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Caregivers Corner - August 2001
Competence with Compassion

For more than two decades, The Center for Advocacy for the Rights and Interests of the Elderly (CARIE) � a Philadelphia-based non-profit agency � has been working to improve the well being, rights and autonomy of older persons through advocacy, education and action.

One of CARIE�s ongoing initiatives is abuse prevention education for long-term care staff.  CARIE began during the late 1980s to explore how the frustrations and difficulties nursing home staff face in their daily dealings with residents relate to abusive practices.  Among the many forces at work contributing to a difficult and stressful living and working environment are:

High turnover, sub par staffing levels, caregiver fatigue and burnout
Perceived low job status among primary caregivers
A high degree of interpersonal conflict between residents and staff as well as between co-workers
The highly regimented medical model of care delivery that limits individual freedoms and choices
Misguided staff attitudes that residents are childlike and need disciplining at times
Staff who are dealing with stressful personal lives in addition to the demands of their work
Fears and anger associated with caring for frail elders who are mentally and/or physically impaired
Lack of adequate skills to effectively manage conflict, defuse anger and minimize resident aggression

CARIE�s Competence with Compassion: An Abuse Prevention Program for Long Term Care Staff has been designed to build awareness of elder abuse in nursing homes and to provide primary caregivers with some of the knowledge and skills they need to ensure an abuse-free environment.  The training course not only educates about abuse but also provides opportunities to practice conflict intervention strategies through role-playing, case discussion and small group work.

The curriculum addresses a wide range of topics that affect abuse and neglect:

Identification and recognition of types of abuse (physical, psychological and sexual abuse, financial exploitation, and active and passive neglect)
Possible causes of abuse and warning signs
Understanding the personal feelings of caregivers
Differing cultural and ethical perspectives
Care recipient stresses and abuse of staff by residents
Ethical and legal issues of reporting suspected abuse
Caregiver intervention strategies

When the Nurse Aide Resident Abuse Prevention Training Act of 1997 was signed into law in Pennsylvania, CARIE was instrumental in developing a training manual for the Department of Education. This manual was made available to assist all state-approved nurse aide training programs to comply with implementation of the 23 new and revised objectives that became part of the curriculum guideline requirements for Act 14.  The manual enables primary instructors to provide the required abuse prevention instruction and to prepare new hires to better manage and avoid conflict, handle stress and practice useful intervention strategies. 

To learn more about CARIE�s abuse prevention training programs or other initiatives visit the CARIE website www.carie.org, or contact the organization:

Center for Advocacy for the Rights
and Interests of the Elderly

100 North 17th Street, Suite 600
Philadelphia, PA 19103
(215) 545-5728 phone
(215) 545-5372 fax

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