Care home staff need training and support in helping identify and tackle sexual assaults in nursing homes, according to researchers, who warn that the problem is almost certainly under-reported.
Their research paper examined previous studies on sexual assault in nursing homes, perhaps unsurprisingly, finding the most vulnerable residents were likely to become victims.
“Much more needs to be done for this vulnerable group of people”
Victims of sexual assault were predominately white females with a form of mental and physical impairment and perpetrators were predominately white males, said the Australian researchers.
But they also found resulting investigation and legal action were infrequent due to the “administration complexities” involved, as well as levels of training and policy in care homes.
In addition, nursing homes were generally not adequately equipped to deal with sexual assault cases, they concluded.
They said that, although sexual assault was among one of the most “shocking” types of assault, it was also the “least acknowledged, detected and reported” type of assault among residents.
Their systematic review looked at 15 studies with the aim of identifying victim-perpetrator characteristics and trends on assault type, examination process, legal outcomes, and preventive measures.
“This review.. demonstrates a need for better staff training in detecting, examining, and managing sexual assaults”
The victims were most likely to be females with cognitive or physical impairments. They were often widowed, required assistance in all daily activities, and had difficulty with orientation, communication, or ambulation, and had a number of conditions.
Meanwhile, the perpetrators were likely to be male residents – although sexual assault by staff members was also “substantial”.
Accused care staff were typically male and had criminal histories. Accused residents were typically male, substance abusers, had criminal histories or a form of disability.
However, perpetrator information was limited, said the researchers, with the majority of research studies failing to identify characteristics beyond race and gender.
The study authors acknowledged that a “definitive” estimate of sexual assault prevalence in nursing homes was not possible to ascertain, due to under-reporting and difficulties confirming those incidents that were reported.
However, the researchers highlighted that sexual assault was likely to be “greatly underreported”, due to a number of potential barriers occurring in healthcare facilities.
For example, among the reasons cited were limited staff numbers in nursing homes, as well as a lack of training and influence among the care workforce.
In addition, one of the studies looked at for the review found that around half of the investigators considered that sexual assault was “more challenging” than any other form of assault to investigate.
“This review highlights a gap in knowledge regarding sexual assaults in nursing homes and demonstrates a need for better staff training in detecting, examining, and managing sexual assaults in nursing homes,” said the study authors in the journal The Gerontologist.
“Much more needs to be done for this vulnerable group of people,” added lead author Daisy Smith, from Monash University in Victoria.