Better Management of Elder Abuse in Nursing Homes

Experts at Rush University Medical Center are calling upon federal and state government agencies, health care facilities and social service and health professional organizations to develop better programs for preventing, screening, monitoring and managing elder abuse in nursing homes. // For many years, geriatric and aging experts at Rush have studied the prevalence and adverse health outcomes of elder abuse in the U.S. and globally.

The call for action is based on the results of a study where a research group in New York analyzed data collected on elder mistreatment and abuse in nursing homes. The study indicates that the prevalence of resident-to-resident elder mistreatment in ten New York state nursing homes from 2009 to 2013 was 20.2 percent.

"Elder abuse is a common, sometimes fatal and costly public health issue that affects as estimated 10 percent of 64.9 million community-dwelling U.S. elderly adults," said Dr. Xinqi Dong, Professor of Geriatric Medicine at Rush and principal investigator of many elder abuse studies. "An estimated 1.4 million people reside in nursing homes, but little is known about elder abuse among these residents."

The different types of potential mistreatment include:
- 9.1 percent for verbal abuse
- 5.2 percent for physical misconduct
- 0.6 percent for sexual misconduct
- 4.0 percent for invasion of privacy
- 0.9 percent for menacing gestures or facial expressions
- 0.3 percent for unwanted caregiving.

The study was based on resident self-reports, staff interviews, staff case reports, facility case reports, researcher observations and medical record reviews.

"Elder abuse is multifaceted and encompasses psychological, physical and sexual abuse," said Dong. "We see neglect as well as financial exploitation."

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In the case studies, invasion of privacy and inappropriate caregiving contributed to 21.3 percent of the 407 cases of resident to resident elder mistreatment and accounted for 4.3 percent of the overall prevalence of abuse.

More research is necessary to clarify the depth and breadth of resident to resident elder mistreatment. There is potential ambiguity in what constitutes elder abuse and a lot of room for interpretation, especially in the category of "invasion of privacy" as being considered elder abuse. Therefore, the categories of what might constitute as elder abuse need to better defined.

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In Dong's editorial, he states, "This study will help to pave the road toward elder justice research. At the same time, we need to go beyond cross sectional descriptive studies and to rigorously conduct longitudinal studies to examine the incidence, risk and protective factors and consequences of resident to resident mistreatment."

Evidence-based, culturally appropriate intervention strategies for addressing elderly abuse are needed because they currently do not exist.

"National strategies are needed to engage the collective efforts of federal and state government agencies, health care facilities, social service organizations and health professionals to improve current resources and legislation in order to create more effective ways to monitor, screen and manage elderly abuse in nursing homes," said Dong.




Source-Newswise