Recognizing and Reducing Elderly Abuse in Long Term Care Facilities

Elder abuse is a hidden but growing problem in the United States, exacerbated by an aging population, longer life spans, changes in family structures, and the increased use of institutional care for the elderly (Levine, 2003). It has been estimated that as many as 2 million Americans over the age of 65 have been abused, mistreated, or exploited by someone in a caregiver position (National Research Council [NRC], 2003, p. 9). Conservative estimates of the number of abuse cases indicates a prevalence of between 2 and 10 percent (Branch, 2001). Other research indicates that the prevalence of elder abuse may be even higher.

Jogerst, et al. , reported that elder abuse rates from across the United States range from 4. 5 to 14. 6 per 1,000 elders (Jogerst, Daly, Brining, Dawson, Schmuch, & Ingram, 2003, p. 1394). Some of this abuse, tragically, occurs at the hands of spouses, adult children, and other family members (U. S. Department of Health and Human Services Administration on Aging, 2004). Other cases of abuse occur in residential facilities. Older people who live in residential care facilities are at a greater risk of abuse than those who are living with family members or who are living alone (NRC, 2003, p. 446).

The number of older people receiving long-term residential care will increase as the baby boom generation retires and grows older. If current trends continue, this increased number of elderly will make elder abuse could be expected to become a more common problem for the facilities that care for older patients. In addition to the moral and ethical mandates to treat older people with dignity, care, and respect, there are specific laws that are designed to protect the elderly. These legal requirements compel agencies and managers to ensure that the elderly are not abused or neglected by the employees of residential facilities.

The purpose of this paper is to uncover the potential legal liabilities for residential care facilities in cases of elder abuse and to show how a total quality management (TQM) approach could reduce the potential for elder abuse and improve the quality of patient care. Importance of this research This research is important because it could improve the quality of patient care while reducing the potential legal liabilities for residential care facilities. The potential for charges of elder abuse can be expected to increase as the number of patients who reside in residential care facilities increases.

At the time of the 2000 U. S. Census, approximately 4. 5 percent of Americans age 65 and over, roughly 1. 5 million people, lived in a nursing home facility (Hetzel and Smith, 2001, p. 7). Another 900,000 to one million people live in other types of residential care facilities, including assisted living facilities (Hawkes, 2002). This number is expected to increase over the next several decades. The number of Americans over the age of 65 is expected to grow from 35 million in 2000 to 86. 7 million by the year 2050 (He, Sengupta, Velkoff, & DeBarros, 2005, p.

12). Even if the prevalence of abuse does not increase, the actual number of elder abuse cases will continue to grow as the population grows older and more Americans move into the 65+ age bracket and into residential facilities. This unfortunate trend of increases in reported cases of abuse has already been identified in the research on elder abuse. Between 2000 and 2005, there was a 19. 7% increase in the number of reported cases of elder abuse (Teaster, Dugar, Mendiondo, Abner, Cecil, & Otto, 2006).

As noted above, Levine (2003) described several possible factors behind this increase in the number of elder abuse cases reported. Changes in social norms and expectations that occurred during the coming of age of the baby boom generation, including an increased awareness of the rights of the elderly and the disabled and a greater appreciation for the importance of reporting incidents of all types of abuse in general, may make aging baby boomers more likely to report incidences of abuse that occur in residential facilities.

Inconsistencies in the legal definition of what constitutes abuse may also affect the prevalence of abuse that is reported and the potential liability for an agency in a given state. States in which there are laws that specifically define what constitutes the mistreatment of the elderly have a higher rate of reported cases of elder abuse, although there is no evidence to support the theory that actual elder abuse in any given state would be different from such abuse in any other state (Jogerst, Daly, Brining, Dawson, Schmuch, & Ingram, 2003, p.

2134). While this increased tendency to report may have the benefit of reducing the number of cases of intentional and unintentional elder abuse, it will also undoubtedly increase the need for human resource managers at residential care facilities to provide additional training and support for their employees to help to protect the institution from allegations of abuse.

From a legal liability perspective, it is worth noting that the increased awareness of elder abuse may increase the potential for lawsuits against service providers and other liabilities for the facilities that care for this population, even in cases in which the abuse was unintentional or the allegations of abuse were inaccurate.

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