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Identifying just how much abuse occurs in nursing homes, is difficult. Victims are often unwilling or unable to speak up. Perpetrators may be nursing home staff, who have ongoing contact with the victim, and whose presence alone, may be intimidating. Nursing home assaults can be committed by a resident, when staff supervision is inadequate, lackadaisacal, or uncaring. It is almost certain, however, that abuse in nursing homes occurs regularly- a national disgrace.

A comprehensive solution to the problem of nursing home abuse, will be difficult to achieve. Homes across the country, and even within the same geographical region, vary widely in size, quality, and financial stability. No single characteristic of a home, be it part of a nationwide chain, or a single family-owned operation, will guarantee safety for its residents. The attitudes of the management of a given home, is crucial to the risk of abuse. Recommendations by advocacy groups emphasize the importance of screening staff carefully before hiring, and treating staff decently, once they are employed.

Families need to be educated on what to look for in their loved ones, that might indicate abuse (for example, a sudden aversion to interaction with others, dietary changes, and of course, unexplained marks or bruises). Staff must be well-educated on their obligations as mandatory reporters if they suspect abuse, and management must insure that the laws regarding reporting of suspected abuse are scrupulously followed. There are exceptions to every rule, but in general, abuse if less likely to occur in nursing homes in which even the most needy residents, are appreciated and respected.

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