Abstract
BackgroundElder abuse in nursing homes (NH) is a widespread and complex problem. Residents’ ability to share their experiences are impeded, due to a high degree of cognitive problems and frailty, and previous studies are thus mainly based on reports from staff. Therefore, we aimed to give voice to the residents by investigating their relatives’ experiences with elder abuse in NH.MethodsQualitative individual interviews were conducted with 16 relatives of residents with experience of abuse and/or neglect in NH. Content analysis was used to analyse the data.ResultsRelatives perceived neglect as most pervasive and staff-to-resident psychological abuse as a key problem. Physical abuse was mostly related to resident-to-resident aggression. Relatives perceived elder abuse in NH to be related to low competence among staff, low staffing, poor NH leadership, working cultures characterized by fear and loyalty to employer or co-workers, and a lack of individualized care for the residents. Furthermore, relatives themselves experienced maltreatment from NH, which caused them to suffer stress, anxiety and distrust. Relatives also expressed a need to compensate for lack of care.ConclusionsRelatives of NH residents who had experienced abuse reported that neglect of basic care and individual rights was predominant and viewed organizational explanations as most important. Relatives perceive themselves as collaborators in care and are emotionally attached to their family member. Therefore, if relatives experience resident abuse or neglect, it inflicts a feeling of being mistreated themselves, particularly if they are not listened to or their notice of abuse on the part of the resident is ignored or trivialized. Including relatives in a committed partnership with NH in care practices is not only a valuable path to reduce the risk of abuse, but it also leads to a more sustainable healthcare with high standards of quality and safety.
Highlights
The qualitative interviews focusing on nursing homes (NH) abuse elicited responses in two overarching areas - resident abuse and maltreatment of relatives (Table 3)
The informants predictably elicited responses on the theme “resident abuse”. They described how they as relatives felt subjected to maltreatment from the NH when asked about their cooperation with the NH
This study found that relatives whose loved-one experienced abuse or neglect perceive neglect as most pervasive, and they perceive psychological abuse from staff-toresident as a key problem
Summary
Can you describe what you define as abuse and neglect in nursing homes?Your experiences of abuse and neglect as a relative Can you describe your experience of abuse and neglect to the resident of which you are a relative?To detect elder abuse and neglectCan you describe how you found out about incidences of abuse and neglect in the nursing home?Can you describe the communication with staff or nursing home managers?Can you describe if there are things that makes it difficult or challenging to report such incidents?Nursing home management of reported abuse and Can you describe how the nursing home managed the reported/detected incidences of abuse neglect incidences and neglect?Can you describe what is challenging in such a situation?Do you dare to be honest when there is something you are not happy with regarding the care of your family member?The role of relatives to prevent abuse and neglect Can you describe how you as a relative may contribute to prevent abuse and neglect? in nursing homes. Can you describe how you found out about incidences of abuse and neglect in the nursing home?. Prevalence of elder abuse in NH A systematic review and meta-analysis of the prevalence of elder abuse in institutional settings suggested an overall abuse estimate of 64% [20] This estimate was based on NH staff reports of abuse of patients for 1 year. Prevalence estimates for abuse subtypes as reported by residents themselves were highest for psychological abuse (33%), followed by physical (14%), financial (14%), neglect (12%), and sexual abuse (2%) [20]. A Norwegian cross-sectional study of elder abuse in NH found that among the 3693 nursing staff who participated in the study, 60% reported they had perpetrated one or more incidents of abuse during the past year [12]. Physical abuse was reported by nearly 10%, while most staff in this study reported that they had never committed financial or sexual abuse
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