Despite federal and state laws intended to safeguard residents, abuse and neglect in nursing homes is widespread. An estimated 1 in 20 nursing home residents has been the victim of negligence or abuse, yet only 1 in 14 cases ever get reported to authorities.
In nursing homes, neglect occurs when a caregiver refuses or fails to provide basic needs such as food or drink, shelter, health care or protection to an older adult who is vulnerable. Signs of neglect include malnutrition, dehydration, bedsores, poor hygiene and unsanitary living conditions. Other common forms of abuse in nursing homes include resident-to-resident, psychological, sexual and financial abuse.
Why inadequate staffing often leads to poor health outcomes
Unfortunately, people may not have a clear understanding of what constitutes elder abuse and therefore may have difficulty identifying when it occurs. And, victims may be too scared to report abuse or neglect, even to those they trust.
While intentional abuse in nursing homes does happen, the more common fault behind the large number of nursing home injuries and deaths is unintended negligence. Most nursing homes are operated by corporations that are in business to make a profit.
Nursing homes are severely understaffed and staff members are poorly trained. Studies show that more than half of nursing homes are below the suggested levels for nurses’ aide staffing and 1 in 4 are below the suggested staffing levels for total licensed staff.
The impact on residents with low RN numbers
Residents in nursing homes are more vulnerable than they used to be, and the complexity of health issues has increased significantly. Nursing home residents tend to have significant functional and/or cognitive limitations and multiple chronic conditions. Residents’ conditions can change suddenly, and registered nurses (RNs) are the only qualified nurses on staff to determine the best course of action for treatment. Those decisions must be made within minutes.
Yet, nursing homes are severely lacking in around-the-clock RN coverage, and federal regulations only require nursing homes receiving Medicare and/or Medicaid funding to have an RN on staff 8 hours, 7 days a week. Only seven states require 24-hour RN coverage in nursing homes: Connecticut, Delaware, District of Columbia, Hawaii, Maryland, Rhode Island and Tennessee. Research has shown that low RN staffing levels are associated with negative health outcomes such as increased occurrences of pressure ulcers and use of antipsychotic drugs.
In addition to low RN staffing, nursing homes are consistently understaffed. In our own practice, we have seen that time and again nurses’ aides provide most of the needed care, yet they are the lowest paid and least trained staff members. Low pay and work overload often result in caregiver burnout, poor morale and attendance, and high turnover rates. The residents pay the price in the form of inferior care and adverse health outcomes. In the end, nursing home administrators can be guilty of trying to maximize profits at the expense of residents’ health and safety.
To avoid having your loved one in a center that is understaffed, be sure to conduct a thorough review of potential nursing homes. Though not perfect, the current publicly available resources are great places to start your research, so that you can be well equipped to make a decision to avoid the type of center that will provide the wrong kind of care.