We know what good caregiving practice is, and we must teach, recognize and reward its use. We know what bad caregiving practice is, and we must halt it at once, right there, not later, not by memo or meeting, but in the full light of day where it occurs. The latter recommendation requires an agency wide commitment to eradicate custodialism in all its forms and to constantly monitor and assess the quality of the caregiving tone in each residence. One abuse case means a problem in all of the above. There is another explanation.
Managers tend to regard abuse prevention as a policy issue.
It is most decidedly not a policy issue. It is a dilemma. We have made abuse a direct care problem with the result that we receive fewer and fewer reports of abuse and neglect . This loss of communication is the consequence of divided loyalties and common animosities, and these feelings do not yield to administrative authority, slogans, mission statements or a few hours of training. States across the Country require providers to offer abuse prevention training to their employees.