Academic journal article Generations

Sexual Abuse Happens in Healthcare Facilities-What Can Be Done to Prevent It?

Academic journal article Generations

Sexual Abuse Happens in Healthcare Facilities-What Can Be Done to Prevent It?

Article excerpt

Recommendations and practice guidelines from a recent comprehensive study on sexual abuse in institutions.

It is alarming when individuals living in healthcare facilities are sexually or otherwise abused. The Study of the Sexual Abuse of Vulnerable Adults in Institutions was designed to shed light on this problem and gather data that could help assist victims and hold perpetrators accountable. During Phase One of the study, data were collected prospectively and analyzed regarding 429 cases of reported facility-based sexual abuse that had been investigated by regulatory agencies and Adult Protective Services (APS) in five states over six months. Phase Two involved follow-up interviews of randomly selected personnel who had investigated the cases. This article reports on selected findings from Phase Two.

Study Design and Methods

Adult abuse and regulatory agencies in five states participated in the study: New Hampshire, Oregon, Tennessee, Texas, and Wisconsin. APS in all of these states contributed to the study, in addition to the Texas Department of Aging and Disability Services, and the Wisconsin Division of Quality Assurance. The research team prospectively collected data from personnel responsible for receiving and responding to abuse reports regarding all cases of alleged sexual abuse of vulnerable adults, ages 18 and older, living in facilities investigated from May 1 through October 31, 2005. The University of Kentucky Institutional Review Board provided approval for this study.

Within each state, 15 percent of the studied cases were then randomly selected and the involved investigators were asked to participate in an interview. Social workers experienced in abuse investigations conducted the twenty-five-minute interviews by phone and with the subject's permission recorded and transcribed them. Investigators were questioned about their training, experience, and decision making in their specific studied case(s). Based upon their experience with sexual abuse in facilities, they were asked to provide recommendations for serving victims, preventing assault, and handling cases.

Phase One Study Findings

Phase One study findings presented in Ramsey-Klawsnik, Teaster, and Mendiondo (2008) included the following: about one-third of the alleged cases occurred in nursing homes and about one-quarter in state schools. Other locations included state mental hospitals, group homes, and mental health-mental retardation facilities. Thirty percent of the cases involved rape; 3 percent, attempted rape; 42 percent, molestation; 8 percent, sexualized kissing; and 14 percent, non-contact offenses.

Alleged victims ranged in age from 18 to 101, with a mean age of 49.8 years. Disabilities included developmental (40 percent of alleged victims), psychiatric (24 percent), physical (19 percent), and sensory (5 percent). During investigations, 62 percent of the alleged victims who were interviewed disclosed that they had been sexually abused, 28 percent revealed multiple assaults, and 13 percent disclosed additional abuses.

The 463 alleged perpetrators ranged in age from 16 to 96 years, and 74 percent were male. The largest group of alleged perpetrators (44 percent) were employees of the involved facilities, 24 percent were residents. Eighteen percent of the cases were substantiated for sexual abuse and 60 percent of confirmed sexual abuse perpetrators were residents. Most (73 percent) of confirmed victims were female (Ramsey-Klawsnik, Teaster, and Mendiondo, 2008).

Findings regarding the 119 alleged and thirty-two confirmed perpetrators who targeted victims older than age 60 were reported in Ramsey-Klawsnik et al. 2008. Facility employees were the most commonly alleged perpetrators (43 percent), followed by facility residents (40 percent). Most accused were male (78 percent). Two accused staffand four accused residents had criminal histories. All but three of the confirmed perpetrators were male and none were arrested. …

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