Abuse is Difficult to Identify
When a resident has been abused, who is responsible? CNN interviews indicate a couple of factors that make identifying and reporting sexual abuse a challenge for residents and their family members:
- Residents who are targeted most often tend to have mental impairments, such as dementia and Alzheimer’s, or are blind. In response, they often don’t know what is happening and are too confused to identify their attacker. As a result, complaints are only filed when another employee of the home or a family member identifies the abuse and has evidence.
- Facilities are slow to investigate any reports for a few reasons. One, multiple reports can take away their funding, so they’ll make an attempt to hide evidence. Secondly, the home and police officers investigating often don’t believe a resident who complains of sexual abuse because of their health condition. As a result, a single caregiver often turns into a repeat abuser. In certain instances, the home blames the resident, claiming the individual has a history of making false allegations, is a “flirt” or hallucinates.
- Even when a facility identifies a repeat offender – who may have had to go through abuse training after a report – family members aren’t alerted. As a result, family members trusting in the home can’t make the decision to remove their loved one.
- Aides who are caught in the act don’t receive significant punishments. As CNN indicates, they may simply lose certification, but not face criminal charges or the home may keep the individual on after additional training.
States Investigate the Claims – But Don’t Keep Clear Records
Why are there no definitive statistics concerning sexual abuse in nursing homes? This lack of data can be attributed to how reports are handled and what facilities do when a resident or his or her family claims abuse occurred.
For one, claims are investigated at the state level by the Centers for Medicare and Medicaid Services. Data from investigations is used to rate homes and those with repeat offenses are often fined or have their federal funding withheld. However, this approach has several holes in it, including:
- States don’t differentiate sexual abuse from other forms, such as financial abuse. As a result, when family members look at CMS data, they can’t examine the percentage of sexual abuse claims a home actually has.
- As the CMS oversees roughly 15,000 homes nationally, homes that receive federal funding attempt to withhold reports, either intentionally botching an investigation or covering up evidence. In response, CNN found that about 1,000 nursing homes have been cited for mishandling investigations and failing to prevent rape, sexual assault and sexual abuse in their facilities since 2000. From this group, 100 received repeat citations.
- Not every complaint becomes a citation. Investigations might find a lack of evidence, which can result from workers washing bedsheets or requiring residents to take a shower to erase evidence. A home isn’t cited because there is nothing to substantiate a resident’s claim, thus it isn’t included in the CMS’ data.
- Those who would have the influence to report assault – the home’s employees – frequently don’t receive training to identify instances of patient sexual abuse.
Since 2000, over 16,000 complaints of sexual abuse and assault in long-term nursing facilities have been filed and resolved by the state long-term care ombudsmen. Between 2010 and 2015, data by the Administration for Community Living indicates that 226 homes were cited for failing to protect residents against sexual abuse. Of this total, 60 percent were fined and just 16 had their Medicare and Medicaid funding cut. CNN further found that, for the homes fined or having their funding withheld, CMS either cut the amount or only temporarily blocked the facility’s federal funds or was reluctant to close the home, as the residents would have no place to go.
In Connecticut, one location fined was Orange Health Care Center. In 2014, a report from the state Department of Public Health revealed an assault at the home involving two residents.
More recently, an aide at Wilton Meadows Health Care Facility was charged with fourth-degree sexual assault and three counts of second-degree assault. Reports indicate he targeted two of the home’s patients.
Profiles of Perpetrators and Victims
Within a facility’s environment, aides, nurses and other staff members were behind one-quarter of abuse allegations, occasionally filming the incidents or taking pictures with their phones and passing around the evidence. A smaller percentage involved visitors or unknown assailants.
When the home’s staff was involved, reports tended to involve more serious incidents. In certain cases, these reports showed that a group of employees would gang up on specific residents or that one worker would repeatedly assault a handful of patients. In nearly 80 percent of all cases, the aide committing the abuse was the patient’s direct caregiver.
As far as victims are concerned, past studies have shown that:
- The victim is often older.
- The victim has a physical disability or suffers from a mental impairment.
- Female patients are six times more likely to be victims of sexual abuse than male patients.
- Abuse is more likely to occur in a facility than in a home-care setting.
- Statistics show abuse tends to be greater in homes with a higher percentage of residents with dementia or a low patient-staff ratio.
- Only about 30 percent of victims over age 65 report their abuse to police.
- Nearly 30 percent of victims experienced sexual abuse in their home or the perpetrator’s home.
- Most victims tend to be socially isolated and are being neglected by both their caretaker and family members.
- Residents are more at risk if the home has no abuse prevention policy or has a history of citations for abuse and non-compliance.
Furthermore, a previous study conducted by the National Institute of Justice (NIJ) found that patients who were older and had no signs of physical trauma were less likely to be believed. As a result, their claim was less likely to result in a conviction.
What You Can Do
If your loved one is in a nursing home, it’s important to recognize the telltale signs of sexual abuse:
- Your loved one suddenly has a sexually transmitted disease (STD).
- They suddenly have a hard time sitting or walking.
- Reports of an unexplained pelvic injury.
- The inner thighs or genital area shows signs of bruising, bleeding or irritation, or your loved one experiences pain in this area.
- A high level of agitation.
- Your loved one seems withdrawn, is experiencing panic attacks or displays PTSD symptoms.
- He or she displays aggressive, inappropriate or unusual sexual behavior or seems to be in an inappropriate relationship with the alleged perpetrator.
- Suicide attempts.
If you believe your loved one is a victim of sexual abuse in a nursing home, we believe the facility must be held accountable. If you have a claim to pursue or are dealing with a home that refuses to listen to your loved one’s complaints, turn to our team at Trantolo & Trantolo for assistance.