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Almost half of all nursing home staff have witnessed elderly abuse by relatives

More than 3,000 nursing home employees shared what they have witnessed of violence and abuse from visiting relatives and friends.

More than 40 per cent of nursing home staff had witnessed psychological abuse such as scolding, arguing, derogatory comments, and other degrading behaviour. Nearly 10 per cent had observed physical abuse.
Anne Sliper Midling journalist at Norwegian Scitech News
Presented by: Presented by: Presented by: NTNU - Norwegian University of Science and Technology
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These figures come from the first major study in Norway to investigate violence and abuse from relatives against their own elderly family members who are admitted to nursing homes.

“I don’t think the findings are particularly surprising,” says Anja Botngård, researcher at NTNU.

She asked more than 3,600 nursing home employees from 100 nursing homes in Norway to share what they have witnessed of violence and abuse from visiting relatives.

“Previous research has shown that factors such as relatives’ poor mental health, substance abuse, and financial dependence are strong risk factors for committing violence,” says Anja Botngård, associate professor at NTNU.

The results showed that 45.6 per cent of nursing home employees had observed one or more cases of violence or abuse in the past year.

Risk increases with exhaustion

“The most frequently reported was psychological abuse, including shouting, arguing, derogatory remarks, and other degrading behaviour. There are examples of other types of abuse as well, but they have been observed and reported by employees to a lesser extent. Let’s hope that it occurs just as rarely as it's reported, but it could be that it's reported less because it happens when no staff are there to witness it,” says Wenche Malmedal, a professor at NTNU.

Ranked by percentage, here’s what nursing home employees reported:

  • 44.8 per cent had observed psychological abuse
  • 8.4 per cent had observed physical violence
  • 2. per cent had observed financial/material abuse
  • 0.7 per cent had observed sexual abuse at least once in the past year.

Relatives have no formal responsibility under Norwegian law for the care of elderly people living in nursing homes.

However, many elderly people live at home for a long time before they receive a place in a nursing home. During this period, many relatives carry a significant caregiving burden. When the family member moves into a nursing home, it can be difficult for relatives to let go of the responsibility they have had for a long time, Botngård believes.

“Some relatives may also feel that the elderly person is not receiving adequate care in the nursing home, and may therefore continue to feel a sense of responsibility,” she says.

Botngård believes this can lead to relatives taking on more caregiving duties than they actually have the capacity for. This can increase the risk of abuse.

The burden of caregiving can also affect the health and quality of life of the person providing the care.

Intimate partner violence can continue in nursing homes

A recent doctoral thesis from Gunn Steinsheim at NTNU shows that when caregiving relatives become exhausted, the risk of them subjecting elderly people to violence and abuse increases. The research also shows that when elderly people with dementia act aggressively towards their relatives, it increases the risk of the relatives responding with aggression.

“Shouting and arguing between spouses or between parents and children can go both ways, but when one of them is ill and in need of care, a power imbalance arises between the person providing care and the person receiving it,” says Botngård.

The study by Botngård and her colleagues only focuses on actions that staff have observed relatives carrying out.

“Based on our study, we cannot say why these actions happen. Previous research has shown that relatives’ poor mental health, substance abuse issues, and financial dependence are strong risk factors,” she says.

Relatives may be spouses, children, grandchildren, and other people closely connected to the elderly person.

Botngård believes the study’s findings must be seen from a life-cycle perspective.

“People who have been subjected to domestic violence may find that the violence continues even though they have moved into a nursing home. Intimate partner violence and abuse from children or grandchildren are also realities in nursing homes. Nursing home staff have a duty to monitor and prevent it,” says Botngård.

A phenomenon that has received little attention

“The important thing for relatives is that the nursing home staff know how to deal with ageing and dementia, and that they have enough time and resources to provide quality care,” says Botngård. 

She also emphasises the need for staff to know how to recognise domestic violence and how to handle these types of incidents when they occur.

Botngård believes the study highlights a phenomenon that has largely been overlooked.

“In recent years, growing attention has been given to violence and abuse against elderly people living at home, and neglect in nursing homes. However, elderly people in nursing homes being subjected to violence and abuse by relatives is an under-researched phenomenon – both in Norway and internationally,” she says.

Botngård notes that further research is needed to understand why this occurs, so that effective measures can be developed to prevent these types of incidents.

References:

Botngård et al. Relative-to-resident abuse in Norwegian nursing homes: a cross-sectional exploratory study, BMC Geriatrics, 2024. DOI: 10.1186/s12877-024-05513-0

Steinsheim, G. Stretched to the Limit? Informal caregiver burden and elder abuse among home-dwelling persons with dementia, Doctoral thesis at NTNU, 2025.

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Read the Norwegian version of this article on forskning.no

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