Physical and Sexual Assault
Any abuse is tragic. Sexual abuse of vulnerable persons is reprehensible and inexcusable. The statistics are disheartening. The only hope is that we can hold accountable the nursing homes and their employees when they violate the laws.
The following information provides some statistics and details about sexual and physical abuse in nursing homes.
How often are nursing home residents physically or sexually assaulted?
- A study of Medicaid Fraud Reports revealed that almost 10% of nursing home abuse cases involved sexual assault. (Payne, B., & Civoic, R. (1996). An Empirical Examination of the Characteristics, Consequences, and Causes of Elder Abuse in Nursing Homes. Journal of Elder Abuse and Neglect, 7(4), 61-74.)
- Residents in long-term care settings are especially vulnerable to abuse, neglect, and exploitation, as they often have dementia (Dyer, Pavlick, Murphy, & Hyman, 2000; Pillemer & Finklehor, 1988; Wolf & Pillemer, 1989).
- Sexual predators know older people with disabilities are easy prey. Many nursing home residents are vulnerable people with disabilities. People with disabilities are 1.5 to 5 times more at risk of suffering a sexual assault than members of the general population. (Sobsey, D. (1994). Violence and abuse in the lives of people with disabilities: The end of silent acceptance. Baltimore: Paul H. Brookes.)
- One study reports that 15 out of 20 sexual assaults of nursing home residents were committed by nursing home staff. (Burgess, A.W. (2000) Sexual predators in nursing homes. Journal of Psychosocial Nursing & Mental Health Services, 38(8), 26-35)
- A 2003 study found an “overwhelming number of identified perpetrators were facility residents aged 70 and over.” This study calls for appropriate staffing levels based on resident needs and “the necessity of correct…monitoring of residents in nursing homes.” (Teaster, P.B., & Roberto, K.A. (2003). Sexual abuse of older women living in nursing homes. Journal of Gerontological Social Work. 40(4), 105-119.
- A 2002 General Accounting Office (GAO) report noted intolerable levels of physical and sexual abuse in nursing homes. (General Accounting Office. (2002). Nursing homes: More can be done to protect residents from abuse. Washington, D.C., U.S. General Accounting Office.)
- Eleven out of 20 nursing home residents died of trauma within the first year following an attack. (Burgess, A.W. (2000). Sexual predators in nursing homes. Journal of Psychosocial Nursing & Mental Health Services, 38(8), 26-35.)
Nursing home residents and families should be educated about physical and sexual assault.
Residents and families need to know that sexual assault does occur in nursing homes and assisted living residences. Residents and families should be prepared for both prevention and detection of sexual assault.
What is sexual assault?
When a person is physically forced into sexual contact, threatened, manipulated, and/or tricked into sexual contact.
Rape is sex by force without consent.
A range of sexual behavior may be involved in the offense. These include:
- “Hands-Off” offenses – This type of offense may include exhibitionism; voyeuristic activity; forcing an individual to view pornographic materials; sexual harassment and threats.
- “Hands-On" offenses – This type of offense may include kissing; touching/molesting the breasts, genitals, or buttocks; oral/genital contact and penetration of vagina or rectum with penis, fingers, or object.
- Harmful genital practices – This type of offense includes unwarranted, intrusive, and/or painful procedures in caring for the genitals or rectal area. This includes application or insertion of creams, ointments, thermometers, enemas, catheters, fingers, soap or objects when not medically prescribed and unnecessary for the health and well being of the individual. Perpetrators may appear obsessed with the behavior, claim that the harmful practices are required for health or hygiene reasons, or may be reluctant to stop when instructed to do so by health care professionals.
What is sexual assault?
- They are perceived as easy targets
- Seen as less likely to report sexual assault
- Their reports of sexual assault are less likely to be believed
- Physical or mental condition may make them unable to report sexual assault
- They are isolated from family and friends
- They have low self esteem due to poverty, changing roles, decline in health
- They have reduced physical resilience
- They have increased dependence
Signs and Symptoms of sexual assault include:
- A nursing home resident may make clear and direct statements suggesting sexual assault, or hint that sexual assault may have occurred.
- A resident may reports witnessing sexually abusive behavior directed toward another person.
- Trauma may be present around an individual’s genitals, rectum, mouth, and/or breasts, including bleeding, bruising, injury, infection, scarring, redness, pain, and/or irritation.
- A resident who is uninvolved in consenting sexual relations is diagnosed with a sexually transmitted disease.
- Evidence of forcible restraint of an individual is observed such as restrain marks, hand or fingerprints, etc.
- There is evidence of physical abuse such as bite marks and/or burns.
- A resident displays shame or guarded behavior when asked about physical signs of abuse.
- An individual displays fear or strong ambivalent feelings toward a particular caregiver, or nursing home staff person.
- A resident displays extreme behavior when provided personal care.
- Inappropriate boundaries exist between a resident and a caregiver.
- A caregiver is overly intrusive regarding personal care.
Residents with dementia may not be able to report sexual assault so it is important that any changes in their condition or behavior be investigated.
Less than 2 percent of all sexual assault reports are false. Believe residents who report sexual abuse, look for signs and symptoms.
Signs of Elderly Malnutrition and Dehydration
- Anger
- Embarrassment
- Hostility
- Guilt
- Withdrawal
- Depression
- Increased awareness of vulnerability