By Steve Guthart

It’s sad, disheartening and, above all, alarming: Abuse of the elderly in long-term care facilities is a persistent problem, and a costly one too. But taking the right precautionary measures will help prevent incidents while also improving your risk posture. 

Statistics paint the dismal picture. One study of residents at 2,000 facilities uncovered an abuse rate of 44 percent and a neglect rate of 95 percent. And, according to one insurer, sexual assaults, one form of elder abuse, had the second highest per claim average in nursing homes with claims averaging more than $250,000.

Better education as to what it is and who’s responsible is key. Elder abuse can take many forms – physical (including sexual and other violent acts), verbal, psychological or financial. Nursing home employees, family members and even other residents may all be responsible. And, if the facility also offers short-term rehab, mixing in different age groups, it compounds the resident-on-resident abuse potential. Further, if security is inadequate, you never know what kind of violence will walk in off the street. 

For facility operators, prevention is the cure and your proactivity will reduce potential claims, while also serving everyone’s best interests. Where to start? Try taking a deep dive into your environment to identify the risks. Here are five guidelines to help.

  1. Review trends in your facility. Reports should be analyzed for troublesome occurrences and their nature. This review should set your direction for preventative measures. 
  2. Educate your staff on how to recognize and prevent elder abuse. Rape is only one form of sexual abuse. Exhibitionists are a problem. So is unwanted touching and kissing. Your employees should be trained to recognize the danger signs and implement interventions. Common indicators include residents or employees who appear hostile or fearful, talk to themselves, yell obscenities or are non-responsive to a nurse’s questions. 
  3. Examine your work practices. Various types of controls will protect everyone. Monitor levels of staffing during meal breaks, for example, to ensure optimal staff/resident ratios. Discourage employees from working alone or in isolated places. 
  4. Make employee background checks mandatory.  Start with pre-employment screening. A history of violence is a reliable behavioral predictor. Red flags will include an arrest record for violent acts, DUIs or other bad behaviors.
  5. Assess the security of your facility’s environment. Even if it’s located in a low-crime area, certain measures are critical to ensure everyone’s safety. Entrances and doors should be kept locked and well lit. Halls, nooks and crannies need adequate lighting, too. Alarms should be located throughout the building, with working video monitors at all entrances. Staff should have photo IDs visible on their bodies. And a sign-in/sign-out process, ideally automated, must be rigorously followed. No visitors should be admitted without knowing who they are.

The reality is that prevention is the ultimate best practice. Taking measures like these show you’re doing all the right things that are reasonably possible to mitigate the risk of abuse of your residents. And that’s much of the battle in defending your organization against claims based on negligence. 

HUB International’s team of risk experts will work with your organization in assessing its risk posture for exposures to claims like elder abuse.