Violence in care: Recognizing, preventing & your safety as a caregiver

 

When care becomes a test of endurance: How to recognize violence, protect yourself and find help

Violence in care is a topic that is often hushed up or trivialized - and yet many of us encounter it in our day-to-day work. Whether in home care, nursing homes or Hospital: Violence has many faces and can affect anyone - people in need of care, caregiving relatives and also you as a professional caregiver.

Maybe you remember a moment when a difficult conversation, a dismissive look or an aggressive action affected you deeply. Violence in care often happens quietly, sometimes insidiously - and yet it leaves its mark. Did you know that, according to recent studies, one in three Nurse has already experienced psychological or physical violence in Germany or Austria? This is a reality that we can no longer ignore.

In this article, you will learn how to recognize violence, what you can do to prevent it and which contact points there are for you. Together, we will ensure that care relationships remain safe, respectful and free of violence - for you and your fosterlings.

A nurse sits beside an older man in a bathrobe on the edge of a bed, holding his hand and offering support in a bright, white room.

 

Understanding violence: The invisible sides of everyday care

Violence has many faces: what does it actually include?

Violence in care is more than just hitting or loud shouting. It often manifests itself very subtly - through ignoring, humiliation, inappropriate language, financial exploitation or failure to provide necessary help. The World Health Organization (WHO) defines violence in care as "any single or repeated act or failure to respond appropriately within a relationship of trust that causes harm or distress to an older person".
Find out more at ZQP - Zentrum für Qualität in der Pflege

Physiotherapist performing a pain relief massage on a senior woman in a clinic, with another patient receiving treatment in the background.

 

Case study: 

Sabine has been working for five years as a nurse in a Senior Residence in Austria. She loves her job, looks forward to interacting with the residents every day and puts her heart and soul into it. But everyday life is often a real challenge: the team is regularly understaffed, time pressure and constantly new tasks determine the daily routine.

On a particularly hectic day, Sabine is called to visit Mrs. M. - a resident who has recently been suffering from severe confusion. Mrs. M. struggles to wash herself, flails her hands and doesn't want to be dressed. Sabine can feel her own patience waning. Under stress and under pressure to complete all the tasks on time, she speaks louder than usual, becomes gruff, pulls Mrs. M.'s shirt over her head somewhat roughly and urges her to do it faster.
Later, in the break room, Sabine tells her colleagues how difficult the situation was and that she sometimes feels she no longer lives up to her own standards of empathetic care. She realizes that she has been more impatient for some time, sometimes gets angry with residents or says words that she later regrets - and that she feels guilty afterwards.

A few days later, an experienced colleague approaches Sabine. She cautiously asks how she is really feeling and whether there is anything on her mind. During their conversation, Sabine realizes how much pressure she is actually under - and how easy it is for excessive demands to lead to small, sometimes unnoticed forms of violence, such as rough handling or harsh words.

Sabine decides to get support, takes part in a violence prevention workshop and talks openly with her team about stress, borderline experiences and being overwhelmed. She learns to better recognize her own warning signals, to take breaks more consciously and to ask for help when things get too much. Today she knows that violence in care has many faces - and often begins on a small scale, especially when no one talks about their own stresses and strains. It is not a sign of weakness, but of professionalism to get help and talk about your own feelings and challenges.

 

Typical forms of violence according to ZQP and WHO:

Forms of violence in care

Form of violence Description example Effects for those affected
Physical violence Physical acts that cause pain Rough touching, hitting, restraining Injuries, fear, loss of trust
Psychological violence Violation through words or behavior Insults, ignoring, threats Depression, withdrawal, anxiety
Sexualized violence Unwanted sexual acts/implications Groping, lewdness, violation of privacy Trauma, shame, loss of trust
Financial exploitation Misuse of money/assets "Borrowing" money, misusing an account, coercion to give gifts Existential fears, loss of control
Neglect Failure to provide necessary assistance or care No hygiene, too little to drink/eat Health risks, loss of dignity, isolation
Structural violence Violence through institutional procedures/rules Coercive measures, lack of staff, isolation Feeling of being at the mercy of others, humiliation

Violence is not always obvious! It also includes disrespectful communication, lack of attention or withholding information.

 

Violence affects everyone: Who is affected?

Violence in care can affect any site - and can also come from all sides:

  • Caregivers versus people in need of care
  • Care recipients or relatives versus caregivers
  • Residents:inside the home

     

Imagine being criticized for a mistake in the break room, even though time was short - that's psychological violence. Or you are pushed or insulted by a person with dementia - that hurts and exhausts you. Violence is never "normal" and is not an occupational hazard that you simply have to accept!

 

Causes of violence in care: Where does it come from?

In everyday nursing care, you have a great responsibility - for the well-being of the people entrusted to you, but also for your own health. But if the pressure becomes too great, the climate can quickly change. Violence in the care sector has many causes - and they often arise where excessive demands meet silence.

An elderly person with gray hair raises her hands defensively while a caregiver points a finger at her. The scene suggests a case of verbal or physical abuse in a care environment.

 

Occupational overload: When the pressure gets too much

Imagine: Even before you start work, you know that the day will be too short again. The team is understaffed, new tasks are constantly being added and the residents' needs are piling up. This constant stress and time pressure puts a strain on your body and soul - and sometimes leads to you reacting more irritably, becoming impatient or less empathetic to challenging behavior.

Studies show: Staff shortages, lack of breaks and lack of support are key reasons why nurses - and alsocaregiving relatives - reach their limits. If this excessive demand is not recognized or addressed, the risk of mistakes, misunderstandings and even violence increases - no matter how hard you try to remain professional at all times.

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Nora's tip: Pay conscious attention to your own warning signals such as constant tiredness, irritability, sleep disorders, headaches or a feeling of helplessness. These are not weaknesses - but important messages from your body and soul! Talk to colleagues or make use of support services before the pressure becomes too great. More about causes at Gewaltinfo.at

 

Causes and effects in care

cause Effects on caregiver Effects on those affected
Staff shortage Exhaustion, irritability, mistakes Neglect, less time for attention
Time pressure Hectic, stress, less empathy Insecurity, fear, frustration
Missing training Lack of knowledge about violence prevention Misunderstandings, conflicts
Own burdens/addiction Decreasing inhibition threshold, aggressiveness Danger for all involved

 

Social & personal factors: When taboos block the way

Not only working conditions, but also social and personal factors influence the risk of violence. There is often a lack of awareness - violence is played down, made taboo or not even recognized as such. Sentences such as "I didn't mean it that way" or "That's just part of it" are unfortunately still part of everyday life.

In addition, anyone who has experienced violence in the past or is under psychological stress can slip into destructive patterns of behaviour more quickly - sometimes without realizing it. Addiction problems or unresolved crises also increase the risk of aggressive behavior in day-to-day care.

 

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Nora's tip: Be honest with yourself: Nobody is perfect, and being overwhelmed is not a sign of weakness. On the contrary: it shows strength to seek support, speak openly and recognize your own limits. This is the only way you can take care of yourself and your protégés in the long term - and prevent violence together with others.

 

Preventing violence: What you can actively do

Violence in care is not an inevitable fate - you can actively contribute to making everyday care safer, more respectful and more appreciative. Prevention starts with yourself, your team and everyone who bears responsibility.

A young woman sits at a table in the kitchen, holding her head in her hands in frustration, while an older woman stands in the background, gesticulating with her hands and apparently arguing.

 

1. Recognize signs early - for you and your protégés

The early recognition of violence is the most important step towards prevention. Violence has many faces: it can be loud and visible, but also quiet and subtle. That's why it's so important to look out for warning signs - in people in need of care as well as in yourself.

Warning signs in care situations

Warning signs for people in need of care Warning signs for caregivers
Unexplained injuries, hematomas Exhaustion, irritability
Withdrawal, fear of certain people Sleep disorders, headaches/back pain
Lack of hygiene, weight loss Feeling of being overwhelmed
Loss of appetite, depressive mood Cynicism, indifference
Statements like "I am afraid" Thoughts of giving up
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Nora's tip: If you notice such warning signs in yourself or your protégés, address them openly - whether in a team, with a trusted person or anonymous advice centers.

 

2. Strengthen your resilience - how to protect yourself

A strong inner resistance (resilience) is the best protection against excessive demands and the emergence of violence. You can train resilience - often with small exercises that can be easily integrated into your everyday life.

  • Relaxation techniques: Breathe deeply, feel how your shoulders sink and let go of everyday life for a moment. Just five minutes of conscious breathing or a short break can work wonders and help to regulate stress and aggressive impulses.
  • Supervision & Exchange: Regularly talk to your team or use anonymous counselling services, such as the Austrian Chamber of Labour. Shared experiences help you to recognize your own stress and find solutions.
  • Self-protection: Stay calm in borderline situations, set friendly but clear boundaries - and get help if you need it. Your safety has top priority.
  • Further education: Use every opportunity for training on violence prevention, de-escalation and non-violent communication. Knowledge is protection!

 

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Nora's tip: At noracares.at, you will not only find flexible jobs, but also a community to exchange ideas, practical relief ideas and support with all the challenges of everyday care. So you can avoid being overwhelmed in the first place!

 

3. employer responsibility - your safety first

Care facilities and employers have a great responsibility to prevent violence in the care sector and ensure your safety. Good employers take this issue seriously and implement clear measures:

  • Psychological evaluation:Regular review of mental stress and working conditions.
  • Training & Further training: Ongoing offers on violence prevention, communication and stress management.
  • Technical measures:emergency call buttons, safe workplaces, emergency plans and sufficient staff.
  • Messaging system:A simple and clear way to report and document incidents of violence anonymously.
  • Prevention culture: Promoting appreciative, respectful and open interaction within the team - no one should be alone here with worries or fears!

 

What to do in an acute case? Your rights & options

Sometimes it happens quite suddenly: you witness or become a victim of violence in everyday care work. This is when it is important to act quickly and calmly - and to know what steps to take to protect yourself and others. Here you will find your clear emergency plan for emergencies:

A woman in a pink shirt holds her head in her hand and covers her face. She appears to be stressed or angry.

 

Your emergency plan in case of violence - step by step

Steps in the event of an incident

step What to do?
Security Get yourself (and others affected) to safety immediately! Leave the situation if necessary.
documentation Write everything down as precisely as possible: When, where, what happened, who was involved? Even small details count.
message Inform your supervisor, a person of trust or the works council immediately. Do not hesitate to report the incident!
Support Get support from advice centers, experts - and in acute cases directly from the police or victim protection agencies.

 

Contact points for help in Austria & Germany

If you are looking for support or would like to report an incident, there are numerous reputable contact points that can help you:

  • Center for Quality in Care (ZQP) - Violence prevention
  • Ministry of Social Affairs Austria - Violence in care
  • Care and Living - Advice Hotline Telephone advice and support for relatives and caregivers
  • Number Against SorrowFree, anonymous help for all ages

 

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Nora's tip: You're not alone - and it's your right to protect yourself! Talk to us in the noracares community or contact one of the above-mentioned specialist agencies directly. Together we will find a solution and send a clear signal against violence in care.

 

Graphic of nurse Nora with a stethoscope around her neck and the text 'Nora's conclusion' on a green banner. Closing remark or summary in the health sector.

Together against violence in care! Violence in care affects us all - as carers, relatives or people in need of care. It often starts quietly and goes unnoticed for too long. But you are not helpless! With knowledge, mindfulness and support, you can do a lot for your own safety and the well-being of those in your care. Talk openly about your feelings, observe warning signs and seek support early on - from colleagues, advice centers or the noracares community. Together we say NO to violence in care. Because: respect, dignity and safety are non-negotiable.

 

 

A turquoise banner with white text that reads 'Nora's Frequently Asked Questions'. On the right is an illustrated avatar figure of a nurse with blonde hair wearing a turquoise nurse's cap with a white cross, a white collar and a stethoscope around her neck
Violence includes all acts or omissions that harm a person in need of care: physical, psychological, sexual, financial or structural violence. It also includes neglect and inappropriate communication.
  • Physical violence (e.g. hitting, rough handling, restraining)
  • Psychological violence (e.g. humiliation, threats, ignoring)
  • Sexualized violence (e.g. unwanted touching, lewdness)
  • Financial exploitation (e.g. theft, being forced to give gifts)
  • Neglect (e.g. poor hygiene, lack of care)
  • Structural violence (e.g. lack of staff, coercive measures)
Look out for unexplained injuries, frequent anxiety or withdrawal, depressed mood, unkempt appearance or sudden changes in the behavior of those in need of care - as well as your own warning signs such as exhaustion or irritability.
Get yourself and others to safety, document everything, inform superiors or trusted persons and seek support from advice centers, police or hotlines. Silence does not protect - action does!
  • Center for Quality in Care (ZQP)
  • Austrian Ministry of Social Affairs - Violence in care
  • Care and life - advice hotline
  • Number against grief
  • The noracares community


 

Graphic logo of Nora's treasure trove of knowledge, a collection of information for nursing staff. Ideal for presenting nursing knowledge and advice.
  • Violence in care: Any act or omission that causes harm or suffering to those in need of care - physically, emotionally, sexually, financially or structurally.
  • Psychological violence: violation through words, threats, ignoring, humiliation or emotional neglect.
  • Physical violence: Any action that causes pain or injury - e.g. hitting, restraining, holding, or holding someone else down. e.g. hitting, holding, rough handling.
  • Sexualized violence: Unwanted sexual acts or touching in the context of care.
  • Structural violence: harm caused by institutional procedures, lack of staff, lack of resources or coercive measures.
  • Financial exploitation:Unlawful use or taking of money or assets from a person in need of care.
  • Neglect:Insufficient care, lack of support with care, hygiene, nutrition or social contacts.
  • Resilience: Inner resilience and ability to cope with stressful situations in a healthy way.
  • Overload: feeling unable to cope with the demands of day-to-day care - often the cause of stress and aggression.

 

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