How Nursing Homes Can Respect Residents’ Dignity and Prevent Sexual Abuse

Oftentimes patients and family members are unaware of the common practice of gender neutrality many nursing homes and rehabilitation facilities in America use nowadays for patient’s intimate care. This includes: bathing, changing diapers, and dressing. What this means is nurses and aides are randomly assigned for patient care without considering the patient's sex; therefore, in many nursing homes, it is very common for male nurses and aides to perform intimate procedures on women. This was unheard of decades ago. This is very sad. Most patients and their families expect nursing homes and rehabilitation facilities to treat patients with dignity and take precautions to prevent them from being sexually abused.

One doctor from south Florida was very upset to learn that his elderly mother was occasionally being bathed by a male aide. He contacted Medical Patient Modesty in 2016. This doctor could not believe that the nursing home where his mom resided did not have a policy that prohibited male nurses and aides from performing intimate procedures on female patients. He talked with the Director who then agreed to reassign his mom’s care to make sure she would have a female aide. The Director then stated the nursing home would continue to allow male staff members to help other female residents with intimate procedures.

The majority of women are uncomfortable with male medical staff helping them with bathing, taking them to the bathroom, and dressing. Also, many women are opposed to letting their sons, grandsons, and brothers see them naked. They should not have to give up their boundaries about men seeing their private parts in nursing homes.

Here is a case example: Three years earlier, a male aide from a home health agency was assigned to an elderly woman, Mary* (changed her name to protect her privacy) after she had a brain bleed from a fall for bathing needs. Mary told the aide no that he could not help her and he left. Over thirty years earlier, Mary set strict rules taking care of her mom who had Alzheimer’s. Mary hired female caregivers and would never allow any male family members to see her mom naked or give her a bath or change her diapers because she wanted to protect her mom’s dignity. Right before Mary was admitted to a nursing home, she needed help from her son-in-law to walk and get into bed. Her son-in-law showed respect for her dignity by making sure he did not see her naked. That same dignity was completely disregarded at the nursing home. A few days after Mary was admitted to the facility for rehab due to weakness and dementia, a family member was heartbroken to observe a male CNA along with a female CNA going into her room and shutting the door to change her diaper and clothes. The male CNA even carried her clothes out to the laundry room. This was ridiculous. That male CNA should have stayed outside the door until the female changed the female patient’s diapers and clothes. It’s terrible that this woman’s dignity was not respected.

In many states, there is a Care Home Bill of Rights for nursing home residents. One of the patient’s rights is to be treated with respect, consideration, dignity, and full recognition of his or her individuality and right to privacy. Allowing a male nurse or aide to help female residents with intimate procedures is a violation of women’s dignity. To make matters worse, many of those women have dementia or serious physical conditions that leave them defenseless and unable to speak up.

Many women’s prisons in a number of states have policies that prohibit male security guards from stripping female inmates—even if they are suspected of hiding drugs—or watch them showering. These rules are in place mainly for two reasons: 1) To protect female inmates’ dignity. 2) To reduce the chance these inmates will be sexually abused. It is ridiculous that female inmates are seemingly treated better than female nursing home residents. It is wonderful that the prison system has realized the consequences that could arise by allowing male security guards to come into intimate contact with female inmates and the chances of sexual misconduct. The nursing home industry needs to realize these concerns as well.

Responses to Some Arguments Nursing Homes May Use:

1) Nursing homes and hospitals may use the excuse that a male nurse/aide has to assist in bathing certain women because of heavy lifting ensuring the patient is not dropped. This is not true. Due to the potential of sexual abuse, this is very risky. A female nurse or assistant should always bathe a female patient. A male nurse or assistant could help lift a clothed female patient into the bathtub if necessary; leave while a female nurse or assistant bathes her; be called back to get the patient out of the bathtub after the patient has been redressed. It is also safer to use appropriate equipment when necessary, including Hoyer Lifters, EZ-Pivot, and similar devices designed for lifting patients, as to reduce the risk of employee injury. Sponge bed-baths for very frail female patients require no lifting or male assistance whatsoever.

2) All of the male nurses and aides we have hired have no criminal backgrounds and they are very professional. The reality is many male nurses and aides that have sexually abused female residents in nursing homes had no criminal background and acted professional at the start of their employment.

3) Whenever a male nurse or aide has to help with intimate procedures, they always have a female staff member present. Having a chaperone does not always help to prevent abuse. Abuse can happen quickly. That chaperone may be the male staff member’s friend or even girlfriend. Also, this does not take away the fact that a male staff member violates the female patient’s dignity just by the fact of seeing her naked or helping her with intimate procedures. There are times a female nurse or aide may know that the male staff member is doing something wrong, but she may be afraid to expose his criminal activities for fear of being fired or facing discrimination in the workplace. Look at the example of Krista Salda, a nurse at Brian Center who went against the wishes of her boss by reporting Luis Gomez, a well-liked male CNA who sexually assaulted multiple women at the Brian Center in Waynesville, NC by reporting him to the police. A few days later, Krista Salda was fired. Krista shared that she doubts she could work in nursing homes again and that facilities are reluctant to hire whistleblowers. Not many nurses could have done what Krista did. Many nurses and aides do not want to risk losing their jobs.

Sexual Abuse in Nursing Homes Is Common

Residents who have dementia or mobility limitations due to a stroke are easy prey for sexual abuse. Many of those residents cannot say what happened due to their condition or are not believed. Sexual assault in nursing homes is extremely hard to prove, as well, it is underreported because many of the victims have unreliable memories due to dementia.

An exclusive 2017 CNN investigation found the Federal Government has cited more than 1,000 nursing homes for mishandling or failing to prevent alleged cases of rape, sexual assault and sexual abuse at their facilities between 2013 and 2016. Nearly 100 of those facilities had been cited multiple times during those same three years.

Sexual abuse happens in nursing homes more than most people can imagine. The truth is most people may never know if their loved ones had been sexually abused in a nursing home especially if they have dementia. There is also a higher chance of sexual assault happening at night since there is less supervision.

A List of Few Cases of Sexual Assault in Nursing Homes:

1) George Kpingbah, a 76-year-old male nursing assistant, was caught raping an 83-year-old woman in a nursing home in Minneapolis in 2014. For years, he continued to work at the same facility despite allegations from other female residents that he sexually assaulted them. The earliest complaint was in 2008.

2) Walter Martinez, a St. Louis nursing aide, faced felony rape charges and years in prison after confessing in his resignation letter to sexually abusing two elderly residents. Martinez ended up receiving two years of probation after the alleged victims died or suffered from such severe dementia that they were unable to testify. This case shows that victims with dementia and other debilitating diseases are often considered such unreliable witnesses that even cases where the assailant actually confesses to the crime end up being thrown out and/or result in little punishment for the defendant.

3) Luis Gomez, a well-liked male nursing assistant in Waynesville, NC (a small town), raped numerous women at a local nursing home. He had worked at several other nursing homes in the area. He even helped his wife get a nursing aide job at a nursing home he worked at previously. Complaints of sexual assaults by female residents were ignored. He helped with bathing residents, taking them to the bathroom and changing their diapers. He sexually assaulted one woman as he helped her to shower and change her diapers. He loved his job and went the extra mile in helping residents according to a former co-worker so many people considered him to be a great man. He was finally reported to the police by one brave nurse, Krista Salda who lost her job a few days later. After a weeklong trial, Gomez was found guilty of raping two Brian Center residents and convicted on six counts that included forcible rape with a physically helpless victim.

4) Nathan Sutherland, a 36-year-old male nurse, sexually assaulted a woman in a vegetative state and got her pregnant at a facility in Arizona. He had a clean criminal background. Her caretakers and family were shocked when she gave birth to a baby. The facility had to look for records of male staff members who had worked with her and obtained a DNA sample from Nathan Sutherland. His DNA matched the baby’s.

It is time for the nursing home industry to wake up to the fact that their gender-neutral approach to intimate care of female residents is what has caused sexual abuse by male staff members to raise dramatically over the past two decades. It is disturbing that most of those nursing homes that had incidents of male nurses or aides who have sexually assaulted female patients continue to allow male nurses / aides to participate in intimate care of female residents. Disregarding any patient’s dignity opens the door for potential sexual abuse. This heinous crime usually does not happen overnight, but slowly.

Enacting a Policy To Protect Female Residents

Nursing homes should enact a policy that prohibits male nurses and nursing assistants from performing intimate procedures on female residents such as changing their diapers, cleaning them after a bowel movement, dressing them, and bathing. This job should only be performed by female nurses or nursing assistants.

Male staff members at a nursing home should only assist women when they are covered. There should be no private interaction between a male staff member and a female resident at any time. For example, if a male staff member needs to lift a woman from a wheelchair into her bed, the door to the room should always be completely open so anyone in the hallway can witness what is going on. This is a necessary precaution to prevent sexual abuse.

It is very important that nursing homes continue to hire male nurses and assistants. They are very necessary for three reasons:

1) Many male patients are uncomfortable with female nurses or aides helping them with things that involve exposure of their private parts, such as showering. Every male patient should have the option of a male nurse or aide for intimate procedures. Also, many men prefer that their wives help with showering whenever possible and this should be an option if the male patient’s wife is able to help. Many male patients value their modesty, but do not feel like they can speak up because our society teaches that modesty does not matter for men and that modest men are “weak”.

2) There have been incidents of male patients who have inappropriately touched or sexually assaulted female nurses or CNAs who helped them during intimate procedures.

3) Male staff members often do a better job than female staff members at lifting patients and heavy objects.

To protect female residents, nursing homes need to enact a policy that prohibits male staff members from helping women with personal care tasks. Sexual abuse in nursing homes would decrease with this policy. This policy would also ensure respect for women’s dignity. Male staff members at nursing homes should treat female residents with respect and dignity, as if female residents were their mothers, grandmothers, or sisters and this means not seeing them naked. Nursing homes should put a heavy emphasis on assigning their male nurses and aides to assist with male residents for personal care tasks as much as possible. This would help to ensure more respect for men’s dignity.

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A nurse is accused of impregnating a woman in a vegetative state who later gave birth

How to protect a loved one from abuse or sexual assault in a nursing home