Upholding Human Rights in Nursing Homes: Training Needs to Address Elder Abuse

Overview: Elder abuse is a critical issue for social work education and practice. This study identifies elder abuse training needs from a national sample of social services directors. Social work educators can develop students' practice skills within the nursing home environment to identify elder abuse and intervene appropriately.Proposal text:

Introduction: Elder abuse is a critical issue for social work education and practice. Elder abuse is a complex health and social issue that can take many forms and occurs across community-based and institutional settings around the world (WHO, 2021). The CDC defines elder abuse as “an intentional act or failure to act by a caregiver or another person in a relationship involving an expectation of trust that caused or creates a risk of harm to an older adult” (2021, p. 1). The CDC (2021) identifies different forms of elder abuse (e.g., physical abuse, sexual abuse, emotional or psychological abuse, and financial abuse, and neglect). The violence perpetuated has very serious implications for older people - their physical health, mental health, financial stability, and social well-being suffer as a result (WHO, 2021).

Evidence suggests that elder abuse is rampant in nursing homes. While federal and state authorities are responsible for addressing elder abuse in nursing homes, the social worker is uniquely responsible for addressing the psychosocial needs of nursing home residents (Bern-Klug et al., 2021). The risk of becoming a victim of elder abuse increases with individual-level factors that are common among people living in nursing homes, such as functional dependence/disability, poor physical health, cognitive impairment, poor mental health, and low income (WHO, 2021). For example, about half of all nursing home residents nationally are living with dementia, 46% have depression, and over 90% require assistance with activities of daily living such as bathing, dressing, and transfers into and out of bed (Harris-Kojetin et al., 2019, p. 22). Systematic reviews and meta-analyses have found alarmingly high rates of elder abuse in nursing homes and long-term care facilities, estimating that approximately 2 in 3 staff have committed abuse in the past year (e.g., Mogaka, Bistas, Bistas, 2020; Yon, Ramiro-Gonzalez, Mikton, et al., 2018). Research has also described a surge in elder abuse cases as a result of the COVID-19 pandemic (Chang & Levy, 2021).


Methods: Nationally representative data from the 2019 National Nursing Home Social Services Directors Survey (Bern-Klug et al., 2021) is summarized to describe what training is needed to better address elder abuse in nursing homes.

Findings: The majority of social services directors indicated a moderate or strong interest in receiving training on how to explain and support other staff within the following areas: (1) types of resident abuse, neglect, and/or exploitation by staff, residents, family and/or other visitors (75%); (2) establishing trust with a resident and/or family who feels mistreated by the nursing home or by a staff member (78%); and (3) interacting with visitors whose behaviors are perceived as threatening to residents or to staff (75%). Findings suggest a need to increase competencies in both the “basics” and more advanced practice skills.

Conclusion: Social workers must advocate to uphold the human rights of older adults at risk of elder abuse. Social work educators can provide greater emphasis on elder abuse in the curriculum, and develop evidence-based and context-specific training to respond to practitioners’ need for advanced practice training.