Any behavior that harms a resident’s emotional health, contentment, or their self-worth could be considered emotional nursing home abuse. Actions that fall under this category include giving a patient the “silent treatment,” isolating them from their relatives and friends, causing distress or pain through verbal or non-verbal actions, or treating them like a child. It could also include threats, humiliation, harassment, or intimidation.
These actions may not even be intentional. They could be the result of the caregiver being improperly trained, being ignorant of correct interactions, or simply being unable to deal with the stresses of his or her job. On the other hand, such actions might be the result of the caregiver attempting to punish the resident for some reason, such as being uncooperative.
It has also been found that physical abuse often accompanies psychological abuse, so patients are at risk of receiving a double dose of mistreatment. To place this problem in perspective, note that a random survey of nurses’ aides in nursing homes found that 40% admitted to at least one act of psychological abuse in the previous 12 months. This is a very broad category and it is very important to the resident’s mental health.
Although many researchers are in agreement that emotional abuse is very much under-reported, it is surprising to learn that physicians are part of the problem. Studies have reached the conclusion that physicians are less effective than other groups of professionals in identifying abuse, and that they are generally not aware of the legally mandated reporting. Additionally, they are often unaware of the many resources that are available to help them in this regard.
Because of the broad definitions in this category, it is difficult to accurately track the number of incidents that are actually occurring; however, by looking to the state agencies that investigate and prevent this sort of abuse, they all report that their caseloads are increasing.
This occurs when a patient is unreasonably confined to a particular area, such as his or her room, or a particular portion of the facility by the nursing home staff. Perhaps they feel the patient has been uncooperative, abusive or just difficult to work with. They may threaten the patient with the withholding of food or water, or removing crutches or a wheelchair from their access.
Withdrawal or Social Isolation
Another problem to be alert for is withdrawal or social isolation of patients. Stress among patients or between patients and an overworked staff can lead to a patient’s withdrawal or social isolation. This could also fall under emotional abuse. This behavior can be a symptom of abuse by staff or other residents and care should be taken to determine the cause.
Social isolation can come about when the patient refuses to participate in any of the available social activities, including watching television in a community setting, playing games, or participating in other group activities. It can also lead to withdrawal, where the person does not want to leave their room, speak to caregivers, other patients, or even relatives.
If withdrawal or social isolation does occur, the doctor may institute a combined therapy of drugs and psychiatric intervention. Before such treatment is applied, you should insist on an evaluation for non-medical evidence of abuse that may be causing your loved one to become withdrawn.
If you have any nursing home abuse questions or suspect nursing home abuse, contact us at 1-888-554-1010 for a confidential, no-cost consultation.
Centers for Disease Control and Prevention National Center on Elder Abuse, Administration on Aging The New England Journal of Medicine