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Catherine Hawes. There has been very limited research on elder abuse, although there is some evidence that suggests it may be nearly as widespread in the community as child abuse Bourland, ; Fulmer, ; Kleinschmidt et al.

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Four deficiencies, listed below, are related to abuse.

The OIG found 4, abuse complaints, involving nearly one-third of the facilities certified to participate in the Medicare or Medicaid programs. Department of Health and Human Services, OIG austarlia found that ombudsman complaints about quality of care have also been increasing in recent years.

Further, the U. They are dependent on the … nursing facility operator for their food, medicine, medical care, dental care, and a bed; a roof over their he; for assistance with virtually every daily activity.

In a survey of CNAs preparing to go through a special training session aimed at preventing abuse and neglect, 37 percent of the CNAs reported they had seen neglect of cyat resident's care needs MacDonald, All but 7, facilities are in the last category and are the focus of our initiative. CNAs who participated in focus groups also had very clear and specific ideas about what constituted neglect in nursing homes Hawes et al.

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Moreover, k those who enter a nursing home, more than half 55 percent will have a total lifetime use of at least one year. In addition, both studies found that sweqr majority of nurses 59 percent and 66 percent, respectively were unaware of laws on elder abuse, and a surprising of nurses 43 percent working in EDs or home health were unaware of state mandatory reporting requirements. Neglect means failure to provide goods and services necessary to avoid physical harm, mental anguish, or mental illness.

They attributed this decision to the fact that the penalty for a CNA found to have committed abuse was being barred for life from nursing home employment. A review of records and care practices in 14 facilities in 11 states, conducted with protocols similar to the Swezr, documented inadequate treatment in one-third of the facilities in the areas of nutritional support, pressure ulcer care, prevention of contractures, pain management, and personal assistance Johnson and Kramer, Daughter of a Texas Resident, Hawes et al.

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Interviews with more than staff members who subsequently participated in an abuse-prevention training program also indicated substantial levels of abusive behaviors by staff caregivers in nursing homes. In this project, 77 CNAs from 31 nursing facilities received training. For example, as one resident reported: My roommate—they throw him in the bed.

In addition to deciding on how to define abuse and neglect for purposes of research, austraalia additional critical decisions and challenges must be addressed. The probability of use increases dramatically with age, rising from 17 percent for those aged 65 to 74 to 60 percent for persons aged swexr to Moreover, these figures may underestimate the of persons who are actually at risk for abuse or neglect in a nursing home.

First, the list must be constructed at the state level. Georgia Nursing Home Resident Atlanta Long-Term Care Ombudsman Program, In addition, 38 percent of the residents reported that they had seen other residents being abused, and 44 percent said they had seen other residents being treated roughly.

In nursing homes, other types of actions have been included, such as improper use of physical or chemical restraints. Millions of elderly are at risk over the course of their lives, and this population at risk will increase, given current demographic trends.

These findings are troubling, because state policymakers wish to expand the role of RCFs Mollica, House of Representatives, As part of their responsibilities, the ombudsman program established a National Ombudsman Reporting System NORSusing standardized definitions of complaint types and resolutions Administration on Aging, House of Representatives, RCFs are known by more than 30 different names, including adult congregate care, personal care homes, homes for the aged, adult care homes, and group homes.

Moreover, as noted, in a few states, even for the general, mixed population facilities, there are multiple licensing agencies, or some that while others offer registration e.

General ing Office a found that more than half had received unacceptable care, including lack of appropriate attention to dramatic, unplanned weight loss, failure to properly treat pressure ulcers, and failure to manage pain. In focus group interviews, the directors of the state survey agencies that had overall administrative authority for the nurse aide registries expressed concern about the relatively low rates of substantiation, particularly because most tended to believe that residents and families complained only when something ificant had occurred.

Finally, some families reported that they did not file formal complaints in some cases because all their energy was directed at getting adequate medical care for their loved one who had been abused, moving them to the hospital, and then finding a new nursing home for the resident following acute care discharge Bowers et al.

They also reported incidents in which pressure ulcers were improperly treated, leading to sepsis and death. Resident Risk Factors Several studies have examined the characteristics of individuals living in community settings e. Second, there are multiple licensing agencies in many states.

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Federal funds for the program are through the Older Americans Act, and some programs also receive state funding Huber et al. Asutralia percentage of homes with abuse violations has been increasing, probably as a result, at least in part, of more stringent reporting requirements and increased vulnerability among residents.

They treat her so bad. In some states, there is a separate licensure category for very small homes e. The lady made some remark.

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One group includes facilities specifically d for special populations, such as for persons with substance abuse, mental illness, or developmental disabilities. Other studies have had similar findings with regard to staff in hospitals. However, in most states, the investigations of abuse by the nurse aide registries do adhere to the standard of beyond aduot reasonable doubt Hawes et al. Georgia Nursing Home Resident Atlanta Long-Term Care Ombudsman Program, Focus groups and individual interviews with residents and family members for a study of the nursing home complaint-investigation process also produced reports of abuse and severe neglect.

Nevertheless, the disparate evidence that is available and discussed below suggests the existence of a serious problem that warrants further study.