Residents' Fear of Retaliation in America’s Nursing Homes: An Exploratory Study

Abstract

The phenomenon of residents’ fear of staff retaliation when voicing care concern and making mistreatment complaints in nursing homes has been shown in research to be common. Despite longstanding concerns by care advocacy organizations about this phenomenon and its impact on residents (including emotional suffering, inadequate care, and mistreatment due to fear-driven lack of reporting, investigation, and resolution), little research examined it to date. Using 100 standard survey and complaint investigation reports from state survey agencies in nursing homes in 30 states, the researcher of this qualitative study aimed to improve understanding of residents’ lived experience of four aspects of this phenomenon—fear of retaliation, allegations of threats of retaliation, perceived retaliation, and actual (confirmed) retaliation—and their emotional consequences. The findings could inform practice and policy changes necessary to realize residents’ federal right to speak up without fear of retaliation when advocating for dignified and safe care.