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Abuse and Neglect in Long-Term Care Essay Sample

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Introduction of TOPIC

A long term care facility is housing for the elderly and disabled that are not capable of residing in a home of their own. “There are nearly 17,000 nursing homes in the United States with a total of 1.6 million residents, and numbers are expected to quadruple to 6.6 million residents by 2050”(Dehart, Webb & Cornman, 2009 p.361). Subsequently, there is abuse that takes place in these facilities. Even though some people are not aware of abuse, abuse is a wide spread phenomenon consisting of verbal, physical, and resident to resident abuse that is taking place in long term care facilities. Abuse prevention is transpiring to overcome these various abuses that occur (Dehart et al, 2009).

The first type of abuse stated is verbal abuse. Verbal abuse is generally defined as profane, insulting, and obscene language or sexual advances (Voyer et al, 2005). There are some employees that work in these facilities and assume that it is ok to use profane language and raise their voice at residents. Abuse being complicated to provide a definitive definition, some individuals just claim they do not know profane language is considered verbal abuse (McGarry & Simpson, 2009). Regardless of what the resident does to the employee, the employee should always handle it in a professional manner.

Individuals perceive that if the outburst is unintentional and they did not intend for it to happen then it is not considered abuse (McGarry & Simpson, 2009). When people work and live in the same place and depend one on another daily for their everyday living there is a potential for abuse to arise (Daly & Jogerst, 2006). In consideration of verbal abuse the receipt of verbal abuse can suffer emotional and mental distress that can lead to clinical depression (Voyer et al, 2005). Before having an intentional or unintentional angry outburst one should always consider the after effect that may be cause by this angry outburst. Verbal abuse is more prevalent that physical or sexual abuse in long term care facilities (Rosen et al, 2008); (Daly & Coffey, 2009). Verbal abuse is present everywhere although, it should not just be overlooked because it can result in traumatic experiences.

Physical abuse is another type of abuse that takes place in long term care facilities. Physical abuse can be described as punching, biting, spiting, scratching, pushing, and throwing things (Voyer et al, 2005). Residents with Dementia, Alzheimer, and aggressive behaviors have a potential to abuse staff (McGarry & Simpson, 2009) this can result in the staff abusing the patients. The use of physical restraints on residents can cause them to have more physical aggression than before (Voyer et al, 2005), therefore physical restraints should be used sparingly and only when strictly necessary. Studies reveal that abuse and neglect are more a part of life than just isolated incidents in long term care facilities all across the country (Malmedal, Ingebrigtsen & Saveman, 2009).

Evidence of physical neglect may be poor hygiene, signs of malnutrition, failure to thrive or just looking very unclean and inappropriately dressed. 80 per cent of abuse and neglect that occurs in long term care facilities is not documented and goes unreported (Daly & Coffey, 2009). Care givers can be reluctant to give the appropriate care to some residents because of the physical agg

ression displayed by those residents. When working in long term care facilities, one must diligently

watch for signs of physical abuse and neglect such as bruising, being unclean, and fear of being approached. Safeguards and training on what constitutes abuse and neglect needs to be put in place with employee mandates to help ensure that caregivers remain attentively aware of the signs (Dehart et al, 2009).

Moreover there is resident to resident abuse that takes place in long term care facilities. These facilities usually have two to three patients in one room unless one is placed in a private room. Having to share living space with other individuals can cause anger and aggression to build up with other residents (Voyer et al, 2005). Although when the term “elder mistreatment” arises in regards to nursing home care and long term care most think of the resident being abused by the staff but the issue of resident to resident aggression is a more problematic and prevalent phenomenon (Rosen et al, 2008). Resident to resident abuse is widely overlooked by staff and family members. Despite the fact that some residents are not in their right state of mind due to Alzheimer’s or another health condition, abuse should still not be disregarded (Rosen et al, 2008). If abuse is transpiring among residents it should be reported so the appropriate action can be taken to resolve it. At times there is also unintentional resident to resident abuse that takes place, some residents try to help and assist other residents resulting in physical harm (Rosen et al, 2008). Direct care givers and staff need to always be on the lookout for potential resident to resident harm.

Concerning all the abuse that is transpiring in long term care facilities there is abuse prevention being put into place (Dehart et al, 2009) ; (McGarry & Simpson, 2009) ; (Daly & Jogerst, 2006). “In 1965, the Older Americans Act was passed and established programs that offer service and opportunities for old Americans and 1987 an amendment to the act required Local Area Agencies on aging to assess the need for elder mistreatment prevention services” (Daly & Jogerst, 2006, para, 2). Although there are abuse prevention programs that strive to prevent abuse and have explicit guidelines for care givers to prevent, identify, and manage abuse, it is still occurring (McGarry & Simpson, 2009).

The direct care givers in long term care facilities such as certified nursing assistants have an obligation to be aware of abuse and neglect and report anything suspicious (McGarry & Simpson, 2009). Anyone working in long term care facilities should understand that residents deserve the upmost care and respect, it is not just a job but caring for people. Family members can also contribute to abuse prevention as well by reporting any abnormal behavior, marks on residents or abuse they have witnessed (Rosen et al, 2008). The residents’ family members may not think that resident to resident aggression should always be reported, but it should even the smallest of aggression could lead to a harmful situation. Abuse is not acceptable in any manner for any reason and should always be reported and dealt with in the proper method (Dehart et al, 2009).

Described in this paper is a large spread phenomenon of abuse and neglect in long term care facilities. Also in consideration of abuse, abuse prevention is being presented. The types of abuse described were verbal, physical, and resident to resident. Abuse prevention is needed to help control the abuse that takes place in these facilities. Various acts have sought to ensure and protect the rights that the elders have and address the pitiable standards of care that elderly individuals have previously received (McGarry & Simpson, 2009). Residents’ family can also be affected by abuse that transpires, they can suffer embarrassment by their behavior and in due time reduce their regularity of their visits (Voyer et al, 2005). It is critical to be aware of abuse and neglect in long term care facilities, abuse can lead to appalling and terrible outcomes, even if it seems small (McGarry & Simpson, 2009).


Daly, J. M., & Jogerst, G. J. (2006). Nursing home Statutes: Mistreatment Definitions. Elder Abuse and Neglect, 18(1), 19-24. Daly, J., & Coffey, A. (2010). Staff perceptions of elder abuse. Nursing Older People, 22(4), 33-37. Retrieved from Academic Search Complete database. DeHart, D., Webb, J., & Cornman, C. (2009). Prevention of Elder Mistreatment in Nursing Homes: Competencies for Direct-Care Staff. Journal of Elder Abuse & Neglect, 21(4), 360-378. Malmedal, W., Ingebrigtsen, O., & Saveman, B. (2009). Inadequate care in Norwegian nursing homes – as reported by nursing staff. Scandinavian Journal of Caring Sciences, 23(2), 231-242 McGarry, J., & Simpson, C. (2009). Identifying, reporting and preventing elder abuse in the practice setting. Nursing Older People, 21(1), 33-38. Retrieved from Academic Search Complete database. Rosen, T., Lachs, M. S., Bharucha, A. J., Stevens, S. M., Teresi, J. A., Nebres, F., & Phillemer, K. (2008). Resident-to-Resident Aggression in Long-Term Care Facilities. Clinical Investigations, 1(1), 1-11. Voyer, P., Verreault, R., Azizah, G. M., Desrosiers, J., Champoux, N., & Be’dard, A. (November 10, 2005). BMC Geriatrics. Retrieved from http://www.biomedcentral.com/1471-2318/5/13

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