URGENT need advice on resident to resident abuse.

[Vblub01]

Hi everyone! I really need advice on how to go about this issue I have at work. I am a CNA at a long term facility and recently have been working with a husband and wife who share the same room. The husband is alert and oriented as the wife has Alzheimer's dementia. The woman most of the time has no idea what she is saying and she is not all there. The husband tends to get frustrated and irritated with her because she doesn't respond correctly or doesn't follow directions with him so when he gets upset he hits her. First he starts to yell at her and then he'll smack her. I have heard him yell at her and be vulgar to her but i have not witnessed him actually hit her. I know he does hit her because other staff have seen him or heard him do this to her. He has been doing this to her for a long while. They have been at this facility for about 3 months or so i would say. Of course the administrator and higher ups know about it but all they have done it talk to him about it. There has been no actual action. The only thing the administrator has done is say "well if it happens again he will have to leave" but that it the thing! She has already talked to him about it 3 times! Because he keeps doing it and gets away with it. It is so disgusting that the administrator just wants the money. I hate to say it but it is true. The husband was a lawyer for a very long time and of course pays a lot of money to be at this place so i think that is why he gets away with everything. Is that right? Is it right for him to be there abusing his wife just because he pays a lot of money? I don't know what to do about this but it makes me feel very uncomfortable to work with him and knowing that he does this to his wife. The poor lady is defenseless and of course does not deserve to be treated this way. It really bothers me and i just want know what i can do to help. Thank you all for reading this and comments on this are very welcome.

[Tulsaoknurse]

If you have followed the chain of command and that didnt work, as I'm sure it didn't because I worked in longterm care for many years and as long as that paperwork is done correctly seems that they could care less about some of those patients. They put on a good front but money is their main game. The higher up, the bigger the cover up. What I would reccomend is that you call that hotline number for reporting abuse and they should have one posted in your facility. Report it! They WILL investigate and don't let the administrators and nurses act like they didn't know. Remember who youtold and when you told them. Sometimes we are all they have to protect them, and it sounds like his wife may need a seperate room ASAP for her protection. I hope this helps, Good Luck.

[lovinlife11]

It's abuse, you have a duty and moral obligation to report. If this man is alert and oriented he should realize his wife can't help it, what a coward!

[TheCommuter, BSN, RN]

You followed the chain of command by reporting to the administrator. You can go up the chain of command a little further by notifying someone at the corporate office of the nursing home. You can even take it further by reporting to the state regulatory agency that annually surveys the nursing home.

However, be sure to have your ducks in a row if you wish to pursue this issue. Unfortunately, I have seen too many workers be targeted in a retaliatory fashion for reporting abuse and other wrongdoings. Good luck to you.

[tokebi]

By law, nurses are mandated reporters and thus obligated to report any suspected abuse of children and elderly. You're not even required to go through your superiors, and it seems that your DON or administration chose to betray the vulnerable victim under their care. Why don't you look into the specifics about mandated reporters in your state? I believe you can contact either law enforcement or public health agencies. It might differ from state to state, but my understanding is that you first make a call, and then file a written report within certain time frame -- sooner the better.

While the report is not anonymous, I don't think your identity will be known as the one who reported the abuse if the case gets investigated.

As much as I'd like to urge you to report this case, I know things are not always black and white. You must reflect on the matter with both your heart and your head. I am so sorry you have to go through this dilemma and I only wish you the best, whatever decision you make.

[jadelpn, LPN, EMT-B]

Nursing homes have omsbudsmans. That would be were I would go to if in fact the higher ups did nothing but speak to the man. If the staff sees him hitting her, then that becomes an assault situation, and needs to be dealt with either with the police, the state reporting agency or both. This guy being a major jerk to his wife could use intervention with a family meeting, social work....

I am NOT in any way excusing behaviors, however, being in a small room with a person with severe dementia can cause some intense burn out pretty quickly. If the husband is snapping, he needs respite. And that may mean an alternate living arrangement. Hitting, however, is a whole different issue. To talk to him was one thing, but was anything done to try and prevent same from happening again? There needs to be a meeting, there needs to be a plan, and the staff who witness the hitting need to come forward.

[Morainey, BSN, RN]

Call your ombudsman. What a crappy situation.

[monkeybug]

It's abuse, you have a duty and moral obligation to report. If this man is alert and oriented he should realize his wife can't help it, what a coward!

Mandatory reporting laws vary from state to state.