Nursing-home staff require training in detecting, examining and managing sexual assaults

Smith D, Bugeja L, Cunningham N, et al.  A systematic review of sexual assaults in nursing homes  The Gerontologist. 2017; 1-15.

Review question

•    What are the characteristics of sexual assault that happens in nursing homes?

Background

•      Sexual assault refers to non-consensual sexual contact of any kind. It is the least acknowledged and reported form of elder abuse.

•      Older adults who live in long-term care facilities or nursing homes are vulnerable to sexual assault. Residents are highly dependent on their caregivers, and often have physical or cognitive disabilities that affect their capacity to defend themselves and report sexual assaults. They also live in close proximity to staff, visitors and other residents who may have sexually assaulted people in the past.

•      Identifying the characteristics of nursing-home sexual assault can help us design effective sexual-assault prevention interventions specifically for the nursing-home setting.

How the review was done

•      A detailed search of a number of electronic databases was conducted to identify studies published from 1949 to2015.

•      Studies that were written in English and focused on sexual and physical assault cases in nursing homes were included in the systematic review. A total of 2,291 studies were identified in searches, and 15 were included in the review after assessing their eligibility.

•      The authors stated that they did not receive any funding for this review.

What the researchers found

•      Sexual assault victims were more likely to be females who were disabled and received financial assistance. Offenders were more likely to be male residents or staff members with past criminal histories. Assaults usually happened in the evening, when there is less staff present in the nursing homes.

•      Nursing-home staff were often not properly trained to deal with sexual assault. Sometimes, injuries were not thoroughly documented, and evidence was accidentally destroyed, making it difficult to convict offenders. As well, victims often did not receive therapy and suffered many negative physical and psychological consequences. One study found that more than 50% of victims died within a year of the assault.

•      Overall, more research is needed on this topic. There were very few papers written about the subject, and many of the papers found did not report forensic details comprehensively.  

Conclusion

•      It was difficult to determine the characteristics of sexual assault that happens in nursing homes, partly because nursing homes are often poorly equipped to prevent and respond to sexual assaults.