Types of Abuse and Neglect

Types of Abuse

• Verbal Abuse: Includes critical or insulting remarks made verbally, in writing, or through gestures, often using technology.
• Forms of verbal abuse:
  • Screaming or cursing
  • Insults targeting race, ethnicity, religion, or sexual orientation
  • Threats of harm or frightening statements
• Sexual Abuse: Defined as non-consensual sexual contact, encompassing:
  • Sexual comments or remarks
  • Inappropriate touching or grabbing
  • Sexual assault, including rape or coerced nudity
  • Unauthorized sexual recordings
  • Forced observation of sexual acts
• Exploitation: Taking advantage of a resident for personal gain, examples include:
  • Using a resident's belongings or money without consent
  • Identity theft or unauthorized purchases on behalf of the resident

Technology Abuse

• Involves posting or sharing private information about a resident on social media or internet platforms.

Neglect

• Defined as the failure to provide adequate medical or personal care to a resident, potentially causing:
  • Physical harm
  • Pain
  • Mental anguish
  • Emotional distress
• Examples of neglect:
  • Failing to assist residents in getting dressed or out of bed
  • Leaving residents unattended in unsafe situations

Resident’s Bill of Rights

• Must be prominently displayed in care facilities.
• Residents or their guardians should receive a copy upon admission, ensuring:
  • Right to voice grievances without fear of retaliation
  • Safety during conflicts between residents
  • Accurate and immediate reporting of conflicts to healthcare staff
• The State Ombudsman assists in resolving complaints between residents and facilities.

Definition of Abuse

• Intentional actions that harm or injure another person, which can include:
  • Physical, psychological, verbal, elder, and financial abuse
  • Sexual assault or rape
  • Abuse via technology

Forms of Physical and Mental Abuse

• Physical Abuse: Includes harmful physical actions such as:
  • Hitting, kicking, grabbing, scratching
  • Any threatening gestures or behaviors
• Mental Abuse: Involves conduct causing humiliation or fear, such as:
  • Yelling or threatening isolation
  • Deprivation of care or family contact
  • Sharing humiliating images or videos

Vulnerable Adults

• May receive services from licensed agencies, often in family settings where they may struggle to report abuse or neglect.

Patient Self-Determination Act (PSDA)

• Federal law established in 1991, requiring facilities to inform residents of their treatment choices and rights.
• Residents should declare if they have a living will or durable power of attorney for healthcare.

Care Approaches

• Task-Oriented Care:
  • Focuses on completing specific tasks, often resulting in rigid schedules.
  • Can lead to residents experiencing loneliness and lack of engagement.
• Person-Centered Care:
  • Prioritizes individual resident choices in daily activities.
  • Caregivers maintain consistency and have more decision-making authority.
  • Encourages a home-like environment with flexible meal and activity schedules.

Conclusion

• Understanding various forms of abuse and neglect is crucial in providing ethical care and maintaining the dignity of residents in healthcare facilities.

Federal and State Regulations for Nursing Assistants

• Omnibus Budget and Reconciliation Act (OBRA) 1987: Establishes standards for Nursing Assistant (NA) training and registration, identifying required skills and minimum requirements.
• Standards of Care: Set for all long-term care facility residents; mandated annual surveys to ensure standard compliance implemented by state agencies.
• Background Checks: Individuals must complete a background study and fingerprinting, with disqualifying information available on the Department of Human Services (DHS) website; disqualified individuals cannot provide direct care.

Personal Qualifications for Nursing Assistants

• Appropriate Behavior Traits:
  • Honesty, patience, caring, courteousness, dependability, accountability, and respectfulness essential for NAs.
• Positive Attitude:
  • Show self-respect, cooperation, maturity, and high standards in duty.
• Personal Health:
  • Maintain good health to avoid injuries, ensure personal hygiene, and wear appropriate work attire.

Productive Work Habits for Nursing Assistants

• Role Definition: Care provided under direct nurse supervision for both male and female residents; services for vulnerable adults available through licensed agencies.

Patient Self-Determination Act (PSDA)

• PSDA Overview: Federal law since 1991 that requires facilities to inform residents of their rights regarding treatment options.
• Advance Directives: Residents should indicate presence of living wills or durable powers of attorney for health care.

Task-Oriented Care vs. Person-Centered Care

• Task-Oriented Care:
  • Focuses on routine tasks and one-size-fits-all approach; can lead to fragmented care and disconnection from residents.
• Person-Centered Care:
  • Emphasizes individual preferences, choices, and needs; fosters a home-like environment with flexibility in daily routines.

Non-Verbal Communication

• Types of Non-Verbal Communication:
  • Facial expressions, posture, gestures, touch, and pacing; significant for conveying emotions and thoughts.
• Awareness in Interactions:
  • Non-verbal cues often communicate more than words; important to recognize this in resident interactions.

Effective Communication

• Key Elements:
  • Effective communication occurs when the intended message is successfully received.
• Techniques:
  • Minimize background noise, maintain body language awareness, speak clearly, and engage in active listening.
• Barriers to Communication:
  • Includes lack of attention, background noise, misunderstandings, and inappropriate environments.

Care Plans

• Development Process:
  • Created during care conferences with resident and family participation; essential to understand goals and tasks assigned to care team members.
• NA Contributions:
  • NAs play a crucial role by making observations and reporting physical, mental, or emotional changes to nursing staff.

Incident Reporting

• Definition of an Incident:
  • Any event outside routine care that may endanger residents or staff; must be reported immediately to the charge nurse.
• Examples of Incidents:
  • Include lost personal items, accidents, injuries, or theft.
• NA Responsibilities:
  • Maintain safe environments, adhere to policies, and provide accurate incident reports without bias.

Record Keeping Responsibilities

• Documentation Duties:
  • NAs are responsible for recording resident care, behavior changes, and daily activities through various forms.
• Chart Importance:
  • Resident charts are legal documents; entries must be accurate, legible, and safeguard resident confidentiality.
• Common Abbreviations and Terminology:
  • Communication with nursing staff involves standard abbreviations and medical terms essential for clarity in documentation.