Aged Care Duty of care question

Nurses General Nursing

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Note: I am not a nurse but I am posting this because my gf who is a nurse has had this experience and the issue has annoyed me.

hi everyone

my gf works in an aged/palliative care and they have recently had a new resident arrive with dementia. About a week ago my gf was taking care of him when he violently attacked her. She pressed the emergency button, no one came for a while and when they did they were apparently less than useful or sympathetic to the situation. My gf was later told that the resident used to be a woman abuser and alcoholic etc. this was her first "attack" situation so she was pretty traumatised about it. She is okay now but was told to work a different part of the home for a while.

so a week later now, my gf has been told this man has been luring other women with dementia in the home to his room and kissing them and molesting them. My gf was upset and said to the managing RN nurse what should they do to which the managing RN replied "there is nothing we can do because he has dementia, the best we can do is keep an eye on him"

so my my question is - is this true? Can nothing really be done because this man (using the term loosely) has dementia? Doesn't the nursing home also have a duty of care to tell families of these other women with dementia that their loved ones are being repeatedly sexually assaulted and nothing is being done? And can my gf do anything to address this situation?

thanks for your time if you're reading this.

Specializes in Pediatric Hematology/Oncology.

Your gf can always call law enforcement out to do a report on the physical assault (seriously, if management thinks nothing about that then call the cops - that will get their attention). Also, mentioning that he is actively 'luring' (IF that is what he is doing; luring is different from the other patients wandering into the room and him not-quite-intentionally putting his hand down their pants) other patients into his room to sexually assault them is another situation entirely. Though he has dementia, if he is 'luring' other patients, there's something to that. And, if law enforcement can build a history and document things that are going on, that's only going to help, especially if it escalates to the point that he needs to go to a geri-psych inpatient facility. A lot of places act like nurses getting assault is part and parcel of the job. That is incorrect and we are only now starting to see movement away from that line of thinking.

Specializes in Psych (25 years), Medical (15 years).
im sure you can understand that some people find it incredibly difficult to stand up to authority no matter what line of work they are in with a chain of command.

Huwscor, it is very understandable, given both you and your girlfriend's situation. This is all new to you, and you are unsure as what to do- it's all murky. Many us are seasoned crows who have been down that road before and it's all black and white.

You're doing a fine job- just keep on keeping on.

I strongly suspect this is a mandated report situation. The sexual abuse of residents is abuse and licensed nurses are required by law to report it. The consequences for not doing so vary from state to state. That the abuser is also a resident with dementia only means that the perpetrator won't be criminally charged. It does not mean nothing can be done. More likely, the facility does not want to get the state involved. I know in my state, such abuse is a reportable event.

OP, if your gf has already notified facility management of the problem and they blew her off, she has a legal obligation to take it to the state regulators. She could lose her license if she knows and does nothing.

Of course, she will lose her job if she goes above the bosses/owners and she might never again be employable in this field. She should seriously weigh her choices and the consequences of all of those choices, to other staff, the patients, and to herself.

She could do a police report about him assaulting her. She might want to get a lawyer re: her assault, too, because the facility she works for probably knew the man's history and the strong possibioity of him assaulting someone again - or, as you said, assaulting lots of people. Again, think about the consequences of these choices.

Your GF should never be alone with him ever again.

And if she is a mandated reporter, she must report or be in even more trouble.

Uuuh... does anyone know if there are federal whistle blowing policies that cover her in this event? My knee jerk reaction is to say, "Call law enforcement (and later, even the local news!)"

But then again, HIPPA.... It feels like just going along with the employer's resolution is criminal. Yuck.

I'm sorry I don't have any answers.

Specializes in UR/PA, Hematology/Oncology, Med Surg, Psych.

She needs to contact Adult Protective Services in your state. The phone number should be easy to find. She can make the report, APS will investigate, and the facility will not be told the source of the original accusation. These are vulnerable adults being abused, she must report.

The BON in that particular state can have those things documented with objective evidence, not just subjective complaints, because..to be investigated, you need solid proof

Dementia or not, caregivers are entitled to a safe place to work! This also goes for other residents and this patient's own safety.

Uuuh... does anyone know if there are federal whistle blowing policies that cover her in this event? My knee jerk reaction is to say, "Call law enforcement (and later, even the local news!)"

But then again, HIPPA.... It feels like just going along with the employer's resolution is criminal. Yuck.

I'm sorry I don't have any answers.

Whistleblower protection means the employer cannot retaliate against her for reporting. Though as others have said, a report can be made without necessarily tipping them off to who made the report.

If the facility tried for discipline or fire her unjustly because she reported, she could sue the pants off them.

Personally, I think she may be better off looking for a new job, especially with a year of experience under her belt.

Specializes in SICU, trauma, neuro.
the managing RN replied "there is nothing we can do because he has dementia, the best we can do is keep an eye on him"

This is a truckload of bovine feces. Women -- vulnerable women -- are being sexually violated in their home, and they have every right to protection. Vulnerable adult reports must be made to adult protective services. Your gf is a mandated reporter, so it really doesn't matter what this supervising RN said. (Shame on the supervising RN, by the way. She knows about sexual violence being committed upon residents under her care, and she refuses to help them. "Keeping an eye on him" is not possible when each nurse is responsible for 30 residents. I don't use the phrase "shame on them" lightly, but truly, shame on her.)

I believe that those being accused in reports can't be given the name(s) of those making the report, so she should be fine job-wise. Even if she wasn't though, could she really sleep at night knowing that she has allowed these women to be violated? Jobs are replaceable. People are not.

Specializes in UR/PA, Hematology/Oncology, Med Surg, Psych.
This is a truckload of bovine feces. Women -- vulnerable women -- are being sexually violated in their home, and they have every right to protection. Vulnerable adult reports must be made to adult protective services. Your gf is a mandated reporter, so it really doesn't matter what this supervising RN said. (Shame on the supervising RN, by the way. She knows about sexual violence being committed upon residents under her care, and she refuses to help them. "Keeping an eye on him" is not possible when each nurse is responsible for 30 residents. I don't use the phrase "shame on them" lightly, but truly, shame on her.)

I believe that those being accused in reports can't be given the name(s) of those making the report, so she should be fine job-wise. Even if she wasn't though, could she really sleep at night knowing that she has allowed these women to be violated? Jobs are replaceable. People are not.

Totally agree. If that was my vulnerable mother being touched inappropriately and staff didn't report it and protect her...

Specializes in Psych (25 years), Medical (15 years).
Of course, she will lose her job if she goes above the bosses/owners and she might never again be employable in this field.

I respectfully disagree that she will loose her job if she goes to outside resources.

Without going into great detail, in two different events, I have informed as many as four outside entities of situations when I believed the circumstances were not adequately resolved after going through the chain of command. I went as far as to inform one administrator of my intent and no repercussions resulted.

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