Connecticut Long Term Care Ombudsman Program

Voices Speak Out Against Retaliation

Prompted by a resident question at the VOICES Forum in 2005, Connecticut’s Long Term Care Ombudsman Program (LTCOP) initiated a statewide work group and also commissioned the University of Connecticut Health Center to study Fear of Retaliation in skilled nursing facilities.  That study concluded that Retaliation and the Fear of Retaliation is a reality in any supportive housing situation.   Retaliation can be either egregious or subtle; many forms of retaliation may not even be recognized by residents or staff.   Therefore, as one part of a comprehensive awareness initiative, LTCOP designed the Voices Speak Out Against Retaliation training video to acknowledge that Fear of Retaliation is a reality for individuals living in skill nursing facilities.  It is recommended that a facilitated discussion follow the video.  The discussion asks two questions –
1) in the video, when speaking about Fear of Retaliation, what did the residents tell you? And 2) what can you do in your role to diminish and/or overcome Fear of Retaliation?
 
To assist with training, access the following training resource materials:
For more information or to order a copy of this video please contact the Connecticut State Long Term Care Ombudsman Program at 1-866-388-1888.
 
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Additional Resources and Reports

Caspi, Eilon, PhD. (June 2023).
"They Make You Pay: How Fear of Retaliation Silences Residents in America's Nursing Homes."
Prepared for the Long Term Care Community Coalition.

This report examines the pervasive issue of fear of retaliation among nursing home residents, detailing strategies and barriers faced by Ombudsman representatives.

Key Findings:

  • Prevalence: Fear of retaliation is widespread and significantly hinders the reporting of care concerns or mistreatment.

  • Barriers: Institutional culture, staffing challenges, and inadequate oversight compound the issue.

  • Recommendations: Emphasis on educational initiatives, advocacy, and legislative reforms to promote safety and dignity for residents.

The report underscores the importance of systemic changes to alleviate residents’ fears and enhance the effectiveness of advocacy programs.

For more information and additional resources, visit the LTCCC's website: LTCCC - Fear of Retaliation

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Caspi, Eilon, PhD. (May 2024).
"Residents' Fear of Retaliation in America's Nursing Homes: An Exploratory Study."
Published in the Journal of Applied Gerontology.

This exploratory study provides an in-depth analysis of residents' fear of staff retaliation in U.S. nursing homes. Utilizing 100 standard survey and complaint investigation reports from state survey agencies across 30 states, the study examines:

  • Aspects of Retaliation: The research categorizes experiences into fear of retaliation, allegations of threats, perceived retaliation, and confirmed retaliation.

  • Emotional Consequences: Residents experienced heightened anxiety, helplessness, and emotional distress due to fear of retaliation.

  • Barriers to Reporting: The study highlights how fear of retaliation serves as a significant barrier, preventing residents from reporting substandard care, abuse, and neglect.

The findings call for increased awareness, policy changes, and the implementation of protective measures to ensure residents can voice concerns without fear.

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Caspi, Eilon, PhD. (December 1, 2024).
"A Bridge Over Scary Water: Ombudsman Program Strategies and Barriers in Addressing Residents’ Fear of Retaliation in Long-Term Care Homes."
Prepared for the Connecticut Long-Term Care Ombudsman Program.

This report examines the pervasive issue of fear of retaliation among nursing home residents, detailing strategies and barriers faced by Ombudsman representatives. Key findings highlight:

  • Prevalence: Fear of retaliation is widespread and significantly hinders reporting of care concerns or mistreatment.
  • Barriers: Institutional culture, staffing challenges, and inadequate oversight compound the issue.
  • Recommendations: Emphasis on educational initiatives, advocacy, and legislative reforms to promote safety and dignity for residents.

The report underscores the importance of systemic changes to alleviate residents’ fears and enhance the effectiveness of advocacy programs.

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Caspi, Eilon, PhD. (November 28, 2024).
"Silenced: Residents’ Fear of Retaliation in 40 Nursing Homes in Illinois."
Prepared for the Alliance for Community Services.

This report investigates fear of retaliation in Illinois nursing homes, summarizing 42 state investigation reports. Key insights include:

  • Case Studies: Illustrative examples of verbal, emotional, and physical abuse linked to retaliation.
  • Systemic Failures: Weak enforcement of abuse prevention policies and environments that silence residents.
  • Call to Action: Advocates for policy reforms and improved abuse prevention measures to protect residents’ rights.

Through real-life cases, this report highlights the urgent need for regulatory and cultural reforms to ensure residents’ safety and well-being in long-term care facilities.