Preface Ix
Part I: Nursing Homes and Theories of Abuse
Chapter 1. The Nature of Nursing Homes = 3
Myths and Facts about Nursing Homes = 5
How Nursing Homes Got Started = 8
Nursing Homes As Bureaucracies = 10
Nursing Homes As Total Institutions = 13
Barriers to Nursing Home Abuse Research = 14
Chapter 2. Nursing Aides: The Backbone of Care in Nursing Homes = 17
Workforce Issues and Problems of Nursing Home Aides = 17
Narratives of Nursing Home Aides = 24
Chapter 3. Understanding Abuse = 27
Why Nursing Homes May Be Good for Abusers = 28
Nursing Homes and The Motivated Offender = 29
Patients and Their Possessions As Suitable Targets = 33
Guardianship in Nursing Homes = 33
Countervailing Forces = 35
Summary = 36
Part Ii: Nursing Home Theft
Chapter 4. Employees and Theft = 39
Results from The Survey of Employees = 40
Conclusions about Employees = 52
Chapter 5. The Victims and Their Families = 55
Family Members' Reports of Theft = 57
What Is Stolen? = 59
Conclusion = 65
Chapter 6. Preventing and Reducing Theft = 67
Theft Precautions for Patients = 67
Theft Precautions for Nursing Homes = 69
Reporting of Theft = 71
Theft Prevention Training Programs = 72
Part Iii: Physical and Mental Maltreatment
Chapter 7. Physical Abuse and Neglect = 75
Abandonment, Segregation, and Neglect = 75
Government Reform Committee = 76
Types of Physical Abuse = 80
Sexual Abuse = 84
Neglect = 86
Chapter 8. Psychological Abuse and Neglect = 89
Types of Psychological Abuse = 90
Some Effects of Psychological Abuse = 93
Neglect = 96
Chapter 9. Reducing The Risk of Physical and Psychological Abuse = 99
Screening Practices = 99
Staff Education and Training = 103
Advocacy = 105
Part Iv: Fraud, Reform, and Recommendations
Chapter 10. Exploitation of Nursing Home Patients: Their Finances and Rights = 109
Financial Abuse = 109
Reform of Nursing Home Regulations = 112
Chapter 11. Summary and Conclusions = 117
Appendix. Methodology = 123
Data Collection = 124
Employee Questionnaires = 125
Measuring Theft = 126
Response Rates from The Survey of Employees = 127
Victimization Survey = 128
Family Members' Questionnaire = 128
Glossary = 131
References = 135
Index = 141
Part I: Nursing Homes and Theories of Abuse
Chapter 1. The Nature of Nursing Homes = 3
Myths and Facts about Nursing Homes = 5
How Nursing Homes Got Started = 8
Nursing Homes As Bureaucracies = 10
Nursing Homes As Total Institutions = 13
Barriers to Nursing Home Abuse Research = 14
Chapter 2. Nursing Aides: The Backbone of Care in Nursing Homes = 17
Workforce Issues and Problems of Nursing Home Aides = 17
Narratives of Nursing Home Aides = 24
Chapter 3. Understanding Abuse = 27
Why Nursing Homes May Be Good for Abusers = 28
Nursing Homes and The Motivated Offender = 29
Patients and Their Possessions As Suitable Targets = 33
Guardianship in Nursing Homes = 33
Countervailing Forces = 35
Summary = 36
Part Ii: Nursing Home Theft
Chapter 4. Employees and Theft = 39
Results from The Survey of Employees = 40
Conclusions about Employees = 52
Chapter 5. The Victims and Their Families = 55
Family Members' Reports of Theft = 57
What Is Stolen? = 59
Conclusion = 65
Chapter 6. Preventing and Reducing Theft = 67
Theft Precautions for Patients = 67
Theft Precautions for Nursing Homes = 69
Reporting of Theft = 71
Theft Prevention Training Programs = 72
Part Iii: Physical and Mental Maltreatment
Chapter 7. Physical Abuse and Neglect = 75
Abandonment, Segregation, and Neglect = 75
Government Reform Committee = 76
Types of Physical Abuse = 80
Sexual Abuse = 84
Neglect = 86
Chapter 8. Psychological Abuse and Neglect = 89
Types of Psychological Abuse = 90
Some Effects of Psychological Abuse = 93
Neglect = 96
Chapter 9. Reducing The Risk of Physical and Psychological Abuse = 99
Screening Practices = 99
Staff Education and Training = 103
Advocacy = 105
Part Iv: Fraud, Reform, and Recommendations
Chapter 10. Exploitation of Nursing Home Patients: Their Finances and Rights = 109
Financial Abuse = 109
Reform of Nursing Home Regulations = 112
Chapter 11. Summary and Conclusions = 117
Appendix. Methodology = 123
Data Collection = 124
Employee Questionnaires = 125
Measuring Theft = 126
Response Rates from The Survey of Employees = 127
Victimization Survey = 128
Family Members' Questionnaire = 128
Glossary = 131
References = 135
Index = 141