Elder abuse and neglect: an overlooked patient safety issue. A focus group study of nursing home leaders’ perceptions of elder abuse and neglect

Abstract

Background:The definition and understanding of elder abuse and neglect in nursing homes can vary in differentjurisdictions as well as among health care staff, researchers, family members and residents themselves. Differentunderstandings of what constitutes abuse and its severity make it difficult to compare findings in the literature onelder abuse in nursing homes and complicate identification, reporting, and managing the problem. Knowledgeabout nursing home leaders’perceptions of elder abuse and neglect is of particular interest since theirunderstanding of the phenomenon will affect what they signal to staff as important to report and how theyinvestigate adverse events to ensure residents’safety. The aim of the study was to explore nursing home leaders’perceptions of elder abuse and neglect.Methods:A qualitative exploratory study with six focus group interviews with 28 nursing home leaders in the roleof care managers was conducted. Nursing home leaders’perceptions of different types of abuse within differentsituations were explored. The constant comparative method was used to analyse the data.Results:The results of this study indicate that elder abuse and neglect are an overlooked patient safety issue. Threeanalytical categories emerged from the analyses: 1) Abuse from co-residents:‘A normal part of nursing home life’;resident-to-resident aggression appeared to be so commonplace that care leaders perceived it as normal and hadno strategy for handling it; 2) Abuse from relatives:‘A private affair’; relatives with abusive behaviour visiting nursinghomes residents was described as difficult and something that should be kept between the resident and therelatives; 3) Abuse from direct-care staff:‘An unthinkable event’; staff-to-resident abuse was considered to bedifficult to talk about and viewed as not being in accordance with the leaders’trust in their employees.