Psychological abuse in nursing homes is a type of emotional abuse. Psychological abuse can be more subtle and difficult to detect than verbal or physical abuse, although in many cases psychological abuse takes place in combination with other types of abuse. Although psychological abuse is often viewed as less severe or less common than more visible types of abuse, it can be just as damaging to the victim.
What is Psychological Abuse?
Psychological abuse always involves a structure in which the aggressor has power over the victim. This power allows the aggressor to either directly or indirectly threaten the well being of the victim, causing psychological trauma and anxiety for the victim. In nursing homes, psychological abuse is often committed by the direct caregivers of residents, but can be committed by volunteers, staff members, or even family members of the resident.
Types of Psychological Abuse
Caregivers in nursing homes hold a unique power over residents, as residents must depend on the caregiver for nearly all aspects of daily care. This position makes psychological trauma a side effect of nearly any other type of abuse, as patients often fear that exposing abuse will result in the withholding of daily care. This is a more indirect type of psychological abuse, but there are many types of more direct psychological abuse.
Nursing home residents may be subjected to the following types of psychological abuse:
- Seclusion or isolation from other residents
- Exclusion from group activities
- Psychological manipulation through lies
- Direct or indirect threats
- Caregivers mocking or minimizing the resident to other staff members
- Ignoring the resident, especially leaving the resident alone for long stretches
Signs of Psychological Abuse
The effects of psychological abuse may manifest in the form of extreme personality changes. Patients that were personable and friendly in the past may become withdrawn or sullen; patients that were quiet may become aggressive. Patients may also show more subtle signs, such as skittishness or unwillingness to speak about daily activities. In some cases, patients may also become dehydrated or malnourished because fear of caregivers prevents the patient from asking for food or drink.
Development of certain repetitive behaviors may also indicate psychological abuse:
- Sucking hands or fingers
- Biting self or others
- Hair pulling
- Cutting or other self-harm
- Teeth grinding
Causes of Psychological Abuse
The reasons behind psychological abuse differ slightly from other types of abuse. Abusers may manipulate residents into behaving a certain way because it makes the resident easier to deal with or less likely to report illegal or immoral activities. Psychological abuse and manipulation is also a display of power, and may reveal psychological issues within the abuser.
Preventing Psychological Abuse
Psychological abuse can be as difficult to prevent as it is to spot. The effects of psychological abuse may take time to manifest, and residents may react differently to psychological abuse. Interviewing staff and touring nursing homes may not necessarily reveal psychological abuse as readily as it would reveal neglectful or physically abusive situations.
Communication with Residents
Interviewing residents may help to expose psychological abuse. Residents that have been psychologically abused will often exhibit some indication of emotional instability. Family members of residents should also be in close contact, so that changes in behavior or emotional state will be recognized.
Handling Nursing Home Abuse
If it is discovered that a patient has been a victim of nursing home abuse, the patient should be removed from the setting immediately. The situation should be reported, so that other patients that are being abused can also be removed from harm. A lawyer should be contacted for legal advice about the abusive situation.
Treating Psychological Abuse Victims
Patients that have been psychologically abused in nursing homes may never fully recover. Working with a psychologist may help to uncover disorders such as post traumatic stress disorder, and may help patients to work through emotional pain and insecurities. Medication may help alleviate certain symptoms and may help patients to control physical symptoms and repetitive motions that have developed as a result of the abuse.
“Elder Abuse and Neglect.” American Psychological Association. American Psychological Association, n.d. Web. 16 Feb 2014. <http://www.apa.org/pi/aging/resources/guides/elder-abuse.asp&xgt;.
“Emotional and Psychological Trauma.” HelpGuide.org. HelpGuide.org, n.d. Web. 16 Feb 2014. <http://www.helpguide.org/mental/emotional_psychological_trauma.htm>.