Nursing Home Residents Often Abused By Others in Same Facility: Study

About one in five nursing home patients experience abuse at the hands of other patients in the same facility, according to the findings of new research.

In a study published this week in the Annals of Internal Medicine, researchers indicate that about 20% of residents experience some type of nursing home abuse by others patients, calling attention to the topic of safety in nursing homes nationwide.

Researchers focused on the prevalence of physical, verbal, and sexual abuse by other nursing home residents during a one month observational prevalence study in five urban and five suburban New York state nursing homes. The concern is that abuse in a nursing home can cause physical and psychological injury, decreasing quality of life and impacting the overall health of an individual.

The study focused on 2,000 residents in 10 facilities randomly selected based on size and location. A total of 83% of the facilities and 84% of eligible residents participated. Instances of abuse were identified through resident interviews, staff interviews, shift coupons, observation, chart review, and accident or incident reports.

Of the residents followed in the study, 407 experienced at least one abuse event in the nursing home, and the total one month prevalence was 20%. Verbal taunts accounted for 45% of cases, including screaming and inappropriate words. Physical assaults accounted for 26% of cases, which included hitting or pushing. Menacing gestures accounted for four percent of cases.

Invasion of privacy accounted for 20% of incidents, where one resident entered another room without permission, or where a person took or touched another person’s property.

In all cases, nursing home sexual assaults accounted for less than three percent of cases.

Another study published in 2014, turned up very similar findings, indicating that abuse to nursing home residents occurred in about 1 in 5 patients every month. The study determined abuse was more prevalent than initially expected, the most common types of abuse being verbal, invasion of privacy, physical assault and sexual abuse.

Researchers said instances of abuse occurred when clinical or contextual factors were involved, such as lower versus severe levels of cognitive impairment, residing in a dementia unit, and higher nurse aide caseload. Abuse problems often occur when nursing homes are understaffed to deal with adults with cognitive or psychiatric issues, especially delirium or dementia.

Most facilities were relatively large and researchers say all cases may not have been detected. The prevalence may be much higher since reporting relied on patient, staff and family member recall bias.

Study authors said the problem often occurs when patients with dementia and other neurodegenerative illnesses are put into communal living environments for the first time in decades.

The average patient age was 84 years old and 73% of cases involved women. About 16% of patients resided in a unit for dementia.

Researchers recommend family members look for rooms or units set aside for dementia patients or those prone to aggressive behaviors to help keep patients with neurocognitive issues separate from other patients.

“Strategies are urgently needed to better understand its causes so that prevention strategies can be developed,” wrote study authors.