Elder abuse in Norwegian nursing homes: a cross-sectional exploratory study

Abstract

Background: Elder abuse is a global public health and human rights problem that is predicted to increase as many countries experience a rapid growth in their population of older adults. Elder abuse undermines an older person's well-being and is associated with a range of serious health consequences. In institutional care settings, older residents are particularly vulnerable and hence at higher risk of being abused, but few countries have explored the extent and nature of this phenomenon in national studies. The aim of this study is to estimate the prevalence of observed and perpetrated staff-to-resident abuse in Norwegian nursing homes. Methods: We conducted a cross-sectional exploratory study of nursing staff in 100 randomly drawn Norwegian nursing homes. Nursing staff completed a pen and paper survey measuring how often during the past year they had observed staff commit acts of neglect and psychological, physical, financial/material, and sexual abuse towards residents. They also reported how often they had perpetrated acts of abuse themselves, and these rates were disaggregated by nursing staff's gender, age and education. Results: Of 3693 nursing staff (response rate 60.1%), 76% had observed one or more incidents of elder abuse during the past year, and 60.3% reported they had perpetrated one or more incidents of abuse in the same period. Psychological abuse and neglect were most commonly reported. Male staff reported more acts of physical abuse, while female staff reported more acts of neglect. Higher education of staff was associated with higher rates of selfreported psychological abuse, physical abuse and neglect. Conclusions: This first national survey of staff in Norwegian nursing homes is one of the largest studies globally estimating the prevalence of elder abuse in institutional settings. Overall, we found staff-to-resident abuse to be relatively common, and our findings propose a need for preventive strategies to improve the quality of life and safety of residents in Norwegian nursing homes.

Nurse-patient interaction and self-transcendence: assets for a meaningful life in nursing home residents?

“…Along with competent pain and symptom management, the nature of the nurse-patient interaction in long-term NH care is crucial. Frustration, suffering, hopelessness, meaninglessness and depression result from not being attended to or treated with indifference, and thereby violating individuals' sense of worthiness [113,114] which negatively impact residents' mental and physical symptoms or ailments [29,112]. Possibly, older adults' self-acceptance and thereby their sense of self-worth and value can be strengthened by active listening, recognizing and empowering the uniqueness of this person whose subjective experiences are taken seriously and respected, all of which supporting global wellbeing.…”

Resident-to-resident aggression in Norwegian nursing homes: a cross-sectional exploratory study

“…In this article we will present findings on resident-to-resident aggression. The prevalence of staffto-resident abuse is reported elsewhere [37].…”

“…The remaining 3693 participants were included in the analysis, giving an analytic response rate of 58.3%. The flowchart of randomisation and recruitment is shown in Botngård et al [37].…”

“…To the best of our knowledge, no other instruments exist that have measured both staff-to-resident abuse and resident-to-resident aggression in the same study, which was the purpose of this national survey of Norwegian nursing home staff. The description of the original questionnaire [35], translation process and modification of survey instrument, and the pilot study is described in our article of staff-to-resident abuse [37]. The final survey questionnaire contained 23 items measuring how often staff had observed residents committing acts of verbal aggression (7 items), physical aggression (7 items), material aggression (4 items), and sexual aggression (5 items) towards co-residents during the past year, with the following ordinal scale: "Never", "Once", "2-5 times", "6-10 times", and "More than 10 times".…”

React and act: a qualitative study of how nursing home leaders follow up on staff-to-resident abuse

“…Leaders of these institutions have a responsibility to ensure that residents' human rights are protected, and that residents are safe and free from harm [9,10]. However, research have found high rates of staff-to-resident abuse in nursing homes [11][12][13].…”