A new study found resident-to-resident abuse to be highly prevalent in a group of New York nursing homes, highlighting an emerging area of focus among centers in Pennsylvania and other states.
The study, published Monday by the Annals of Internal Medicine, found that 20 percent of residents in 10 nursing homes had experienced some form of resident-to-resident mistreatment, ranging from screaming and swearing to physical and sexual abuse.
The study's authors wrote that their study is the first to use standardized and validated methods to assess resident-to-resident mistreatment amid increasing focus in the media on the issue. The authors suggest the attention could prompt improvements in the same way that focus on staff-to-resident mistreatment led to reforms in the 1970s. “Perhaps the most compelling ramification of these findings is that the traditional focus of violence mitigation in the nursing home — staff abuse of residents — may be disproportionate relative to the actual (people) involved in interpersonal mistreatment,” the authors wrote.
Verbal abuse was the most common form of abuse, affecting about 9 percent of residents, followed by a category that includes invasion of privacy and menacing gestures, according to the study results. About 5 percent experienced physical abuse, while 0.6 percent experienced sexual abuse.
“We are well aware that incidences such as this occur within facilities,” said Teresa Osborne, secretary of the Pennsylvania Department of Aging.
The department works to train nursing home staffers to be aware of resident-to-resident mistreatment, identify its causes and document it, Osborne said.
Verbal abuse can lead to physical abuse, and staffers are encouraged to take all forms of abuse seriously, she said.
“All of those issues, regardless of those factors, are taken quite seriously, because we have an obligation to ensure that all residents residing in nursing homes have a right to be treated with dignity and respect,” she said.
Residents were at higher risks of peer abuse if they lived in a dementia unit or received care from nurses with high caseloads, researchers found. Abuse was most common in residents' rooms, followed by dining areas and activity rooms or common areas. Rates of abuse were highest in the afternoon, followed by the morning and then during lunch.
“I think it might be indicative of some of the trends we see in long-term care in general,” W. Russell McDaid, president and CEO of industry trade group Pennsylvania Health Care Association, said of the study.
As people live longer, more are arriving at nursing homes with Alzheimer's disease or other forms of dementia, which makes their behavior more unpredictable, McDaid said. Nursing home workers should be trained to work with people with dementia, and Alzheimer's-specific units are essential, he said.
The study found that 407 of 2,011 residents experienced abuse at least once during one-month periods during which data were collected. Researchers collected data from both suburban and urban nursing homes ranging from 150 to 580 beds.
The study depended on resident and staff reporting of incidents, which subjects the results to recall bias, the authors note. They note that only three of the 407 incidents were detected by chart entries in medical records, raising concerns about how many instances of abuse go undocumented or unreported at nursing homes in general.
Both Osborne and McDaid emphasized the importance of visiting nursing homes to find the right fit for someone considering moving into one. Osborne encourages people to visit at different times of day, meet with staff, ask questions and find a suitable home.
“You want to go and visit yourself. Is this where my mom or dad would fit in?”
Wes Venteicher is a Tribune-Review staff writer. Reach him at 412-380-5676 or wventeicher@tribweb.com.
