Careharm

Careharm is a term used to describe harm that arises from caregiving processes, services, or environments, rather than from the underlying medical condition alone. It covers physical injury, psychological distress, violations of autonomy, and social or financial harm that occur during the provision or withholding of care. Careharm can arise in medical settings, long-term care facilities, home care, social care, and custodial settings, and may result from both acts (such as incorrect medication administration, inappropriate restraints, or procedural errors) and omissions (such as neglect, missed monitoring, or delayed response to needs).

Common forms of careharm include iatrogenic injuries from medical treatment, pressure injuries from inadequate turning or nutrition, dehydration or malnutrition due to insufficient monitoring, neglect or abuse, privacy violations, coercive or overly restrictive practices, and the financial or social harms that can accompany care arrangements. Careharm can also stem from caregiver burnout, poor communication, or cultural and linguistic barriers that impede safe, respectful, and appropriate care.

Mitigating careharm involves risk assessment, incident reporting, and a culture of safety within organizations, alongside person-centered care, informed consent, and shared decision-making. Training, adequate staffing, clear care plans, and ethical oversight help minimize harm. Safeguarding policies, quality improvement initiatives, and mechanisms for feedback from patients and families are important components of reducing careharm and improving overall care quality.

Careharm intersects with related concepts such as patient safety, iatrogenic harm, caregiver burden, and ethical care, highlighting the need for ongoing attention to the safety and dignity of those receiving care.