Contributors to Elder Abuse I. Introduction - General Introduction Elder abuse is a major issue in long term care facilities.

One in three facilities has been cited for a violation, and it is estimated that many more violations stay under the radar because they are never reported. - Basic Context 95% of nursing home residents say they have seen another resident be mistreated and 50% of nursing home staff admit to mistreating a patient. Around ninety percent of nursing facilities fall below the average recommended staff to patient ratio. - Perspectives Some individuals believe that it is not understaffing that leads to elder abuse but a lack of training and understanding of those who can pick up on the signs of elder abuse that leads to the prevalence of mistreatment in nursing facilities. I believe that it is not a lack of training but a lack of the proper amount of staff that contributes to the prevalence of elder abuse in nursing facilities. - Thesis Statement Understaffing of caregivers in nursing facilities is the main cause of most elder abuse that occurs within in long term care or assisted living facilities. II. Opposition Perspective - Restate Opposing Perspective An opposing perspective on this issue centers around the idea that lack of training of those caring for individuals and those who could pick up on the signs of mistreatment in nursing facilities contributes the most to the prevalence of elder abuse. They believe without proper training caregivers may not see that they ways they are treating patients are harmful or abusive and family members may not be able to pick up on it. - Details They believe that elder abuse is so prevalent because those who are caring for the individuals do not have enough training and those who can pick up on the signs of elder mistreatment, such as family and social workers, do not pick up on the signs. - Accepted Context This perspective would be correct in nursing facilities but not in situations where the caregiver is a family member. In situations where the family is the abuser other factors may come into play. III. Writer's Perspective - Restate Writer's Perspective and Position Having a poor staff to resident ratio makes it impossible to provide the care needed for residents and leads to the serious forms of abuse that occur in nursing facilities. - Re-emphasize Claim Understaffing of caregivers in nursing facilities is the cause of most elder abuse that occurs within long term care of assisted living facilities.

- Details Understaffing not only makes it impossible to provide all needed care to residents but it puts a large amount of stress on the caregiver. This causes caregivers to make poor decisions about importance of care or take out their frustration on the resident. This can develop into many types of abuse including neglect, physical and emotional abuse. - Accepted Context This view is best under the conditions that the residents are in a nursing or residential care facility not under the care of a family member. In family situations other factors come into play, but in the nursing facility understaffing is the major factor. - Refutation of Opposition The oppositions perspective is incorrect because all individual who are employed at these facilities must have a certification at minimum and are well educated in the signs and types of abuse. The reason they continue to commit these types of mistreatment is because they are overly stressed and do not have enough to time to provide the quality of care that they should. This is a problem that no amount of education and training can fix.

IV. Common Ground (Rogerian Step Four & Proposal) - Proposed Solution/Resolution as Common Ground A solution to this issue would be to require nursing homes to have minimum staffing limits which meet the recommendations set forth by the US Department of health and human services. A recent study they conducted showed that a minimum of 2.8 hours of care was needed per patient by a certified nurse assistant and 1.3 hours a day from licensed staff. - Context In order for this to occur nursing homes would need to hire more staff. This is good common ground because it increases staffing levels and since it makes for a more relaxed work pace it allows more time for staff training if needed. This regulation would decrease the amount of abuse that occurs in nursing facilities. - Implementation It would need to be regulated by the government and the department of health and human services and would be followed by all nursing facilities in the United States. - Resources Government support would be needed and there would need to be an agency assigned to keep track of these conditions in nursing facilities. V. Alternatives I do not believe there is another option that can suit the needs of both my side and offer common ground to the opposing side.

VI. Concluding Statements -Predictions I predict that the incidence of elder abuse would decrease dramatically if all nursing facilities were required to have minimum staffing limits. - Other Concerns (possibly to wrap up loose ends or ideas) or Rhetorical Questions This solution would also accommodate the concerns of those with the opposing perspective because more staff would mean a slower paced work day and more time for on the job training when a new employee is hired. VII. Works Cited Center of Excelence on Elder Abuse and Neglect Universty of California Irvine. Fact Sheet:Abuse of Residents of Long Term Care Facilities. N.p.: Center of Excelence on Elder Abuse and Neglect Universty of California Irvine, n.d. Center On Elder Abuse.org. University of California Irvine, Feb. 2012. Web. 10 Apr. 2013. <http://www.centeronelderabuse.org/docs/Abuse_of_Residents_of_Long_Term_Care_Fa cilities.pdf>. Shipman, D, and J Hooten. "Public Policy. Are Nursing Homes Adequately Staffed? The Silent Epidemic Of Malnutrition And Dehydration In Nursing Home Residents: Until Mandatory Staffing Standards Are Created And Enforced, Residents Are At Risk." Journal Of Gerontological Nursing 33.7 (2007): 15-18. CINAHL Plus with Full Text. Web. 13 Apr. 2013.