Verbal Abuse in Nursing Homes is a Serious Concern

It is reported that one in ten nursing home residents are verbally and/or emotionally abused during their nursing home stays. When an allegation of abuse is reported, it must, by law, be investigated.

Verbal abuse happens to a nursing home resident when a staff member, a family member or another resident says something to the resident that causes them to feel emotional pain, distress or fear. The approach used by a nursing home to confront verbal abuse from a staff member is quite different from the approach used with a resident’s family or with another resident. The concern for the resident is foremost in any approach, but when the alleged abuse is said to have come from a staff member whom a resident perceives as having a position of authority and power over them, it requires a more disciplinary approach.

In the case of a family member verbally abusing a resident, the facility can alleviate most of those situations through counseling with social services; and, if needed by having a staff person be present when that family member visits. Instances of resident to resident abuse allegations can usually be mitigated by separating the residents and controlling their interaction with one another. However, when a staff member says something abusive to a resident, and it is substantiated by other staff or alert residents, that staff person is first of all suspended, and is possibly terminated depending on the investigation outcome. If not terminated, the accused staff member and other staff are re-trained to emphasize the importance of retaining a non-abusive attitude even in the most trying circumstances.

New residents in a nursing home have a huge amount of adapting to do and the emotional trauma they experience in that regard is tremendous. They must now rely upon others for their physical care and emotional security. It is at this time that verbal abuse can be most destructive to a resident’s health and be as harmful as physical abuse. It can also be a time when the resident may be the one hurling verbal abuse at family, other residents and staff.

Probably the most common cause of verbal abuse is frustration and impatience, and one of the most common times when verbal abuse occurs in a nursing home is when a resident is eating, requires the presence of a staff member, and it takes what seems like forever. For a staff member that may be overburdened and short-handed, having the patience to allow a resident to eat at what seems to be and often is at a “snail’s pace” just because the resident’s care plan requires that a staff member be present while the resident eats can be very frustrating. Even family members may also grow frustrated and impatient in this same situation.

Maybe the staff member has four other residents to help with their eating,
Maybe there are 2 CNAs who called in sick and the staff member has to cover her assignment plus help fill-in for the absent staff,
Maybe the staff member is having a rough time with her marriage, or her children, or her car broke down and it is going to cost a whole week’s wages just to pay for it,
Maybe the visiting family member has an appointment to make and they didn’t allow enough time; and, they feel guilty because this is the first time they have been to visit in over a month.

Sometimes the resident is the verbal abuser and hurls very abusive statements at a staff member who is trying to care for them, and when the staff member talks back to them, what the resident hears and perceives can be different in word and tone that it actually was. It presents a kind of two-edged sword. Here is an example of that kind of verbal abuse accusation:

A resident reported to a nurse administrator that the med nurse had yelled and told her to, “Shut UP!” Yet, the med nurse gave a whole different account of the incident. She reported that the resident was pressing her to hurry and give her medications and when the med nurse said, “I’m sorry, it’s taking me a while, it’s my first time down this hallway and I have to read line by line.” The resident replied, “No it’s not, I see you down here a lot.” The med nurse replied, “I’ve been down here, but it’s my first time working this shift on this hall, and I have to read this line by line.” At that, the resident said, “Don’t you have two eyes?” When the med nurse picked up a tube of Asper Cream, the resident said, “That’s the wrong cream, don’t you know what you’re doing?” At that, the staff member reported that she said to the resident, “Please don’t talk to me like that. I’m trying.” Then the staff member finished the medication administration and left the room. When the resident’s roommate, who has a BIM score of 15 and who was in the room at the time, was interviewed, she denied hearing anyone being told to shut up. But, at the same time, the roommate did not recall anything else of what was said. Other staff indicated that they believed that the resident has not been herself lately. It seems that the resident had a history of difficult behavior, making frequent accusations and not liking it when new staff she did not know provided her care. So, the accusation was not upheld and the med nurse was reassigned to a different hall. The resident now has 2 staff members present during her care for her protection and protection of the staff. But, was the situation really and truly resolved?

Verbal abuse can be more difficult to spot than other types of abuse, because there are no visible signs. Residents and fellow staff members may also be unwilling to expose abusers. This may stem from fear or a desire for attention, even attention of an abusive nature. Since patients are dependent on staff and family members, patients may fear that their daily needs will not be met as retaliation if the abuse is exposed.

Common types of nursing home verbal abuse against residents include:

Yelling
Rude remarks
Insulting or mocking
Speaking disdainfully about patients to other staff members
Accusing and blaming
Trivializing concerns
Criticizing
Threatening

Whatever the reason, verbal abuse is never acceptable and must always be addressed and recognized for the potential psychological damage that it may cause to residents who are already emotionally fragile and often disoriented. In extreme situations, the stress that verbal abuse places on a resident can weaken their immune system and make them more susceptible to stress-related illnesses and conditions. It is also important to note that confirmed verbal abuse in nursing homes can result in formal citations and fines. It is one of the most commonly-cited types of emotional abuse that happens in nursing home.

One of the ways a nursing home can mitigate and reduce incidents of verbal abuse is through staff training and support. Med-Net Compliance’s E-learning modules cover a multitude of issues that can equip staff to better handle their personal stress and the stress from a demanding job.

To find out more, contact info@mednetconcepts.com.