Registered Nurses' Association of Ontario

Factors and Conditions that Contribute to Abuse and Neglect in Institutions

Abuse and neglect in institutional settings is a complex and multifaceted issue that requires a combination of strategies at various levels to prevent it from occurring (McDonald et al., 2012; Spencer, 2006). Below is an overview of factors and conditions that contribute to abuse and neglect in institutions.


  • inadequate number of staff/inappropriate staff mix to meet the needs of residents
  •  staff who have not been adequately trained (e.g., no training in dementia care, transient staff)
  • rationing of supplies
  • culture or regime of institution (e.g., set bed times, assembly line caregiving)
  • lack of supervision
  • overcrowding/congestion


  • burnout/emotional/physical exhaustion
  • disempowered staff
  • personal stress such as performing “double duty” (i.e., providing care at work and at home)
  • alcohol or substance abuse
  • personal history of abuse
  • attitudes: ageism, condoning abuse and neglect


  • dependency based on physical limitations
  • communication difficulties
  • cognitive impairment
  • physical or social isolation (e.g., few visitors, no family involvement)
Older Adults
Preventing and Addressing Abuse and Neglect of Older Adults: Person-Centred, Collaborative, System-Wide Approaches
Background Information