“Past research has identified LTC residents as a high-risk group for elder abuse and neglect (Yon et al., 2019). At times of stress, anxiety, and resource constraints, older persons might be even at a greater risk. Moreover, in many countries, the current guidelines on physical isolation do not allow for visits to LTCS. Although the prevention and monitoring of elder abuse and neglect should be well regulated and ongoing within the institution, there is no doubt that family members and outside visitors take an important role in ensuring the quality of services. In the absence of outside visitors, care provided to a particularly vulnerable population in society is not monitored by people outside the setting. This is particularly relevant in the case of elder abuse and neglect, which often occurs behind closed doors.”

Ayalon, Liat et al. “Long-term care settings in the times of COVID-19: challenges and future directions.” International psychogeriatrics vol. 32,10 (2020): 1239-1243. doi:10.1017/S1041610220001416

Even though long-term care facilities were now required to allow visitors, administrators advised visitors to stay away during COVID outbreaks that sometimes lasted for weeks.  (I didn’t heed that advice.)  Furthermore, COVID-related staff shortages raised the risk of both abuse and neglect.  David’s accounts of being thrown on the bed might reflect his fear when staff moved him quickly or when they used a hoist – or they might reflect abusive behavior. 

So many unknowns, so many unknowables.