Maltreatment of Patients in Nursing Homes: There Is No Safe Place

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Overview

"Abuse, although often not detected or reported, existed in every facility we surveyed. It is a serious problem."

Old, weak, and often cognitively impaired, nursing home patients can be easy targets for physical, psychological, material, and financial mistreatment at the hands of those entrusted with their care, safety, and well-being. Maltreatment of Patients in Nursing Homes: There Is No Safe Place examines the dark side of nursing homes, where not every employee has the commitment of Mother Theresa. This groundbreaking book applies criminological theory to help develop practical methods of controlling abuse and presents the results of the first and only nationwide study on the theft of patients’ belongings, a form of abuse too often ignored by the nursing home industry.

Maltreatment of Patients in Nursing Homes surveys employees, administrators, and family members of patients in 47 nursing homes throughout the United States. Their responses provide invaluable insights on a wide range of topics, including the social and psychological factors that cause different types of abuse, characteristics of nursing home patients and employees, the bureaucracy of nursing homes, victimization rates, workforce issues of nursing home aides, and federal regulations for nursing homes. The information gained from the surveys forms the basis for detailed recommendations for creating a safer environment and reducing all forms of abuse, including theft-prevention training programs, background checks and improved screening of potential employees, education and advocacy for current staff, and the reform of federal regulations.

Maltreatment of Patients in Nursing Homes examines:

  • types of physical abuse (restraints, sexual abuse, neglect)
  • the who, what, and why of nursing home theft
  • types of financial abuse (trust accounts, bank accounts, improper charges for services and drugs, identity theft)
  • types of psychological abuse (abandonment, segregation, childlike treatment, verbal abuse)
  • effects of psychological abuse (depression, learned helplessness, psychiatric disorders)
  • reasons for abuse by employees (staff turnover, job burnout, job dissatisfaction, caregiver stress)
One of the few books to deal with abuse of the elderly outside a domestic setting, Maltreatment of Patients in Nursing Homes: There Is No Safe Place interprets and analyzes abuse to provide new ways of thinking about this growing problem and new methods of preventing it from growing any more widespread.
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Editorial Reviews

Doody's Review Service
Reviewer: Marcia K Flesner, PhD, RN, MHCA (University of Missouri-Columbia)
Description: The book reports on a nationwide study of theft from nursing home patients, and discusses theories explaining why physical and psychological abuse occurs in nursing homes. The authors then offer practices to reduce the risk of abuse in nursing homes.
Purpose: The book's purpose is to report on a nationwide study of theft from patients in nursing homes; to discuss theories regarding abuse in nursing homes; and to suggest strategies to reduce abuse in nursing homes. Validating that theft and abuse does occur in nursing homes is important, because we cannot address a problem until we have a factual view of the problem. The authors discuss a topic that is rarely broached due to its sensitive nature.
Audience: The audience would be the management team of nursing homes. The authors are credible authorities; they performed the research, one has experience with the elderly and the other is a professor of criminal justice who has published extensively.
Features: The book relates the results of a nationwide study about misconduct in nursing homes in which 1,116 employees and 417 families returned surveys responding to questions about their experiences with theft in nursing homes. Two index scores, attitudes toward patients and maltreatment by patients were used, suggesting sources of motivation for theft from patients. The information would be of value to long term care management teams. The authors recommend reporting theft to local authorities as a strong deterrent to prevent repeat offenders from remaining employed in the long term care setting.
Assessment: When I saw the title, I was prepared to dislike the book. I did not want to accept the fact that "there is no safe place" in a nursing home. But the authors won me over as they discussed the motivations behind abuse and offered practices to reduce it. Unfortunately, as long as we ask humans to take care of vulnerable humans, we are faced with the possibility that misconduct will occur. The book offers a clear look at the problems of abuse and theft and offers ideas to reduce the risk in nursing homes.
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Product Details

Table of Contents

  • Preface
  • PART I: NURSING HOMES AND THEORIES OF ABUSE
  • Chapter 1. The Nature of Nursing Homes
  • Myths and Facts About Nursing Homes
  • How Nursing Homes Got Started
  • Nursing Homes As Bureaucracies
  • Nursing Homes As Total Institutions
  • Barriers to Nursing Home Abuse Research
  • Chapter 2. Nursing Aides: The Backbone of Care in Nursing Homes
  • Workforce Issues and Problems of Nursing Home Aides
  • Narratives of Nursing Home Aides
  • Chapter 3. Understanding Abuse
  • Why Nursing Homes May Be Good for Abusers
  • Nursing Homes and the Motivated Offender
  • Patients and Their Possessions As Suitable Targets
  • Guardianship in Nursing Homes
  • Countervailing Forces
  • Summary
  • PART II: NURSING HOME THEFT
  • Chapter 4. Employees and Theft
  • Results from the Survey of Employees
  • Conclusions About Employees
  • Chapter 5. The Victims and Their Families
  • Family Members’ Reports of Theft
  • What Is Stolen?
  • Conclusion
  • Chapter 6. Preventing and Reducing Theft
  • Theft Precautions for Patients
  • Theft Precautions for Nursing Homes
  • Reporting of Theft
  • Theft Prevention Training Programs
  • PART III: PHYSICAL AND MENTAL MALTREATMENT
  • Chapter 7. Physical Abuse and Neglect
  • Abandonment, Segregation, and Neglect
  • Government Reform Committee
  • Types of Physical Abuse
  • Sexual Abuse
  • Neglect
  • Chapter 8. Psychological Abuse and Neglect
  • Types of Psychological Abuse
  • Some Effects of Psychological Abuse
  • Neglect
  • Chapter 9. Reducing the Risk of Physical and Psychological Abuse
  • Screening Practices
  • Staff Education and Training
  • Advocacy
  • PART IV: FRAUD, REFORM, AND RECOMMENDATIONS
  • Chapter 10. Exploitation of Nursing Home Patients: Their Finances and Rights
  • Financial Abuse
  • Reform of Nursing Home Regulations
  • Chapter 11. Summary and Conclusions
  • Appendix. Methodology
  • Data Collection
  • Employee Questionnaires
  • Measuring Theft
  • Response Rates from the Survey of Employees
  • Victimization Survey
  • Family Members’ Questionnaire
  • Glossary
  • References
  • Index
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