Elder Abuse in Residential Care Facilities
Elder abuse is a catch all term referring to any deliberate or negligent act by a care giver or any other individual that results in harm or a major risk of harm to a vulnerable adult over the age of 60 years (Stefanacci & Haimowitz, 2013, p. 68). Under the umbrella definition for elder abuse, more specific types of abuse can be identified such physical abuse, sexual abuse, emotional abuse, exploitation, neglect and abandonment (Stefanacci & Haimowitz, 2013, p. 68).
The physical abuse refers to the infliction, or threat to inflict, physical harm onto an elderly individual or the deprivation of their basic needs. Sexual abuse is defined as any ...view middle of the document...
As mandatory reporters of abuse and neglect, it is vital that nurses are trained to identify and assess the presence of abuse or neglect among their patient populations. The nurse must also be aware of state and federal laws that concern the reporting of elder abuse when it is identified. The aim of this paper is to present statistical data showing the under reporting of elder abuse in RCF, highlight deficiencies in staff training that contribute to the problem and discuss the impact of elder abuse on the health care system and nursing.
The Issues Involved with Elder Abuse in Residential Care Facilities
Nurses have a moral obligation to uphold the principles of beneficence, maleficence, and fidelity when caring for patients in any health care setting. The principle of beneficence refers to the expectation that the nurse will do good to prevent harm, while nonmaleficence refers to the nurse’s obligation to protect the patient from harm. The principle of fidelity relates to the nurse’s obligation to not abandon the patient and maintain continuity of care (Westrick & Dempski, 2009, p. 258).
According to the ANA Code of Ethics for Nurses with Interpretive Statements (2001), “the nurse promotes, advocates for and strives to protect the health, safety and rights of the patient” (pg. 16). When the nurse identifies factors within a healthcare delivery system that endanger the welfare and wellbeing of the patient action must be taken to report the problem to a higher authority either within the institution or to an appropriate external authority (American Nurses Association, 2001, p. 19).
Five areas of concern have been identified in relation to assisted living facilities. The first is that ALFs were initially modeled to serve the elderly population who required minimal assistance. However, the population in these facilities has increasingly grown to resemble that of a nursing home in regard to cognitive and physical problems. Physical and cognitive impairment are frequently cited as significant risk factors associated with elder abuse (Phillips & Guo, 2011, p. 344). A second issue concerning ALFs is that in a majority of states, the facilities are mainly staffed by unlicensed assistive personnel (UAP) who often have less education than a certified nursing assistant (CNA). A vital element in the prevention of elder abuse and neglect is staff education regarding problem management and conflict resolution (Phillips & Guo, 2011, p. 344).
A third major concern is that unlike nursing homes, ALFs are not subject to federal regulation. The uniform monitoring and regulation of nursing homes by the federal government is thought to be a key deterrent to the mistreatment of their residents (Phillips & Guo, 2011, p. 344). Fourth, small ALFs that house less than 50 residents are isolated and all but invisible, leaving their residents vulnerable to abuse (Phillips & Guo, 2011, p. 344). Fifth, the fact that most ALFs operate for profit has...