Prevention of Elder Mistreatment in Nursing Homes: Competencies for Direct-Care Staff

Existing training on elder mistreatment in nursing homes focuses on detection and reporting of abuse, with little training specifically targeted toward prevention of mistreatment before it occurs. We used qualitative interviews with nursing home staff, policy makers, and related professionals to identify training needs. Based on participant accounts, we drafted a number of competencies essential for caregiver training to prevent mistreatment in nursing homes. Competencies include those dealing with definitions and policies, risks for mistreatment, communication and respect in relationships with residents, and development of a cooperative work environment. Competencies are discussed along with illustrative examples, and implications for practice and policy are addressed.     

Step-Down Multiple Comparison Procedures Using Medians and Permutation Tests

Richter and McCann (2007 Richter , S. J. , McCann , M. H. ( 2007 ). Multiple comparisons using medians and permutation tests . Journal of Modern Applied Statistical Methods 6 ( 2 ): 399 – 412 . [Google Scholar]) presented a median-based multiple comparison procedure for assessing evidence of group location differences. The sampling distribution was based on the permutation distribution of the maximum median difference among all pairs, and provides strong control of the FWE. This idea is extended to develop a step-down procedure for comparing group locations. The new step-down procedure exploits logical dependencies between pairwise hypotheses and provides greater power than the single-step procedure, while still maintaining strong FWE control. The new procedure can also be a more powerful alternative to existing methods based on means, especially for heavy-tailed distributions.