MALTREATMENT IN THE ELDERLY 1

Student: Shona Leach

Student number: 822-836-243
Date: February 26, 2014

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Trust can be loosely defined as relying on the integrity, or surety of a person: As
healthcare professionals that is the type of confidence that is place on nurses, by the clients
and their extended family. To do anything short of working diligently to live up to that trust is
simply an outrage. M. Ben Natans article Psycho-social factors affecting elders maltreatment
in long term care facilities, is an article that takes and in-depth look at some of the different
aspects of elder maltreatment. The pivotal aim of this article was to discuss different variables
that constitute to maltreatment of the elderly in the nursing home. In addition this article also
identified and examined a vast number of reasoning as to why some of these healthcare
providers engaged in the unbecoming way that they did. All this in attempt to understand,
shed light and hopefully inspire change and growth in this dark area of health care. As
nursing students who are about to be engulfed in this fast passed world of client care, it is
important to become aware and informed of what maltreatment and abuse encompasses.
When some hear these words they simple think of the physical not realizing that so much
more fall under these categories; such as sexual abuse, finical abuse, emotional abuse,
neglect, and so much more. Nurses and other members of the health care team need to
actively work to implement ways to continually provide proficient care, and decrease
potential and real risk to their patients. Some different strategies that can be collectively built
on are providing better education and resources to every member of the team that comes into
contact with patients, early assessment and diagnosis of patients that are at risk for
maltreatment, and maintaining better working conditions. We need to shine light on these
grim issues, and become informed of the various ways we can violate the very people that
rely on us, without even being cognisant of our failings.

Being such a culturally diverse country as Canada there is a great need for all
members of the healthcare team to be fully knowledgeable as to acceptable norms within the

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professional settings. Nursing aides are often the most prevalent sector at the long-term care
facilities; these workers do not receive orderly professional training (Natan, 2010).
Considering these findings its is more than fair to say that there is a great need for better
training, and resources so that all workers can perform optimal care. Moreover with educated
workers the odds are better that should the incident arise they will be prepared to notice the
signs and symptom of maltreatment. Even better the number of incidence would be in
decline. Its hard to prevent against something when you are not clear as to what exactly you
are looking for. I can say that I believed that I had a good grasp as to what would and would
not be considered abuse before reading this article. However I can now admit that in some
areas my eyes are more opened, because like many others I was not conscious of the many
way abuse or maltreatment could happen. When I heard those words (abuse/maltreatment)
my mind instantly went to the physical, which is just one of few elder abuse is not limited
solely to acts which leave physical scars; rather acts that result in any form of harm (Payne,
2002). CNO states that Nurses protects the client from harm by ensuring that abuse is
prevented, or stopped and reported. As nurses we have an ethical and legal responsibility to
our clients that we are to adhere to. When looking at how a long-term care facility is operated
it necessary to make this a whole team issue because there are so many people that come into
contact with the clients daily from family members to sitters, nurses aides, and much more.
When something is spoken of regularly it becomes important, and the speaker and
listeners begin to gain a deeper understanding and respect for what is being discussed. This is
why I feel that in the log-term care facility the issue of maltreatment and abuse need to
become vital part of routine assessment where it is included in the nursing process especially
for patients who are at high risk. Studies prove that disabled patients and elders with
dementia have the highest risk of maltreatment (Natan, 2010). Its unfortunate that people
that are in a profession that is built on caring for others would monopolize and build on the

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downfalls of the people in need of their compassion and empathy. It is even more
disheartening when one considers that these illnesses are out of the patients control. CNO
states that the goal of professional practice is to obtain the best possible outcome for clients.
With this statement it is hard to understand how nurses could become so far detached from
some of the core values that they swore to follow.
Studies indicate that the work environment has a crucial effect on maltreatment of
elders in long-term care facilities (Natan, 2010). The fast passed, high demand, and
strenuous environment that healthcare professions work in is already a tough one. When you
add in short staff, unfit facilities, limited or in sufficient supplies or equipment, the already
difficult working conditions gets almost unsuitable. Great work needs to go into maintain a
balanced environment that in conducive to working, where nurses, and other members of the
team can perform their duties effectively. How can one perform proper care when they do
not have the staff or the resources to do what needs to be done? I have been in the health care
setting before where a client had to wait and a half hour to get his broken colostomy bag
changed because there wasnt enough in stock, and the previous nurse neglected to notify the
proper personnel according to nurses lack of nursing staff leads to decisions resulting in
elder maltreatment (Nathan,2010).
Since the publication of both articles that were reviewed, society has taken a bigger
stance on the issue of elderly maltreatment, which is encouraging. This proves that we are
moving in the right direction Payne writes that elder abuse when first conceptualized, was
defined as a social and medical problem rather than a crime problem. The fact that more
people are speaking and writing on maltreatment of the elderly is not only raising awareness
to the issue but also promoting change, and informing the general public. Actively investing
in areas that will promote lasting change in the area of elder mistreatment in long-term care
facilities, is a sure way to keep moving forward and build on how far we have come with

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regards to the issue. Again providing better education, more resources at staffs disposal,
making maltreatment a talked about topic, and providing rich working environment are just a
few things that i took away from the articles that I read. Through knowledge we turn away
from ignorance therefore we need to continually educated and inform ourselves of the issues
that touch us as a society.

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References
College of Nurses of Ontario(CNO) (2006). Therapeutic Nurse-Client Relationship, Revised
2006.Practice Standards, 9-10. Retrieved
fromhttp://www.cno.org/Global/docs/prac/41033_Therapeutic.pdf
College of Nurses of Ontario(CNO) (2011). RN and RPN Practice: The Client, the Nurse and
the Environment.Practice Guidlines. Retrieved from
http://www.cno.org/Global/docs/prac/41062.pdf
Natan, M.B., Lownstein, A., & Eisikovits, Z. (2010). Psycho-social factors affecting elders
maltreatment in long-term care facilities. International Nursing Review, 57(1), 113120.
Payne, B. K. (2002). An integrated understanding of elder abuse and neglect. Journal of
Criminal Justice, 30(6), 535?547. Retrieved from
http://www.sciencedirect.com/science/article/pii/S0047235202001757