Failure to Prevent Verbal Abuse of Cognitively Impaired Resident
Penalty
Summary
A resident with Alzheimer's Disease, depression, and anxiety, who was dependent on staff for personal care and had altered cognition, was subjected to verbal abuse by a nurse aide. The resident's care plan required staff to use simple explanations, orientation guides, and to reapproach if the resident refused care. On the evening of the incident, a nurse aide was observed by a charge nurse aggressively gesturing and yelling at the resident while attempting to provide care. The charge nurse reported that the aide shouted phrases such as, "what's up with you? Don't be putting your hands on me, and you're not going to put your hands on me," after the resident became combative. Another LPN in the hallway also heard the aide yelling loudly at the resident, and both nurses confirmed the aide's behavior was extremely loud and could be heard by others. The incident was witnessed by two nurses, and the aide admitted to raising her voice in response to the resident's actions. The resident was known to resist care and could become combative, but staff were instructed to reapproach rather than escalate the situation. The facility's policies required staff to prevent abuse and treat residents with respect and dignity. The investigation substantiated that the nurse aide's actions constituted verbal abuse, as the aide failed to follow the care plan interventions and facility policies designed to protect residents from abuse.