Nursing home abuse is harrowing and likely more widespread than we now know.  It also has many facets.  A recent study covered by CBS news received national attention not only because of the landmark nature of its work but also because of its findings.  The study found that nursing home abuse is not just a staffing issue, but that many elderly adults in nursing homes face abusive behavior from their fellow residents.

About one in five nursing home residents experience verbal or physical abuse from their roommates or other residents. This is the first large, systemic study of resident-to-resident elder mistreatment in the Annals of Internal Medicine and it was conducted by EAS Board member Dr. Mark Lachs.

The hidden and varied nature of abuse in nursing homes can make it difficult to clearly understand and address.  A comprehensive article in the Sacramento Bee “Sexual Abuse in Nursing Homes and Care Facilities” takes a closer look at these challenges by analyzing the difficulties in exposing sexual assault in nursing homes as well as the reasons for these difficulties. “It hides behind reporting systems that fail to catalog such complaints separately from other forms of abuse that afflict the elderly and disabled. It hides behind business incentives that drive facility owners to conceal abuse.” 

In Maryland, business incentives also led local nursing homes to discharge patients when their Medicare coverage ran out and without ensuring that they would be relocated to a safe environment — even dropping patients off at homeless shelters. The Washington Post article “Md. attorney general says nursing homes kicked out patients to boost Medicare payments  asserts that this was all done in the name of freeing beds for new Medicare patients who could pay more.

Until we fully understand the scope of elder abuse taking place in nursing homes, support will need to be provided for additional research to be conducted to better understand how to create solutions.  However, the good news is that some easy-to-implement solutions may be possible immediately.  In the CBS interview about resident-to-resident abuse Dr. Mark Lachs notes that simple changes in environment, such as the creation of protected private spaces for patients with dementia or removing environmental factors like loud noises known to aggravate dementia patients could help immediately. 

Education of nursing home staff will also be key.  Teaching staff improved ways to interact with patients as well as how to report issues when they arise between residents or involving fellow staff members will provide the foundation for a new and improved nursing home culture.  This new culture will provide a strong foundation for abuse being discovered, addressed and minimized.