As Nursing Home and Assisted Living Residency Rates Increase, Reluctancy to Move Also Increases: A Deep Dive Into the Complex Issue of Elder Abuse/ Neglect and What We Can Do To Make a Change. 

This article focuses on the prevalence/issue of elder abuse and neglect as well as the signs and types of elder abuse, what resources/agencies are already in place nationally and on a state level to aid in the prevention and investigation of elder abuse/neglect, as well as what we as a society, family members, caregivers, and even healthcare professionals can do to make a change in preventing and stopping elder abuse to protect the generation that needs it most.

THE INCREASE IN LONG-TERM/ASSISTED LIVING RESIDENCY AND THE RELUCTANCY TO MOVE

At least 70% of people 65 and up will need long-term care at some point in their life, and the number of seniors expected to need long-term care is expected to increase to 24% of the population in the next 40 years. But as more and more seniors continue to need care, our country faces a shortage of long-term care staff. This problem causes issues not only for seniors but also for their families. Additionally, making the transition from living at home to living in a long-term care facility or assisted living facility can be difficult for seniors, especially if they are isolated, have to adapt their daily routines, and lose independence, privacy, or dignity in some cases. This makes seniors hesitant to transition from living at home to a long-term care or assisted living facility. But the thing that makes the move to long-term care or assisted living the scariest for both the senior and their family, is the possibility of elder abuse or neglect.

MY PERSONAL EXPERIENCE WITH ELDER ABUSE/NEGLECT

I have seen what these facilities are like after the family members leave, and the staff is no longer held accountable by residents’ families, through my experience as a Certified Nursing Assistant and Certified Patient Care Technician. While I have never seen a resident abused in the present, I have seen the aftereffects of abuse. The wounds, bruises, scars, and impacts that this abuse and neglect have on these seniors are shocking and something that I and most wouldn’t realize unless someone had a personal experience or saw it happen firsthand. For most of my life, I have been around both of my elderly grandparents, and have helped care for them as they have approached the ages of 93 and 91 respectively, so I wasn’t completely new to caring for seniors. I hadn’t witnessed or seen what elder neglect or abuse could do, or what forms it could come in until I began my clinical rotations this past winter. Luckily, both of my grandparents have been able to live in their homes as they continue to age, but through caring for residents at local nursing homes, I have seen the impacts of elder abuse and neglect. I have seen what leaving seniors in bed in the same position for hours on end, for example, can do. I have seen the bed sores, the wounds from bed rails, and the way that some staff members treat residents who are unable to fight back or respond to abusive words or practices. These experiences have continued to show me the need for more awareness about elder abuse and neglect, and improving the quality of long-term care and assisted living facilities.

WHAT ARE SOME SIGNS/THINGS THAT WE CAN LOOK FOR?

While elder abuse can take many forms, there are some signs that family members and caregivers can look for to spot abuse/neglect. These things could include changes in behavior, unexplained burns, wounds, scars, or bruises, poor hygiene or appearance, or even a change in financial patterns. Additionally, family members can watch for signs of neglect/abuse in those residing in long-term care facilities or assisted living facilities by watching for signs such as unexplained pressure sores, hazardous/unsafe living conditions, messy appearance (unwashed hair/clothes), or lacking personal care or mobility items such as glasses, walkers, hearing aids, etc.

WHAT LAWS/THINGS ARE ALREADY IN PLACE TO PREVENT/STOP ELDER ABUSE/NEGLECT? 

There are currently some services/agencies in place that are designed to aid in the reporting and investigating of elder abuse/neglect allegations. These include the Adult Protective Services Agency, designed to protect adults from abuse, neglect, and exploitation, and the National Center for Elder Abuse, designed to guide reporting and provide resources for specific state laws on elder abuse/neglect. Additionally, in 1972 the Long-Term Care Ombudsman Program was formed, placing ombudsmen (people working on behalf of each state) regularly into long-term care and assisted living facilities to serve many roles, such as an advocate for residents to exercise their rights, an investigator, a mediator between the nursing home and resident with a grievance, and educator for both residents and their families. Similarly, many states have a bill of rights for residents residing in long-term care and assisted living facilities that entitle them to certain rights because of their residency. In Missouri, these rights include the right to a dignified existence (one that is free of abuse, neglect, and exploitation, and guarantees they are treated with respect, dignity, and consideration), the right to raise grievances, rights regarding finances (such as managing their finances), and even the right to privacy.

WHAT CAN WE DO TO PREVENT/STOP THE PREVALENCE OF ABUSE/NEGLECT? 

How can we as a society, caregivers, family members, healthcare professionals, and the aging population make a change to prevent or stop the rising incidence of elder abuse/ neglect? While this is a complex issue, several important steps can be taken to prevent or stop elder abuse/ neglect. The most important step is to first educate society on the prevalence and forms of elder abuse/ neglect, thus leading people to become more vigilant and able to recognize the signs and types of elder abuse/ neglect, as well as the risk factors such as caregiver burnout,

familial conflict, lack of social support, etc. Another important step that caregivers specifically can take is to monitor their mental health and take time to care for themselves while also attending to their elders’ care as well. This can promote a healthy balance between caregiving, and also prevent burnout, something that has proved to lead to an increased incidence of elder abuse/ neglect. While healthcare professionals play a huge role in potentially detecting elder abuse/ neglect and promoting a healthy balance between caregiver self-care and proper elder care, when asked, 58% of physicians were unsure if they accurately I’d abuse in elderly patients. This raises a huge issue, not only because the physician could be the only person to detect abuse, or for the elder to confide in about an abusive situation, but also because they can report and get the proper authorities involved to get the elder out of the abusive/ neglectful situation. To correct this issue, better education for these healthcare professionals needs to occur, such as educating long-term care staff and assisted living staff about the signs of abuse/ neglect. Additionally, increased use of tools such as the Elder Abuse Suspicion Index (EASI), a 6-step questionnaire filled out partially by the patient, and partially by the physician could be used; a tool that has proved to be successful in 47% of patients 65 and up who were cognitively intact.

WHAT IF I SEE/WITNESS ELDER ABUSE/NEGLECT? 

The first and arguably most important step to preventing elder abuse/neglect is to report potential cases of neglect/abuse when suspected. If you suspect that a loved one or someone you know is being/has been abused, reach out to authorities (call 911 if the individual is in immediate danger if action isn’t promptly taken) and to a knowledgeable Nursing home abuse lawyer.