report from the Atlanta Long Term Care Ombudsman Program and Atlanta Legal Aid Society to the National Citizens Coalition for Nursing Home Reform. Atlanta, Ga: Author.
  5. U.S. Government Accounting Office (2008). Nursing Homes: Federal Monitoring Surveys Demonstrate Continued Understatement of Serious Care Problems and CMS Oversight Weaknesses (Publication GAO–08-517).
  6. Comijs, H.C., Penninx, B.W.J.H., Knipscheer, K.P.M., & van Tilburg, W. (1999). Psychological distress in victims of elder mistreatment: The effects of social support and coping. Journal of Gerontology, 54B(4), 240-245.
  7. National Committee for the Prevention of Elder Abuse, Virginia Tech, MetLife Mature Market Institute (2011). The MetLife study of elder financial abuse: Crimes of occasion, desperation and predation against America’s elders. Westport, CT: Authors.
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Dr. Christine Traxler

Christine Traxler, MD is a retired family practice physician, graduate of the University of Minnesota School of Medicine in 1986, and freelance writer, having worked with patients in rural Minnesota for two decades. She has written several books on medical topics and currently resides in Minneapolis, MN, where she works as a freelance writer on medical topics.

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