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Is a Nursing Home Resident Just “Down,” or Is It Something Worse?

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In the popular imagination, nursing home abuse is visible and tangible, manifesting itself in cuts, bruises and scars, or obviously fearful, angry or withdrawn behavior on the part of a loved one. The reality, however, is that just as the physical abuse of elders is frequently hidden in plain sight, emotional and psychological abuse is even more easily obscured – with the scars often deeper.

Statistics compiled by the National Association of Nursing Home Attorneys suggest psychological abuse is the most common form of elder mistreatment. For its part, the National Center on Elder Abuse estimates the phenomenon impacts about 12% of seniors, but in a separate survey, close to half of nursing home staff acknowledged they had psychologically abused patients in the past. It is highly probable that even these higher figures only scratch the surface.

Any relationship with power dynamics involved is vulnerable to abuse. But for seniors in long-term care, the risk is especially great. Physical and mental weaknesses, combined with limited access to the world outside a facility, can leave them exposed to captive bullying, humiliation and threats. Here’s what to know about psychological abuse in long-term care, and what you can do to respond.

What Are the Signs of Psychological Abuse?

Psychological and emotional abuse can take shape in name-calling or belittling a senior, mocking or laughing at them, speaking to and treating them like a child, or threatening to isolate them from loved ones as leverage for compliance, which was an all too easy tactic during the coronavirus pandemic.

This form of abuse also includes more insidious tactics, such as taking and hiding personal possessions, and disorienting a senior with false or misleading information. It can overlap with physical abuse, such as verbally threatening a senior with violence or restraint. Once a pattern of abuse has been established, even a perpetrator’s body language or looks can become instruments of fear and control.

No single cause exists for psychological abuse in long-term care. While these facilities can be stressful environments with insufficient staffing levels, inconsistent procedures and poor training – especially around infection control – there is never an excuse for vulnerable seniors to become victims of such egregious cruelty.

What Can Be Done to Prevent Psychological Abuse?

As federal and state authorities begin to examine much-needed structural reforms to the long-term care system, additional safeguards specific to the prevention and treatment of psychological abuse are necessary inclusions.

There is a clear need for regular mental health screenings of nursing home residents, and to expand these procedures to include abuse detection, akin to the training that hospital emergency department staff receive. Patient behavior management and de-escalation training will also help nursing home staff keep their emotions under control while engaging with residents suffering from dementia and mental illness.

While these measures remain a work in progress, loved ones, members of seniors’ clinical teams, nursing home staff and members of the public alike hold individual responsibilities to prevent and protect.

Above all, the ubiquitous rule, “if you see something, say something,” should also be expanded to senses or hunches. A normally talkative, outgoing resident who seems unusually quiet, tense or short-tempered may be a victim, as could someone who avoids the presence or even discussion about a particular member of staff. Paying attention to how a resident talks about a potential abuser, with clues often between the lines of a conversation, can also yield valuable information.

If You Suspect a Senior Is Being Abused

It will safeguard a senior’s wellbeing, and could even save their life, if others who observe any kind of unusual behavior investigate those suspicions. If a situation is obviously serious, a long-term care ombudsman and/or law enforcement should become involved.

Often missed at first glance, psychological abuse is one of the more challenging forms of elder mistreatment to confront. But family members, friends and bystanders are far from powerless. By watching for signs, asking questions and remaining tethered to our loved ones, we can stamp out this silent crisis, case by case.

Do not delay getting legal advice if you believe your elderly loved one has become a psychological or emotional abuse victim. The experienced legal professionals at Jehl Law Group are here for you, and we’re just a consultation away.