Strengthening Communities Where We Live, Work, and Play | Page 22

Understanding the Abuse Dynamic
in Long-Term Care Facilities

U.S. adults age 65 or older currently number 41.5 million and
make up 14% of the population. By 2030, the combination of
longer life spans and baby boomers will increase this number
to an estimated 72 million or 20% of Americans.
Among community-dwelling
older adults:
• Elder abuse affects one out
of 10.
• Among those with dementia, it
affects one out of every two.
• But, only one out of every
26 cases is reported to
community agencies.

While there is no national data
on elder abuse in long-term care
facilities, facility deficiency and
ombudsman reports suggest
it is serious and widespread. In
Michigan, families of residents in
nursing homes have reported that
24% of older adults have been
physically abused.

NEW FRONTIERS: ELDER ABUSE
AND FORENSIC NURSING
A Growing Problem for a Growing Population

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Assistant Professor Carolyn E. Ziminski
Pickering, PhD, RN, focuses her research on the
abuser in the multiple contexts of interactions
between the caregiver and patient. The
grounded theory project examines relationships
between worker safety and patient safety in
nursing homes. In these facilities, certified
nurse aides (CNA) are the 24/7 caregivers, but
they have little say in their work. With a focus
on occupational and safety issues, the project
will gather data from CNAs on their ability to
provide quality care, including poor quality and
unsafe care such as elder abuse and neglect.
It will also explore workplace violence, where
bullying among staff can impact standard
patient behavior.

Creating Interventions that Support
Nursing Staff
Once the variables relating to abuse are
better understood, policies and strategies can
be strengthened to prepare CNAs with more
relevant training, develop policies to improve
staff ratios and working conditions, and empower
them to have more control over their work.
Research findings will also help shape
curricula on elder abuse prevention at all
nursing education levels. Essential knowledge
and skills will better prepare RNs to care
for vulnerable older adults who have been
mistreated or are at high risk for mistreatment
by trusted others. This work reflects the NIH
mission to encourage creative discoveries and
innovative research.

The Role of Nurses in Reporting Abuse
Nurses are ethically and legally bound to
report suspected elder abuse. They need to be
able to recognize the types of abuse: physical,
sexual, emotional/psychological, abandonment,
financial/material exploitation, and neglect.
They are called upon to assess, diagnose,
and intervene, not only through reporting
but through providing care, recognizing that
intervention may need to include both the
abused and the abuser.

Assistant Professor
Carolyn E. Ziminski Pickering, PhD, RN
Experience and Inspiration
As a CNA working her way through
nursing school in long-term care facilities,
Pickering experienced firsthand the
underreported and complex issue of
elder abuse.
Research
Pickering received a Research Article
of the Year Award from the Journal of
Forensic Nursing for her article exploring
forensic implications of bruises. Her
current research project, The Influence
of Workplace: Violence on the Older
Adult Resident/Nurse Aide Caregiving
Relationship, is funded by the American
Nurses Foundation
Professional Organization Activity
As a member of the International
Association of Forensic Nurses and chair
of the research committee, Pickering is
helping draft their international research
agenda. Recognized as a leader in the
emerging field of Forensic Nursing, she
was appointed to the Advisory Committee
of the American Nurses Association
Professional Issues Panel on Workplace
Violence and Incivility.

MICHIGAN STATE UNIVERSITY COLLEGE OF NURSING • NURSING.MSU.EDU

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