Study Provides New Data on Resident-to-Resident Nursing Home Abuse

A recent study provides extensive new data about the prevalence of resident-to-resident abuse in our nation’s nursing homes. The study concluded that “inappropriate, disruptive, or hostile behavior between nursing home residents is a sizable and growing problem.”

The study, funded by the National Institute on Aging, was conducted by Weill Cornell Medical College and Cornell University and was presented at the annual meeting of the Gerontological Society of America, held in November.

The study’s author, Dr. Karl Pillemer, considers the research groundbreaking. “We were shocked by how extensive this [resident-to-resident elder mistreatment] was,” Pillemer told the New York Times.

However, resident-to-resident abuse is a well-known problem. In one of many earlier studies, the 2010 National Ombudsman Reporting System identified resident-to-resident abuse as the second most common form of elder abuse in nursing homes, representing 22% of all complaints, according to the National Center on Elder Abuse.

However, the Cornell study does make an invaluable contribution by providing the most extensive data on the problem ever gathered. A total of 2,011 residents of ten New York nursing homes were studied. Information was collected through interviews of residents, relatives and staff members; questionnaires completed by residents and staff; and analysis of written reports and inspections. In addition, research assistants did direct observation for two to six months in each of the 10 facilities.

The result was “the most detailed portrait of this phenomenon ever developed,” Pillemer said.

Every Month: One of Five Residents Victimized

The study concluded that 20% of nursing home residents experience mistreatment by another resident during a four-week period. Resident-to-resident mistreatment includes:

  • Verbal abuse, including cursing and yelling, experienced by 16% of the residents during a four-week period.
  • Invasion of privacy, including unwelcome entry into a resident’s room or possessions, experienced by 11% of residents.
  • Physical incidents: including hitting, kicking or biting, experienced by 6%.
  • Sexual incidents, including exposing one’s genitals, touching other residents and unwanted sexual advances, experienced by 1%.

The study contends that although more attention has been given to elder abuse inflicted by relatives at home and staff at facilities, resident-to-resident mistreatment in nursing homes may be a greater problem.

Several Solutions

As with the many other problems that occur at nursing homes, there is no easy fix to resident-to-resident mistreatment. However, there are several things that can be done to reduce the incidence of resident-to-resident abuse.

Greater awareness is always the essential first step toward improvement. Federal regulations state that nursing home residents have “the right to be free from verbal, sexual, physical, and mental abuse, corporal punishment, and involuntary seclusion.”

Nursing homes have an obligation to protect their residents’ rights. Residents, families, staff members and the public must be better educated to not tolerate abuse and to report it when it occurs.

Staff training on resident rights and prohibitions. Some poorly educated and trained nursing home staff do not take resident-to-resident abuse seriously. A 2011 report on the problem by John Marshall law professor Lisa Tripp describes an incident in which three Kentucky nursing home aides watched in amusement as a male resident raped a female resident.

That kind of ignorance is revolting, but unfortunately, far too common. Nursing homes should be required to better train their staff members about elder abuse, including resident-inflicted abuse.

Better reporting. Many negative resident encounters are unreported for several reasons: they are undetected, staff do not take the incidents seriously, some victims are unable to speak for themselves, and some facilities avoid documenting problems to avoid repercussions.

Tripp said abuse inflicted by dementia patients is categorized differently, resulting in skewed statistics.

“Because demented residents lack a willful intent to abuse, federal regulators classify sexual and physical abuse committed by demented residents as accidents,” Tripp wrote. “This understates the problem of sexual abuse in nursing homes [and] devalues the experience of the victims.”

* More staffing is always on the list of solutions for nursing home problems. More trained staff would be able to intervene more often to prevent abuse and to report abuse when it occurs.

* Screening and appropriate placement of residents. The Cornell study identified the profile of the typical resident abuses other residents. The abuser is usually younger, has less physical and mental impairment and has already demonstrated behavioral problems.

A Massachusetts advocacy group says nursing residents should be screened for a history of abusive behavior, so staff members can be on the alert.

* Facility culpability: Tripp writes thatwhere dementia is driving the conduct, a better focus is on regulatory solutions because they focus on facilities’ culpability.”

Nursing home abuse is no small problem. More than 3 million people reside in nursing homes, according to the National Center on Elder Abuse.

According to the Cornell study, that means more than 600,000 older Americans are experiencing mistreatment at the hands of their co-residents every month. Like all of us, those Americans have a right to protection against abuse in their own homes.