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Nursing Home Abuse
"There are nearly 17,000 nursing homes in the United States that currently care for 1.6 million residents — a figure expected to quadruple to 6.6 million residents by 2050."
—U.S. House of Representatives, Committee on Government Reform- Minority Office
Eye witness accounts and surveys have sadly shown that nursing home abuse and neglect is a serious problem, and that there also is significant underreporting. Major underlying causes of elder mistreatment, according to findings of the National Academy of Sciences Panel to Review Risk and Prevalence of Elder Abuse and Neglect, are:
- Stressful working conditions, particularly staff shortages
- Staff burnout
- Inadequate staff training
Prevention of Abuse and Neglect in Long Term Care Settings
The most effective prevention programs, experts say, use a combination of strategies to protect vulnerable elders. In 2002, the National Center on Elder Abuse commissioned a review of prevention research related to abuse in nursing homes and other long term care settings. Strategies identified in the literature include:
- Assure coordination between law enforcement, regulatory, adult protection, and nursing home advocacy groups.
- Support education and training in interpersonal caregiver skills, managing difficult resident care situations, problem-solving, cultural issues that affect staff/ resident relationships, conflict resolution, stress reduction techniques, information about dementia, and witnessing and reporting abuse.
- Improve work conditions, through adequate staffing, enhanced communication between direct care and administrative staff, more time to nurture relationships between staff and residents, humane salaries, opportunities for upward mobility, and greater recognition, respect and understanding for the difficult lives many workers lead.
- Assure compliance with federal requirements concerning hiring of abusive nurse aides.
- Promote environments conducive to good care.
- Assure strict enforcement of mandatory reporting, as well as educate professionals and the public (non-mandatory reporters).
- Improve support for nurse aides (support groups).
- Support and strengthen resident councils.
- Assure that hiring practices include screening of prospective employees for criminal backgrounds, history of substance abuse and domestic violence, their feelings about caring for the elderly, reactions to abusive residents, work ethics, and their ability to manage anger and stress.
Read
Research Review: Abuse in Nursing Homes
Links to Online Resources
Where to Report
- Nursing Home Abuse Hotlines
This is NCEA's directory of state hotlines for reporting abuse in nursing homes, assisted living, or board and care homes.
- Where Can I Go For Help?
This is a directory of all state and regional ombudsmen, state offices on aging, state licensure and certification agencies, state adult protection agencies, nursing home quality review boards, Medicaid agencies and Medicare Fraud Control Units nationwide.
- Abuse and Neglect
This fact sheet from the National Citizens Coalition for Nursing Home Reform explains resident rights and steps to take if these rights are jeopardized. Links to US directories.
- Resolving Nursing Home Problems
Fast facts about the nursing home oversight and reporting system, with links for more information.
Resources for Caregivers
Reports and Studies
- Elder Abuse in Residential Long-Term Care Facilities: What Is Known About Prevalence, Causes, and Prevention
Excellent overview of elder abuse by Catherine Hawes, Ph.D., and given as testimony to the U.S. Senate Committee on Finance, June 18, 2002.
- Abuse and Neglect
National Citizens' Coalition for Nursing Home Reform fact sheet.
- Elder Abuse in the Institutional Setting
1997 article by Christine L. McDaniel, J.D.
- National Clearinghouse on Family Violence
A project of Health Canada, this site includes links to discussion papers and annotated bibliographies on institutional abuse.
- Nursing Homes: More Can Be Done to Protect Residents from Abuse
US General Accounting Office (GAO) report to Congress from March 2002, on law enforcement's role in responding to and investigating allegations of nursing home abuse. It focuses on experiences of three states: Georgia, Illinois, and Pennsylvania.
- The Silenced Voice Speaks Out
Report of an Atlanta (Georgia) Legal Aid Society project to, among other things, "produce a study which contains quantifiable evidence on the abuse and neglect of Atlanta nursing home residents and which measures the timeliness and thoroughness of the state regulatory response."
News Links: Nursing Home Abuse
Organizations: Nursing Home Abuse and Neglect Prevention
- A Perfect Cause
A grassroots non-profit organization dedicated to long term care reform, see links for federal regulations for nursing homes governing resident rights and Nursing Home Litigation Guide.
- Adult Victims of Crime and Abuse in Residential Care Facilities
This action partnership brings together experts nationwide to provide information and galvanize concerned citizens to address elder or adult abuse in residential care facilities. Action partners include the National Organization for Victim Assistance (NOVA), the National Association of Adult Protective Services Administrators (NAAPSA), and the Office for Victims of Crime (OVC).
- Long Term Care Link
This non-profit Internet portal is a hub for information on long-term care, with Web links to State and Area Agencies on Aging nationwide, family caregiver resources, and more.
- National Citizens' Coalition for Nursing Home Reform
The leading national consumer group working on nursing home quality issues. Site includes a list of all state long-term care ombudsmen and their contact information.
- National Long Term Care Ombudsman Resource Center
Ombudsmen serve over 2 million residents of nursing homes and board and care facilities. This link contains resources for ombudsmen as well as caregivers.
Federal Government Web Sites
- About Nursing Home Inspections
A Centers for Medicare & Medicaid Services plain-English description of the nursing home oversight system.
- Medicare and Medicaid Nursing Facility Quality Improvement Act of 2003 H.R. 787 (Introduced in House February 13, 2003)
To amend titles XVIII and XIX of the Social Security Act with respect to reform of Federal survey and certification process of nursing facilities under the Medicare and Medicaid Programs.
- Medicare: Nursing Home Compare
This government agency site offers detailed information about the past performance of every Medicare and Medicaid certified nursing home in the country.
- Medicare: Nursing Homes
Official government nursing home Web site of the Centers for Medicare and Medicaid Services. The site contains links to a nursing home checklist and more.
- Nursing Home Prosecutions
This link from the US Department of Justice Web site takes you to a list of civilly prosecuted "failure of care" cases against nursing homes in the Eastern District of Pennsylvania.
- Nursing Home Quality Initiative
The Centers for Medicare & Medicaid Services (CMS) announced a Nursing Home Quality Initiative pilot project in April 2002. This page includes links to a number of documents involved in the development and implementation of this project.
- Senior Safety Protection Act of 2003 H.R. 208, Sec. 2. Long Term Care Provider Criminal Background Check (Introduced in House January 7, 2003).
- US Administration on Aging
This site contains many Web links to fact sheets, facility directories, statistics, and research articles accessible online. Aging Internet Information Notes: Nursing Homes.
- US Department of Justice
Information on the US Justice Department's Nursing Home Initiative and its Elder Justice efforts. See especially the links to "Medical Forensic Aspects of Elder Abuse and Neglect" and "Promising Practices to Prevent Elder Victimization."
- US House Committee on Government Reform - Minority Office: Special Investigations - Nursing Homes
Rep. Henry Waxman, Ranking Member. Links to reports, testimony, news, and legislation concerning abuse of nursing home residents, nursing home conditions, nursing home staffing, Nursing Home Quality Protection Act of 2001, and more.
Last Updated: October 22, 2003 
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