Defining Resident Abuse within the Culture of Long-Term Care Institutions

Abstract

Although researchers have identified the presence of resident abuse within long-term carefacilities, it has not come under the same scrutiny as have other aspects of abuse against older adults. This is due, in part, to the difficulty in defining the phenomenon. The purpose of this study was to articulate a definition of resident abuse as perceived by registered nurses working in long-term care institutions. Ethnoscience was the method used to answer this question. The five categories of resident abuse characteristics--perception of hurtfelt by older residents, acts of omission or commission, context of care, intentional or unintentional, and behavioral clusters--that emerged through semistructured interviews and focus groups reflect the descriptions given by participants. Identifying a common definition of resident abuse suggests that assessment and intervention to reduce episodes of it are more likely to be effective.

Institutional Abuse of Older Adults: What We Know, What We Need to Know

“…The qualitative studies addressed staff labor appeals following allegations of abuse (Bigelow, 2007), financial abuse of mentally incompetent older adults (Bond, Cuddy, Dixon, Duncan, & Smith, 1999), and two studies of resident perceptions of abuse (Hirst, 2000(Hirst, , 2002. Another study (Bravo, Dubois, De Wals, Hebert, & Messier, 2002) that investigated the relationship between regulatory status, quality of care, and mortality was included because of its implications for elder abuse.…”

“…The degree of and type of abuse reported is a matter of what questions were asked and/or how answers were interpreted. Most studies do not stray from the common types of abuse, including physical, psychological, and financial abuse [e.g., Hirst (2000Hirst ( , 2002 in Canada; Furness (2006) in Great Britain; Despont & Rapin (2000), Thomas et al (2005) in France; Goergen (2001) in Germany; and Jogerst, Daly, & Hartz (2005) in the United States]. There is little agreement on definitions, so the rates reported vary widely.…”

Managing Resident-to-Resident Elder Mistreatment in Nursing Homes: The SEARCH Approach

“…In fact, incidents of yelling and insulting remarks by residents to each other were not seen as forms of abuse by nurse aides in a study by Castle (2012). Consequently, these incidents were not reported, leaving residents at potential risk (Hirst, 2002). CNAs are not experienced in managing aggressive residents who often require individualized intervention such as cognitive-behavioral therapy, validation therapy and/or time out (Gates et al, 2005).…”

The Stress of Caring: The Manifestation of Stress in the Nurse-Patient Relationship

“…However, this phenomenon has frequently been highlighted in the international literature on nursing (e.g. Hirst, 1999;Pillemer & Bachman-Prehn, 1991;Pillemer & Moore, 1989). These international studies focused primarily on patient abuse in the context of caring for the aged and for psychiatric patients.…”