Running head: MALTREATMENT OF ELDERS IN LONG-TERM CARE FACILITIES

Maltreatment of Elders in Long-Term Care Facilities

Name of Research Article: Psycho-social factors affecting elders maltreatment in long-term
care facilities by Natan, M. B., Lowenstein, A., & Eisikovits, Z. (2010)
Name of Supporting Article: Elder Maltreatment: A Review by Collins, K. A. (2006)
Michael Ayeni
821 322 385
For Sylvia Wojtalik
NURS 260
February 24, 2014

MALTREATMENT OF ELDERS IN LONG-TERM CARE FACILITIES

Maltreatment of elders in various long-term facilities can come in various forms and it
can be as a result of different factors. The articles Psycho-social factors affecting elders
maltreatment in long-term care facilities by Natan, M. B., Lowenstein, A., & Eisikovits, Z.
(2010) and Elder Maltreatment: A Review by Collins, K. A. (2006) both focus on the different
types of elders maltreatment and the different factors that can contribute to elders maltreatment.
The College of Nurses of Ontario (CNO) Therapeutic Nurse-Client Relationship, Revised 2006,
practice standard: Protecting the Client From Abuse document describes the various forms of
elders maltreatment and it also discusses some of the steps that can help to prevent elders
abuse. Understanding the various factors that can contribute to an elders maltreatment in
different long-term facilities can help nurses mitigate against the various forms of elders
maltreatments. According to the CNOs Therapeutic Nurse-Client Relationship practice standard
(2006), there are five different forms of abuse. Elders maltreatment can be inform of neglect or
it can either be financial, verbal, emotional, physical or sexual. This various forms of
maltreatment can occur both separately or simultaneously (Collins, 2010). The focus of this
article would be on the three different factors that can contribute to elders maltreatment as
identified by Natan et al. (2010). These factors which includes the presence of unprofessional
staffs, the vulnerability of the patient and the poor staffing management process employed by
different facilities would be discussed in this article. The implication of each of these
contributing factors to nursing practice and different mitigating strategies would also be
discussed.
First, unprofessional attitudes of staffs in long-term facilities can result in different forms
of elders maltreatment but physical abuse is the most prevalent form of elders maltreatment in
long-term facilities (Natan, Lowenstein, & Eisikovits, 2010). Physical abuse can be described as

MALTREATMENT OF ELDERS IN LONG-TERM CARE FACILITIES

an act perpetrated with the intention of creating pain or injury and it can include slapping, blunt
force trauma, traumatic alopecia, force feeding, bites, pinching and improper use of physical
restraints (Collins, 2010). Physical abuse by nursing staffs is usually as a result staff burn-out
and job pressure and this usually promotes negative attitudes towards work and it can also
encourage the lack of empathy towards elders (Natan, Lowenstein, & Eisikovits, 2010). The
nursing implication of not addressing the issue of increasing job pressure on nurses is that it
would lead to more nurses suffering from burn-out. Natan et al. (2010) argued that nursing staffs
who have been working longer at various long-term facility will be less likely to behave
violently towards the elderly because they have more positive attitudes. Hence, there is a need to
educate new and young staff nurses on how to handle work related stress and burnout.
Experienced nurses should also be encouraged through various means like seminars and short
lectures on the need to continue cultivating healthy practices that can help to reduce work related
stress. This will help reduce incidences of elder maltreatment resulting from unprofessional
attitudes of different nursing staffs.
Second, an increase in the level of vulnerability of an elder can expose such an elder to
various forms of maltreatment. According to Natan et al. (2010), elders with dementia have the
highest risk of maltreatment and the most common form of abuse that vulnerable elders suffer
from, is usually verbal and physical abuse. The increase in the vulnerability of an elder subjects
them to maltreatment because they are usually not able to report incidences of maltreatment.
The implication of the increase in the number of helpless elderly patient on nursing practice is
that more nurses would have to handle an increased number of very vulnerable patients. To
prevent and reduce maltreatment of elders therefore, staff nurses must constantly adhere to the
Standard Statement of the College of Nurses of Ontario (CNO) Therapeutic Nurse-Client

MALTREATMENT OF ELDERS IN LONG-TERM CARE FACILITIES

Relationship, Revised 2006, practice standard: Protecting the Client From Abuse document,
which requires nurses to always protect the client from harm by ensuring that abuse is
prevented, or stopped and reported. Therefore, nurses that do not uphold this Standard by
perpetrating or failing to report the maltreatment of an elder should be subjected to necessary
corrective actions. Ensuring that all nurses follow CNOs standard can therefore, help reduce the
occurrence of elder maltreatment especially with patients who are very vulnerable.
Third, poor staffing management process can also contribute to an increase in the
maltreatment of elders in various long-term facilities. Most facilities especially profit-seeking
long-term facilities usually have a low staff-patient ratio. These facilities tend to reduce the
number of nursing staff so as to save cost but they continue to admit more elderly patient so as to
increase revenue. These facilities also tend to have a very high staff turnover ratio because of the
usually poor condition associated with such facilities. This according to Natan et al. (2010) can
reduce the quality of patient care and it can also lead to a higher risk of elder maltreatment.
Elders in such facilities are more likely to experience neglect as a form abuse because nurses in
this facilities have more elderly patients in their care. The implication of poor staff management
in long-term care to nursing practice is that staff nurses working in such poor working
environment would tend to neglect or maltreat some elders in their care. Therefore, there is a
need to always monitor and ensure that long-term facilities have good staff management plans
and such plans must be continually evaluated and updated as required.
Conclusively, reviewing the articles Psycho-social factors affecting elders maltreatment
in long-term care facilities by Natan, M. B., Lowenstein, A., & Eisikovits (2010) and Elder
Maltreatment: A Review by Collins, K. A. (2006) has highlighted the fact that there are
different forms of elders maltreatment. The College of Nurses of Ontario (CNO) Therapeutic

MALTREATMENT OF ELDERS IN LONG-TERM CARE FACILITIES

Nurse-Client Relationship, Revised 2006, practice standard: Protecting the Client From Abuse
document, however listed the five different forms of elder maltreatment to include neglect,
financial, verbal, emotional, physical or sexual forms of maltreatment. This article also discussed
the various factors that increases the incidences of elder maltreatment in various long-term
facilities. Some of the factors identified includes the presence of unprofessional staffs, the
vulnerability of the patient and the poor staffing management process employed by different
facilities. This aforementioned factors, were discussed in a very detailed manner by this article.
The article also explored the implication of some of these factors on nursing practice and the
different mitigation actions that can help to reduce the occurrence of the different forms of
elders maltreatment. Elders maltreatment is very unethical and all staff nurses and student must
always protect their client especially the vulnerably and elderly by ensuring that they prevent, or
stop and report any incidence of maltreatment.

MALTREATMENT OF ELDERS IN LONG-TERM CARE FACILITIES

References
College of Nurses of Ontario (2006). Standards & Guidelines - Therapeutic Nurse-Client
Relationship practice standard: Protecting the Client From Abuse.
Retrieved February 23, 2014, from http://www.cno.org/en/learn-about-standardsguidelines/standards-and-guidelines/
Collins, K. A. (2006). Elder Maltreatment: A Review. Archives of Pathology & Laboratory
Medicine, 130(9), 1290-6. Retrieved from http://search.proquest.com/docview
Natan, M. B., Lowenstein, A., & Eisikovits, Z. (2010). Psychosocial factors affecting elders'
maltreatment in long-term care facilities. International Nursing Review, 57(1), 113-120.
Retrieved from http://web.a.ebscohost.com/ehost