As noted above, older people who live in a residential care facility are more likely to become the victim of one or more types of elder abuse than are individuals who are not living in a 24-hour care facility (NRC, 2003, p. 446). Other factors also increase the risk and make the elderly more vulnerable to abuse. Patients with dementia and depression are more susceptible to being abused than are healthy patients (Bitondo-Dyer, Pavlik, Murphy, & Hyman, 2000).
Two-thirds nursing home residents and 40% of patients in other types of residential care facilities suffer from dementia, Alzheimer’s disease, or some other disability that causes cognitive impairment (Hawkes, 2002, p. 1). There appears to be a high correlation between short-term memory loss and abuse risk among patients who do not have dementia (Shugarman, Fries, Wolf, and Morris, 2003, p. 27). Patients with cognitive impairments or impaired memory are at a double risk.
Not only does their condition render them relatively helpless and more vulnerable to abuse, but they are less likely to speak up on their own behalf and to report incidents of abuse. The inability of patients with dementia and other cognitive impairments to accurately assess and report their abuse has significant implications for those who operate residential care facilities, who must weigh the evidence and conclude whether the reports of abuse by an employee can be substantiated. In some cases, the reports may be valid and the employee may have been physically, emotionally, or otherwise abusive towards the patient.
In such cases, the facility may also be at risk of civil or criminal charges related to the case. In other cases, confused dementia patients may make false reports of abuse, falsely attributing their real or perceived injuries to the actions of an innocent employee. While every case of reported abuse should be taken seriously and should be thoroughly investigated, it is important for managers of health care facilities to collect as much information as possible before drawing any conclusions. It is perhaps significant that while research indicates that people in residential care facilities are more likely to be abused (NRC, 2003, p.
446), Gray-Vickrey (2004) found that in the overwhelming majority of abuse cases, the abuser was a member of the victim’s family and was not a staff member of a residential care facility. Increased age and female gender also appear to be risk factors for abuse. Abuse is two to three times more prevalent in people over age 80 than in those from ages 60 to 80 (Gray-Vickrey, p. 48. ) Women over the age of 80 are the most likely group to suffer from all forms of abuse (Gray-Vickery, 2004, p. 49). Age is also a valid predictor of whether an individual will live in a nursing home. During the 2000 Census, approximately 1.
1% of people age 65 to 74 lived in a nursing home; that number increased to 4. 7% for people ages 75 to 84, and to 18. 2% for people age 85 and older (Hetzel & Smith, 2001). These numbers reflect a decline in the number of nursing home residents during the 1990s, during which 5. 1% of people over the age of 65 and 24. 5% of people over the age of 85 lived in a nursing home (Hetzel & Smith, 2001). It should be noted, however, that the oldest members of the baby boom generation will not reach the age of 65 until 2011, after which the number of elderly people and the number of nursing home residents could both be expected to increase.