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Home care nurses ‘frequently verbally abused’ by clients and their families

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Home care health workers are frequently verbally abused by clients and their families, according to researchers from the US.

They found key drivers for verbal abuse were cramped living conditions, dementia, and unpredictable work schedules.

“Home care workers may be especially vulnerable to impacts from verbal abuse, as the isolated nature of their jobs”

Study authors

The study authors suggested that violent behaviour had become an “occupational hazard” for health and social care workers in the domiciliary environment.

However, they said most of the previous research in this area had focused on physical assault perpetrated against hospital staff or those working in other facilities.

The researchers said they wanted to find out how often home care workers, including nursing, hospice, and personal care aides, had to put up with verbal abuse.

Writing in the journal Occupational and Environmental Medicine, they noted that such abuse could be harmful to health and lead to job dissatisfaction and burnout.

The researchers drew on 954 responses to the US Safe Home Care Survey, which was carried out as part of a larger study on home care working conditions.

It collected information on home care worker demographics, health issues, and general conditions of employment as well as work practices and living conditions and behaviours in the preceding month.

“Requirements of client privacy leave them with fewer resources for social support that can help moderate the stress response”

Study authors

Abuse was defined as being yelled at or spoken to in an angry or humiliating tone, being threatened with violence, being made to feel bad about oneself or subjected to racial, ethnic or religious insults.

The survey found that 22% of participating domiciliary care workers reported at least one incident of verbal abuse by clients or their relatives during the preceding 12 months.

In addition, 51% experienced more than one type of verbal abuse and 5% experienced all four.

Physical abuse was much less common – reported by 7.5% of survey respondents – but care workers experiencing verbal abuse were 11 times more likely to be subjected to physical abuse than those who had not been verbally assaulted.

Older workers above the age of 48 were less likely to be verbally abused than younger workers.

This may indicate greater experience and, therefore, better coping and communication skills, suggested the researchers from the University of Massachusetts.

After taking account of age, certain factors were significantly associated with a heightened risk of verbal abuse, especially cramped client living conditions and having a client with dementia.

Other factors included a client with limited mobility and an unclear care plan. For example, domiciliary workers with predictable working hours had a 26% lower risk of being verbally abused.

The researchers argue that their findings may underestimate the prevalence of verbal abuse, as recall fades over time and staff may make allowances because of their client’s age or condition.

The study authors said: “Home care workers may be especially vulnerable to impacts from verbal abuse, as the isolated nature of their jobs and requirements of client privacy leave them with fewer resources for social support that can help moderate the stress response.

“Approaches to reducing it should be a priority for [their] employers,” and could also benefit clients, the researchers added.

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