Are Your Nursing Assistants in the Know About Abuse & Neglect?

Abuse and neglect are serious problems in our communities and in our institutions. People are most at risk for abuse and neglect when they are unable to take care of themselves. Can your nursing assistants name the two groups of people that are least able to care for themselves? Do they know the difference between abuse and neglect? Here is some basic information you can share with the CNAs at your workplace:

What Exactly is Abuse?

Abuse is some action by a trusted individual that causes physical or emotional harm to the victim. There are a number of different kinds of abuse including:

• Physical abuse (including sexual abuse)


• Emotional abuse


• Financial abuse

What Exactly is Neglect?

Neglect is when someone fails to do things that are necessary to meet the needs of a child or an elderly person. There are two types of neglect:

• 
  Passive neglect is when people don't mean to do harm. Usually, this is because of ignorance--they just don't know any better.


• 
  Active neglect is when people know better and still fail to do what is needed for the care of the child or elderly person.

Where Do Abuse and Neglect Happen?

Abuse and neglect happen in every community around the United States. Every day, there are children and elderly people being abused in their own homes. The abuser is usually a family member, often someone with psychological problems.

Abuse and neglect can also happen in an institutional setting, such as a day care center or a nursing home. The most common type of mistreatment in institutions is neglect. Often, these situations occur because the staff is overworked, stressed out or poorly trained.

Understanding Child Abuse

Child abuse can happen in any type of family-small, large, rich, poor, white, black, etc. It can also happen to children of all ages.

Infants and toddlers are more likely than older children to be seriously injured or killed by child abuse. Abuse to adolescents might go unrecognized, since teenagers might try to hide the problem.

Most often, children are abused by their families or guardians, but there are cases of children being abused by day care workers or other caregivers.

Understanding Elder Abuse

Elder abuse is defined as harm done to persons over the age of 65 by someone who is in a position of being trusted.

There are two types of elder abuse. Domestic elder abuse happens in the person's home. Institutional elder abuse occurs in a nursing home or other long term care setting.

Even if a caregiver is trying to help, it can be considered abusive if they use enough force to cause unnecessary pain or injury to an elderly person.

We can only guess at the number of elderly who are abused every year. The best estimate is that there are about 5 million cases per year, but authorities say that only about 750,000 of them are reported. Elders don't always report the abuse because they are:

• Afraid that the abuser will find out and be angry.


• Afraid that the authorities might take their family members away.


• Ashamed that their family member is abusing them.

If You Report Your Suspicions...

You may be asked some of the following questions:

• Is the client in immediate danger?


• Is the client in need of emergency medical treatment?


• Does the client have any current medical problems?


• What is the client's current living situation?


• Have you seen or heard incidents of yelling, hitting or other abusive behavior?


• Do you know the identity of the abuser?

To Avoid Being Charged with Abuse or Neglect

NEVER:

• Ignore your clients' requests for food, water or bathroom needs-unless what they are asking for is against physician or nursing orders. (For example, you would have to say no to a diabetic client begging you for some chocolate cake or a client on fluid restriction asking for a third glass of water.)


• Keep quiet if the abuser is a coworker. While it may seem like you are "squealing" on a coworker, if you stay quiet you could be guilty of neglect. You will be helping both the client and the coworker if you speak up.


• Take your personal problems out on the clients. Leave your problems at home.


• Let "difficult" clients get the better of you. Think of how you would feel if you had to trade places with them. Treat them with kindness and lots of patience!


• Threaten or make fun of a client. Don't stand quietly by while a coworker does it either.


• Document that "the client is eating fine" if it's not true.


• "Freak out" if a client or family member accuses you of abuse when you know you didn't do anything wrong. Discuss the situation with your supervisor, telling him or her all the facts.

A Final Word

Studies have shown that 93% of nursing assistants have seen or heard of a client being mistreated by a family member or a coworker. You and your coworkers have to work together to prevent abuse and neglect. All fifty states have laws about reporting abuse and neglect, but the laws are different in each state. Check with your supervisor to learn about the abuse and neglect laws where you work.

And, remember! It is not a violation of your client's confidentiality for you to give information about the client to the people responsible for investigating abuse and neglect allegations.