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How to Overcome the Fear of Retaliation and Advocate for Quality Care

How to Overcome the Fear of Retaliation and Advocate for Quality Care

What is the fear of retaliation?

The fear of retaliation describes a feeling of vulnerability in which one’s actions may cause retaliation by another. Retaliation, in the case of long-term care, refers to the act of revenge by facility staff in response to a complaint by a resident or loved one. This fear of retaliation may deter individuals from speaking up when they feel their or a loved one’s quality of care may be lacking or nonexistent.

According to one recent study released by the Long Term Care Community Coalition (LTCCC), 23% of residents believe that if they file a complaint, they will face severe retaliation from those with a duty to care for them. Residents’ apprehension about possible repercussions is significant due to their dependency on facility staff for basic needs.

Despite federal and state laws protecting nursing home residents’ rights to voice grievances about abuse and neglect, the fear of retaliation scares many into silence and has emotional, psychological, and even physical consequences.

Retaliation can be either egregious or subtle, and residents or staff may not even recognize the many forms it can take. Regardless of the form, retaliation by staff is abuse, whether or not harm was intended.

Examples of Retaliation:

PSYCHOLOGICAL ABUSEA facility threatening or attempting to discharge a resident because they, or their family member, filed a complaint; or a staff member yelling or cursing at a resident after they were reported to the charge nurse for failing to provide care.

NEGLECT – A staff person ignoring a resident or intentionally failing to provide care or assistance. Neglect can include unanswered call bells, late meals, ignoring resident requests, and intentionally not providing medication or assistance.

PHYSICAL ABUSE – A staff member hitting, pinching, or being rough with a resident who does not follow directions or complains about something the staff member is doing.

The facility is responsible for protecting residents from abuse and neglect – this includes protecting residents from retaliation. The facility, not the resident or family member, has the responsibility to stop retaliation from occurring. Sometimes, it may be difficult to determine whether staff are retaliating or if a resident’s needs are not being met for another reason, such as understaffing. However, if retaliation is evident or even suspected, there are steps that can be taken.

How to report retaliation:

  • Use the facility’s grievance policy and file a concern with the facility’s Grievance Officer, often the Social Work Director.
  • Contact your local Ombudsman for advice and assistance (401-785-3340)
  • File a complaint with the Department of Health (401-222-5960).

It is not a resident’s responsibility to prevent retaliation. However, when residents hesitate to speak up because of the fear of retaliation, circumstances are unlikely to change and the problems may continue. While it is scary to speak out, it is a resident’s right to be free from abuse and neglect and to have a voice in the way they are treated and how their care is delivered.


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