Elder abuse detection in nursing facilities: using paid clinical competence to address the nation's shame.

Abstract

Each year, five million senior citizens are the victims of abuse in our country-and that figure is a likely underestimate. In California alone, it is estimated that over 225,000 seniors are abused annually. Nursing home residents are particularly vulnerable to abuse, with one-fifth to one-third of these institutions cited for abusive activities that result in actual harm. Regular violations of minimum care regulations by nursing homes have been documented in every state. Despite legal protections, as a practical matter, the review, assessment, and investigation of nursing home care and potential senior abuse is the primary responsibility of voluntary ombudsmen. These volunteers are responsible for regular visits and determination of nursing home quality and resident treatment. This Article contends that, despite their commitment to the cause, voluntary ombudsmen are not a sufficient cure for the scourge of elder abuse. Rather, clinically-trained personnel with legal knowledge must assume the role that lay volunteer ombudsmen are inappropriately expected to play. Use of clinical case managers, who have expertise in assessing clinical factors and can be trained in legal matters, offers significant potential to assist in the detection, and, further, reporting and prosecution of elder abuse. The author concludes that only through use of those with appropriate training and knowledge can the epidemic of elder abuse be effectively addressed.