Nursing Home Staff Shortage: Patient Neglect and Abuse (Video 2:07 mins.)

One reason I wrote Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is to relate, not only cozy stories that depict the positive side of my hospice volunteer experiences in nursing homes, but to also convey those seldom mentioned negative aspects in need of improvement. The reality, supported by research, is that the quality of life for all patients, whether at home or in institutions, depends on the context of their care. Among other variables, that context includes policy makers, staff, equipment, race, and location. That context also includes me, and that’s why I advocate for patients.

Book Excerpt:

“Sometimes a shortage in staff had harmful consequences for patients. This included being left in unchanged beds, not being fully clean, and not being assisted when help was required for eating. Some patients tried to feed themselves, using their hands when they couldn’t see their eating utensils. Patients waiting for help sometimes stared at their food while it turned cold. Those with depression or dementia often had little interest in food. They needed someone to motivate them throughout the meal.”

Staff shortages in nursing homes negatively impact patients around the country. There is no excuse for patient neglect and abuse, especially when it is criminal. According to the National Citizens' Coalition for Nursing Home Reform (NCCNHR), it is a violation of state and federal law for any person, including facility staff, volunteers, visitors, family members or guardians, or another resident, to neglect or abuse a resident.

Neglect and abuse can be reported to the following:

1) The nursing home’s administrator, director of nursing, and social worker
2) The state or local ombudsman
3) The local police or state law enforcement
4) A Protection and Advocacy or Adult Protective Services agency
5) The state survey agency that licenses and certifies nursing homes (often in the Health Department)
6) A citizen advocacy group, or other church or community group that visits regularly

This video about alleged patient neglect and abuse in some New York nursing homes indicates that critical staff shortages can be a contributing factor.

Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes
Hospice and Nursing Homes Blog

Nursing Home Neglect and Abuse

What causes a staff person in a nursing home to neglect or abuse a patient? There could be several reasons. But there is still no excuse for neglect or abuse. I once saw a patient slap a nurse aide so hard, I thought she would fall to the floor. To the nurse aide’s credit, she stopped, took a deep breath, and walked away. Another nurse aide took over. The patient, who had dementia, probably didn’t remember the incident later. I bring up this case to illustrate the kind of stress under which many staff members operate. Working in some nursing homes is not an easy job, especially when staff shortages and increased workloads are often the norm. But stress is not the only reason for neglect and abuse.

All staff members need ongoing training in patient care, as well as ongoing strategies for coping with the kinds of problems that are inherent to their positions. I know nursing home staff members who love their jobs and genuinely care about their patients’ well being. But working in a nursing home requires a special kind of person. Employees who have demonstrated an inability or unwillingness to perform their duties correctly should be held accountable and not allowed to continue working. The same goes for nursing homes that continue to get cited for violations.

Nursing home abuse includes behaviors such as residents being verbally degraded and physically punched, slapped, and even kicked by staff. Sexual abuse has also been reported. Nursing home residents are very vulnerable and sometimes cannot or will not report abuses. That’s why it is so important for caregivers and others to be to be watchful, protective advocates for patients, particularly those with dementia. They should look for signs of abuse, ask patients and other staff members questions, and vary the times of frequent visits.

Most of all, patient advocates should follow through until they get satisfactory results when abuse or neglect takes place. This can be accomplished by reporting what happened to appropriate authorities such as the nursing home administration, the state ombudsman, and the state health department that investigates complaints. Private legal action can be taken against the nursing home. Staff should be aware that certain forms of patient abuse are felonies that will result in prison time.

For more information, contact the Nursing Home Abuse and Neglect Resource Center.

Frances Shani Parker, Author
"Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes”
Hospice and Nursing Homes Blog