What are the motivating factors for elder abuse committed by nursing home employees?

Brian Payne and Randy Gainey of Old Dominion University studied nursing home abuse from the perspective of a criminologist. They found that nursing home abuse occurs when 3 elements are present: an offender who is motivated, absence of capable guardian for the elder and a suitable target. The key to stopping elder abuse is finding a way to minimize or eliminate these 3 elements. For instance, in a nursing home, those patients who have cognitive disabilities are more likely to be abused because they are a suitable target. Also, since many nursing homes have inadequate staff which are poorly paid and poorly trained, the absence of a capable guardian is more common than people think.

Payne and Gainey consider the different motivating factors for the abuse. In some instances, there is abuse because a stressed out employee who is overworked reacts negatively and abusively to an elderly resident because of the situation. In other circumstances, there are “pathological tormentors” where there is no apparent reason for the provocation and there is a very severe response. These pathological offenders or serial abusers have a history of abuse—it is not a one time occurrence.
The reason why it is important to distinguish between the different types of motivating factors is to have laws and policies which actually prevent the abuse. In nursing homes, the residents must rely on laws and formal measures to stop the abuse, yet this study shows that stricter penalties and mandatory reporting laws are not really effective in reducing abuse and therefore cannot act as “capable guardians.” The reason stricter penalties and mandatory reporting don’t really work is because so much of the abuse is not reported and if it is, punishment is not likely.

Therefore, the more effective means of reducing nursing home abuse is to increase the staff to patient ratio so that employees are not overworked and stressed out. Alternatively, more managers should be hired to oversee and supervise the employees who work with the elderly. Another suggestion is to pair employees together as a team so that abuse does not go undetected. Also, better training and increased pay would help reduce the abuse caused by the stressed out employee. Additionally, better background checks, including criminal background checks, should be used to discover past abuse by potential employees.

By studying the precise causes and motivations for elder abuse, we can specifically target the causes and prevent the abuse. Rather than passing stricter laws and more laws about reporting abuse, it would be more effective to increase the staffing requirements and hours requirements for employees so that they are not overworked and over-stressed.


Payne, Brian and Randy Gainey. The Criminal Justice Response to Elder Abuse in Nursing Homes: A Routine Activities Perspective.