Australian Service Providers' Responses to Elder Abuse

This article presents the findings of a survey of 175 service providers in Sydney, Australia, the majority of whom were doctors in general practice. Thirty-two percent of respondents had encountered cases of physical, psychological, or financial abuse or caregiver neglect of people 65 years old and over. Community nurses and social/welfare workers were particularly likely to have encountered cases of abuse. The findings suggest that coordination between health, welfare, and criminal justice agencies in Australia needs improvement. Policies to address elder abuse and neglect in Australia are in their infancy. As a priority governments should work towards effective training of professionals and appropriate intervention guidelines for services.     

The Effect of Care Setting on Elder Abuse: Results from a Michigan Survey

This study compares abuse rates for elders age 60 and older in three care settings: nursing home, paid home care, and assisted living. The results are based on a 2005 random-digit dial survey of relatives of, or those responsible for, a person in long-term care. Nursing homes have the highest rates of all types of abuse, although paid home care has a relatively high rate of verbal abuse and assisted living has an unexpected high rate of neglect. Even when adjusting for health conditions, care setting is a significant factor in both caretaking and neglect abuses. Moving from paid home care to nursing homes is shown to more than triple the odds of neglect. Furthermore, when computing abuse rates by care setting for persons with specified health conditions, nursing homes no longer have the highest abuse rates.     

Intimacy boundaries: between mental health nurses & psychiatric patients

This was the first research study in Canada to explore intimacy boundary violations and sexual misconduct between nurses (both RNs and registered psychiatric nurses) and patients. Using a researcher-generated survey, a total of 923 mental health nurses commented on their sexual attraction to patients, and dating and sexual intercourse patterns with patients. The findings indicated that very few nurses had dated or engaged in sexual intercourse with discharged patients, and the few nurses who had done so tended to be younger men prepared at the registered psychiatric nursing diploma level. A small number of nurses believed it was permissible to have a sexual relationship with a patient while the patient was hospitalized, but none reported having a current relationship. Given the severity of this intimacy boundary violation, nurses need to be educated regarding the serious and dangerous psychiatric effects that can result for patients from engaging in a sexual relationship with nurses. The Code of Ethics of the Canadian Nurses Association and nurses' obligation to follow it needs to be reinforced. Nurses engaging in intimacy boundary violations are vulnerable to patient-initiated lawsuits.     

Employee Assistance Implications for Appalachian Working-Class Women from the Alcohol and Stress Research Project

ABSTRACT

The Southern highlands are culturally isolated from the rest of the South and its traditional residents have distinct alcohol abuse and stress problems that are reflected in the highest alcohol related arrest statistics in America. In 1990 the University of Tennessee Medical Center undertook a survey of nursing assistants and licensed practical nurses in the appalachian region of Tennessee. Two-thirds of the respondents reported alcohol related problems that affected family life, particularly during holidays. Nearly half (49%) reported stress resulting from family members' use of alcohol and/or drugs, 8% report that their mate is a problem drinker, and 29% report that their father was a problem drinker or alcoholic. Yet, only 7% use the EAR Ideas for bridging the gap are discussed.     

Physical abuse of older adults in nursing homes: a random sample survey of adults with an elderly family member in a nursing home

Few empirical studies have focused on elder abuse in nursing home settings. The present study investigated the prevalence and risk factors of staff physical abuse among elderly individuals receiving nursing home care in Michigan. A random sample of 452 adults with elderly relatives, older than 65 years, and in nursing home care completed a telephone survey regarding elder abuse and neglect experienced by this elder family member in the care setting. Some 24.3% of respondents reported at least one incident of physical abuse by nursing home staff. A logistic regression model was used to estimate the importance of various risk factors in nursing home abuse. Limitations in activities of daily living (ADLs), older adult behavioral difficulties, and previous victimization by nonstaff perpetrators were associated with a greater likelihood of physical abuse. Interventions that address these risk factors may be effective in reducing older adult physical abuse in nursing homes. Attention to the contextual or ecological character of nursing home abuse is essential, particularly in light of the findings of this study.     

Physical Abuse of Older Adults in Nursing Homes: A Random Sample Survey of Adults With an Elderly Family Member in a Nursing Home

Few empirical studies have focused on elder abuse in nursing home settings. The present study investigated the prevalence and risk factors of staff physical abuse among elderly individuals receiving nursing home care in Michigan. A random sample of 452 adults with elderly relatives, older than 65 years, and in nursing home care completed a telephone survey regarding elder abuse and neglect experienced by this elder family member in the care setting. Some 24.3% of respondents reported at least one incident of physical abuse by nursing home staff. A logistic regression model was used to estimate the importance of various risk factors in nursing home abuse. Limitations in activities of daily living (ADLs), older adult behavioral difficulties, and previous victimization by nonstaff perpetrators were associated with a greater likelihood of physical abuse. Interventions that address these risk factors may be effective in reducing older adult physical abuse in nursing homes. Attention to the contextual or ecological character of nursing home abuse is essential, particularly in light of the findings of this study.     

Family Members' Reports of Abuse in Michigan Nursing Homes

The objective of this article is to describe abuse and neglect of adults age 65 and older in Michigan nursing homes, as reported by members of their families. Using list-assisted random-digit dialing, data on abuse and neglect for a 12-month period were collected from individuals who had a relative age 65 or older in a Michigan nursing home. Of the nursing home residents represented in this analysis, the majority were female, Caucasian, and widowed. Neglect and caretaking mistreatment were the most frequent types of abuse reported. Comparison of these data with data from the National Ombudsman Reporting System suggests that family members constitute a sensitive source of data on abuse in nursing homes.     

Hypnosis for pain management

Nurses are in a key position to learn and use hypnosis with patients to reduce pain and enhance self-esteem. However, most nurses lack knowledge about the clinical effectiveness of hypnosis and may seek continuing education to become skilled in its use. Painful procedures, treatments, or diseases remain a major nursing challenge, and nurses need complementary ways to relieve pain from surgery, tumors, injuries, and chemotherapy. This article examines the evidence base related to hypnosis for pain management, as well as how to assess and educate patients about hypnosis.     

Assessment for and response to adverse childhood experiences

Literature strongly suggests that early exposure to adverse childhood experiences (ACEs) disrupts crucial normal stages of childhood development and predisposes these individuals to subsequent psychiatric sequelae. Even with these data, little is found in nursing literature that discusses ACEs and their impact on adult mental health. Therefore, the purpose of this article is to address how nurses approach communication with clients about and assess for traumatic life experiences. In addition, screening measures for ACEs will be presented, along with discussion about ethical responsibilities of health professionals and researchers in asking about abuse.     

Assessing the Level of Elder Abuse Knowledge Preprofessionals Possess: Implications for the Further Development of University Curriculum

Elder abuse is a multifaceted problemthat requires interdisciplinary prevention and intervention strategies. An important question that arises is whether professionals are adequately prepared to address elder abuse in this collaborative network. Unfortunately, no studies have been conducted to assess the varying levels of knowledge that preprofessionals enrolled in university courses possess with regard to elder abuse. To fill this void, this study assesses the levels of elder abuse awareness among social work, nursing, health professions, and criminal justice students. Specific attention is given to determining whether there are differences in the amount of exposure to elder abuse literature across the disciplines. The study involves the analysis of survey data collected from 202 students enrolled in health and human sciences classes at a large university. Results show that none of the preprofessional groups, on average, reported knowing enough about elder abuse. Implications for future practice and research are provided.     

Understanding of elder abuse and neglect among health care professionals in Malaysia: An exploratory survey

ABSTRACT

Elder abuse and neglect (EAN) is a hidden public health challenge for Malaysia. This cross-sectional survey studied the awareness of EAN among 148 doctors and nurses from two neighboring states in Malaysia using a self-administered questionnaire exploring their knowledge, perceptions, practices, and experience concerning EAN. Both doctors and nurses demonstrated poor understanding of signs of EAN and exhibited misperceptions on reporting requirements. Both groups perceived EAN as a national burden and reporting it as their responsibility; but most felt they had not been trained to diagnose it. Many were unsure of procedures and whether their own intervention could be effective. Only four (nurses) of 41 participants who suspected abuse during the past year reported the cases. Targeted education and uniform protocols are mandatory to ensure best practice with regards to EAN. Further research is crucial to extend this inquiry into the broader health care workforce.     

Job demands,emotional dissonance and elderly abuse: The moderating role of organizational resources

ABSTRACT

The present study focuses on elderly abuse committed by caregivers in nursing homes. It aimed at a better understanding of neglect and abusive behaviors by considering the working context and the emotional dissonance of these professionals. To achieve this goal, direct effects of emotional dissonance, job demands (workload and emotional demands) and organizational resources (high-quality relationships with the colleagues and the supervisor) on neglect and abusive behaviors were analyzed. Moreover, the moderating role of organizational resources was explored. The study was conducted among 481 nurses and healthcare assistants from different French nursing homes. Overall, results contributed to the literature by pointing out the impact of emotional dissonance and caregivers’ working context on neglect and abusive behaviors. Moreover, results highlighted the moderating effect of high-quality relationships with the colleagues and the supervisor and give rise to potential implications in preventing elderly abuse in nursing homes.     

Scope of practice issues in forensic nursing

1. There is significant role variation, across the Western world, in relation to how forensic nurses practice. 2. The authors conducted a pilot survey of forensic nurses in Australia, New Zealand, the United States, and the United Kingdom to examine forensic nursing practice, role definition, and role boundaries. 3. Issues arising from the data include the visibility of forensic nurses, the client group, forensic-specific education, and role development.     

Physicians' and Nurses' Responses to Abuse of the Elderly:

A survey of Alabama physicians in the fields of internal medicine, family practice and general practice and a survey of nurses in the areas of home health and community health care were conducted in 1987 and 1988 concerning elder abuse and Alabma's thirteen-year-old mandatory reporting/protective services law. The authors found that phyisicans did not understand the law but nurses did. Physicians' attitudes toward the law were ambivalent. Nurses had more negative attitudes toward the law. These attitudes appeared to be based on poor response by authorities to earlier reports.     

The Influence of Agency Staffing on Quality of Care in Nursing Homes

ABSTRACT

Data from a large sample of nursing homes were used to examine the cross-sectional association between use of agency staff, regular staff, and quality. Agency use data came from a survey conducted in 2003 (N?=?1071 nursing homes). The agency and regular staff measures were for nurse aides, licensed practical nurses, and registered nurses. We used a single quality factor constructed from the 14 quality measures in Nursing Home Compare. More agency nurse aides resulted in a smaller increase in quality, compared to the use of an equivalent number of regular nurse aides. Agency registered nurse staff were associated with better quality factor scores, especially in the presence of high levels of regular licensed practical nurses. Our results have policy and practice implications, the most significant of which is that agency registered nurses may be beneficial in a wide variety of circumstances, whereas agency nurse aides and licensed practical nurses should be used with caution.     

Simulation to enhance care of patients with psychiatric and behavioral issues: use in clinical settings

Nurses with a medical-surgical clinical focus often care for patients with psychiatric and behavioral issues in acute care hospitals. This article describes how hospital staff and nursing and theater department faculty joined forces to develop realistic simulated psychiatric scenarios for use by practicing nurses.     

Evaluation of a Training to Reduce Provider Bias Toward Pregnant Patients With Substance Abuse

The objective of this article is not to present a scientific or systematic study, but to provide an initial framework for designing a training workshop to enhance health practitioners’ (nurses, social workers, physicians, etc.) knowledge regarding substance abuse treatment and to decrease their bias toward substance-abusing women, particularly pregnant women in rural communities. We incorporated the 4 Transdisciplinary Foundations from the Substance Abuse and Mental Health Services Administration Competencies Model, with specific competencies targeted that related to provider bias. After the conference, 52 of the 70 participants completed a questionnaire to self-assess knowledge level and confidence in skill related to substance abuse management. Participant mean scores were statistically significantly higher following the conference than 1 week prior (p < .001) in the area of “gender difference with substance abuse,” moving from an average of 2.6 to 4.5 on a 5-point Likert scale. Our conference was successful in increasing attendees’ knowledge about gender difference and substance abuse among pregnant patients.     

Health care professionals' perspectives on barriers to elder abuse detection and reporting in primary care settings

The purpose of this study was to explore health care professionals' perspectives on elder abuse to achieve a better understanding of the problems of reporting and to generate ideas for improving the detection and reporting process. Through a mailed survey, nurses, physicians, and social workers were invited to participate in an interview. Nine nurses, 8 physicians, and 6 social workers were interviewed, and thematic analysis was used to identify the following core themes: preconceptions, assessment, interpretation, systems, and knowledge and education. Participants suggested a reorganization of the external reporting system. More frequent and pragmatic education is necessary to strengthen practical knowledge about elder abuse.     

Preceptorship: a shared journey between practice & education

Creative new approaches must be developed to attract new graduate and transitioning nurses to psychiatric-mental health nursing. In this article, we present a collaborative nurse preceptor program between a clinical practice agency and a university college of nursing faculty group. The preceptorship was designed to facilitate recruitment and retention of new graduate and transitioning nurses into a community-based, psychiatric-mental health agency. This process could be applied in any practice setting to address issues of recruitment and retention. Over the course of more than 2 years, the program has resulted in a 70% retention rate of new and transitioning nurses in the agency; of particular note is the 100% retention of new baccalaureate graduates. This program has positively affected the agency, the nurse preceptors, and the new graduate and transitioning nurse preceptees. We describe the collaborative development and implementation of the preceptor program designed to enhance recruitment and retention of new graduate nurses and nurses transitioning from other specialty areas into community-based psychiatric-mental health nursing practice.