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Rachel Long April 19, 2013 English 1102 Andrew Brown Annotated Bibliography Burnight, Ph.D.

, Kerry, and Laura Mosqueda, MD. Theoretical Model Development in Elder Mistreatment. Rep. no. 234488. NCJRS, May 2011. Web. 10 Apr. 2013. <https://www.ncjrs.gov/pdffiles1/nij/grants/234488.pdf>. This source is an academic report that was found through the UNCC library. It discusses some of the psychological theories as to why elder abuse occurs. The four main theories are Interpersonal, Sociocultural, Intrapersonal, and Multisystemic. Interpersonal attributes abuse to internal factors such as caregiver stress, or difficulty in serving others while receiving no appreciation in return. Sociocultural views elder abuse as a way to maintain control over the individual. Intrapersonal includes factors such as training, and learned behaviors. Multisystemic is a combination of all of these factors. This article gives a different perspective to my research because it shows the psychological reasons people abuse the elderly. It backs up some of the other sources which mention caregiver stress and cultural issues as major contributors to elder abuse. I agree that these are some of the root causes of elder abuse but are no excuse. Measures should be taken to reduce caregiver stress and nurses and nurse aids should be monitored closely by several individuals to ensure they are treating residents like they should. Center of Excelence on Elder Abuse and Neglect Universty of California Irvine. Fact Sheet:Abuse of Residents of Long Term Care Facilities. N.p.: Center of Excelence on Elder Abuse and Neglect Universty of California Irvine, n.d. Center On Elder Abuse.org. University of California Irvine, Feb. 2012. Web. 10 Apr. 2013. <http://www.centeronelderabuse.org/docs/Abuse_of_Residents_of_Long_Term_Care_Fa cilities.pdf>. This source is a brochure or fact sheet which gives an overview of information related to elder abuse. Around 3.2 million Americans are living in nursing homes in American and 900,000 are living in assisted living centers. 1 in 3 nursing homes have been cited for violations and 50% of nursing home staff admits to mistreating patients in some manner. Physical abuse, psychological abuse, and resident to resident abuse are the most common types of abuse that occur in nursing homes. While these were the most eye-catching statistics there were many more that provided me with a lot of guidance when deciding what to further research for this project. This source contributed a lot to my project because it showed me the direction I wanted to go with my research. It was very helpful in that is showed me the most common types of abuse, and just how common abuse of the elderly was. It was after seeing this source that I decided to focus my

research on the prevalence of abuse nursing homes and residential care facilities, and the various factors that influence the different these types of abuse. Elder Abuse and Neglect: In Search of Solutions." American Psycological Association. Ed. American Psycological Association. American Psycological Association, 2012. Web. 01 Apr. 2013. <http://www.apa.org/pi/aging/resources/guides/elder-abuse.aspx>. This source is a long article discusses many aspects of elder abuse written by the APA. I focused on the sections regarding how caregiver stress and societal and cultural issues influence abuse of the elderly. The source points out the fact that caregivers may be more likely to abuse if they are under a large amount of stress, since they take their frustration about the situation or on the elderly individual. Residents with dementia often have bouts of violent behavior which can set off a caregiver who is already angry and provoke undeserved backlash from the caregiver. Many Americans also do not have a great deal of respect for the elderly and view them with less value than they do their own peers. It was very frustrating for me to read this article because the fact that anyone could take their stress out on someone in such a vulnerable position is sickening to me. As CNA I have been in the position of the caregiver who is stressed out and has a very large load of patients. It is something that you have to deal with but I agree that it can be a huge stressor for some individuals. For someone who does not enjoy or see the value in their job could definitely cause them to lash out on the people they are taking care of. National Center on Elder Abuse. 15 Questions and Answers About Elder Abuse. Washington DC: National Center on Elder Abuse, 2005. AdministrationonAging.gov. U.S. Administration on Aging, 2005. Web. 15 Apr. 2013. <http://www.ncea.aoa.gov/Resources/Publication/docs/FINAL%206-06-05%203-180512-10-04qa.pdf>. This source is a booklet found on the U.S. Association of Agings website. It discusses many of the model signs of an abuser, victims and ways to get help for someone who is being abused. Signs of an abuser include substance abuse, controlling, isolating the elder, financial dependence on elder, and speaking to the elder in a foul way. Signs of a victim of abuse include withdraw from activities, bedsores, sudden financial changes, unusual behavior and consistently unclean clothes. Any signs of abuse can be reported anonymously using by contacting the numbers listed in this source. This was an important contribution to the project because it covered the signs of all kinds of elder abuse from all angles. Some of these are small details that may be overlooked. If more caretakers and family members were educated on these common signs of abuse and would actually take the initiative to report it many cases of abuse could be reported. This article was especially relevant to me personally since I am in a position where I can easily notice these signs of abuse in the patients that I care for. Rosenwasser, Marc, prod. "Need to Know: A Cottatge Industry." Need to Know. PBS. 23 Sept. 2010. PBS.org. Public Broadcasting Services, 23 Sept. 2010. Web. 10 Apr. 2013. <http://video.pbs.org/video/1598425692>.

This source is a documentary from PBS about an elderly woman who was placed into a residential care home by her son, who was involved in her care, and died due to complications related to neglect that she experienced at the home. Her son decided to place her in the home because he could no longer take care of her alone and thought the home would be a better option than a long term care facility. He visited her every day, but did not pick up on the subtle early signs of neglect. Weeks later he received a call that she was suffering from severe pressure sores and need to go to the hospital. She never recovered from the infection and died at his home weeks later. The documentary highlighted the fact that facilities such as the one in Washington state she was staying in may be run by individuals with as little as 29 hours of training and the licensing fee to open a facility is on $100. This article demonstrates how lack of training/oversight can lead to abuse of the elderly. Individuals who own these facilities may run them on their own and only need 29 hours of training. For comparison, in North Carolina a CNA must undergo over 100 hours of training, 78 hours of clinical experience, pass a certification exam and operate under the supervision of an RN present at the facility where they work. Ruppe, David. "Elderly Abused at 1 in 3 Nursing Homes: Report." ABC.com. ABC News Internet Ventures, n.d. Web. 10 Apr. 2013. <http://abcnews.go.com/US/story?id=92689&page=1>. This article from ABC discusses the startling statistic that the elderly are commonly abused at 1 out of every 3 nursing homes. This abuse includes things such as pressure soars, malnutrition, poor hygiene and verbal abuse. It brings attention to the fact that abuse in these facilities is much more common than most people realize. Thirty percent of nursing homes in the United States were cited for around 9,000 cases of abuse. Some people are pushing for more restriction on minimum wages and minimum staffing numbers in nursing homes in an effort to increase the quality of care. I have to say that while this statistic angers me it does not shock me. It is also very concerning because if that many cases are reported there are no doubt more cases that are never reported. The statement from the nursing home stating that most of the violations would be of great concern to families, but were not classified as causing actual harm ", also shows why these problems are not getting fixed. Many nursing homes do not see these breaches in care as real issues just as inevitable occurrences. Shipman, D, and J Hooten. "Public Policy. Are Nursing Homes Adequately Staffed? The Silent Epidemic Of Malnutrition And Dehydration In Nursing Home Residents: Until Mandatory Staffing Standards Are Created And Enforced, Residents Are At Risk." Journal Of Gerontological Nursing 33.7 (2007): 15-18. CINAHL Plus with Full Text. Web. 13 Apr. 2013. This article from the Journal of Gerontological Nursing highlights the risk of dehydration and malnutrition in understaffed nursing homes. Studies have shown that 90% of nursing homes are understaffed, and it is one of the major factors that contribute to abuse particularly in the form of neglect as it relates to nutrition. Since most nursing homes do not have enough staff the CNAs do not have enough time to feed residents at an appropriate pace or encourage fluid intake throughout the day.

This article backed up exactly what I already thought to be true. I agree that understaffing is a huge factor in neglect. Many CNAs are so overwhelmed with all the work they have to get done that they do not take the time to perform their job properly. I know from personal experience that some facilities place so many residents with one CNA it is nearly impossible to give everyone the attention that they need.