For those completely dependent on others for their daily care needs, the threat of potential retaliation is enough to totally silence them. The threat of staff retaliation for complaining about care within care facilities like nursing homes is not new. Since the 1960s studies and reports have detailed the nature of the staff/resident relationship and how intimidation and retaliation are, unfortunately, common. More recently, the Long Term Care Community Coalition (LTCCC) released a study on this exact topic in which they spoke with real residents.
The Threats
CMS defines psychological abuse as “verbal or nonverbal behaviors that inflict anguish, mental pain, or distress on an older adult.” Any sort of direct threat or intimidation falls under the category of psychological abuse and is experienced by care facility residents across the country. Abusive staff may, on top of their physical abuse, then psychologically abuse the resident by threatening to abuse them again if they file a report.
The LTCCC also found cases of residents being threatened with eviction for complaining about policy violations. In the LTCCC report they mention a study by the Atlanta Long-Term Care Ombudsman Program, The Silenced Voice Speaks Out.
“‘44% of the residents who had seen abuse of other residents did not report it.’ Of those residents, half did not report it due to fear of retaliation.”
In nursing homes, individuals are incredibly vulnerable, often relying heavily on staff for day-to-day activities and care. Any threat, no matter how small, has a huge impact on whether or not a resident feels safe reporting an issue or filing a complaint. If they fear further abuse, eviction, or any other sort of decline in care, they will not report their abuse which can lead to worse conditions or even death.
The Impact of Abuse
According to the Nursing Home Abuse Center there are many reasons for abuse to occur to begin with, including:
“Burnout
Staff members may have to work long hours, and dealing with residents’ needs can be physically and emotionally taxing. Instead of letting out their frustrations in a healthy way, staff members may verbally or physically lash out at residents.
Greed
Staff members may try to steal life savings or other financial assets of wealthy nursing home residents by getting close to them, forging checks, or taking their credit cards.
Lack of Supervision
A lack of supervision can cause staff members to be inattentive, meaning a resident could face significant neglect for hours or even days at a time.
Understaffing
If a nursing home has staffing shortages, it can place great stress on current employees. According to the Centers for Medicaid and Medicare Services (CMS), a lower ratio of nurses to residents can have a huge impact on the overall health care a nursing facility provides.
Corporate Decisions
Corporations that run multiple nursing homes often try to maximize profits, potentially leading to a number of problems. For example, a nursing home may hire staff members with no experience at a cheaper rate and fail to properly train or monitor them, making nursing home abuse more likely.”
Some additional stats from the Nursing Home Abuse Center include the fact that “seniors who were physically abused had a 300% greater risk of prematurely dying” and “in 2013, over 9,700 complaints about nursing home abuse were filed in the U.S. The most common type of complaint involved physical abuse.” These are significant numbers. They indicate that abuse in nursing homes is quite common. If abuse goes unreported, then the problems—underlying and otherwise—cannot be solved.
It is vital that staff intimidation and threats which lead to fewer abuse reports be investigated. And the LTCCC report is a great place to start.
Abuse Reports Strangled by Fear
A 2007 study done by the University of Connecticut’s Center on Aging found that “roughly one-fourth of the residents interviewed in that study reported worrying about retaliation if they were to report a complaint or concern.” (from the LTCCC report)
The LTCCC report aimed to add the voices of real residents to their study to identify the ways fear of retaliation suppresses abuse reports. Some of the testimony they gathered included:
- A resident initially told a social worker that she was screamed at and called a liar by staff, but later declined to speak about the incident with a surveyor. She explained, “I talked to someone about it and that just caused trouble and I am not going to cause trouble.” She added, “My condemning her is my fault. I am not saying more.”
- A resident was worried he would be “starved out for talking to state surveyors” if he reported physical abuse. Another resident told the surveyor, “What am I supposed to do when you leave? I still must live here. I don’t want to talk anymore.”
- A staff member told a resident to go to bed against her wish and made the following threat, “If you don’t go now, I won’t help you during the night shift.”
- A staff member told a resident’s family, “You better not call state (regulatory services) or it will be worse for the residents.”
- A resident was afraid of voicing grievances “because it backfires on you…staff became aggressive (angry, pushy, forceful, intimidating, and loud).”
These are just some of the findings of the LTCCC report. In all of these cases the abuse goes unreported because the residents, who often have nowhere else to go, fear that their living conditions will worsen and their abuse will continue or worsen. This fear is all too common and must be a focus for resident advocates, ombudsmen, and family.
Report Abuse
To report abuse, call 911 for immediate medical help, as well as the Nursing Home Abuse Center (877-567-2165) for assistance in making your report.
If you or a loved one have been the victim of abuse or neglect, call Gharibian Law (877-460-1187) for a free consultation and the best legal representation.
