Care giving and Elderly Mistreatment.
The National Centre for Social Research (NatCen) and King’s College London (KCL) carried out a Study on mistreatment of Older People in UK, Over Two thousand people in England, Scotland, Wales and the Northern Ireland took part in that research study which took seven months between March and September 2006. This study included people who were aged 66 and over but were living in private households it focused on the group of elderly people aged 66 years and above, the service-providers and the stakeholders, qualitative interviews were carried out on the older people who had experienced mistreatment. (Mowlam., Tennant., Dixon & McCreadie, 2007)
Mistreatment in this context was used to describe both elderly abuse and neglect. There are four major types of elderly abuse: psychological, physical and sexual abuse (interpersonal abuse) and the financial abuse. Mistreatment is defined to mean the pain, injury or damage, which is either intentionally or recklessly. Particularly, this includes striking, kicking, pushing, burning, and maybe strangling, the inappropriate use of the drugs and the physical restraints, the intentional exposure to the cold, and the denial of food all form part of physical abuse to the elderly people. (Pritchard, 2002)
The Psychological/emotional abuse is the most common form of abuse. Due to the human nature, it is often hidden and also very difficult to prove. It involves the use of words, acts or any other means to instill fear, cause humiliation, the emotional stress, or anguish. In most cases the victims may be threatened with punishment or eviction in the case of the residential settings. The Psychological abuse is the worst and it makes use of brutal acts such as infantilizing, ridiculing, humiliation, cursing and very harsh commands, the physical or emotional isolation, ignoring the elderly, and the restriction on the movement.
The Financial abuse involves various financial issues that range from the simple acts of theft to the complex financial manipulations, the improper or unauthorized use of the financial resources or properties of the elderly, the misappropriation of elderly peoples’ income, and the unfavorable transfer of property which may include the apartments. In some severe cases the elderly people who are the residents in the long-term care units may find their personal property stolen by the staff, family members, or visitors.
In terms of Neglect it includes the inadequate health care, poor hygiene, malnutrition and dehydration. In the residential setting, it may result from either an individual employee’s failure or the system failure, such as the insufficient staff control and the motivation.
The issue of the violation of the basic human rights is a broader way of mistreatment, it is taken to imply that the family members or the institutional employees have no respect for the right to privacy and intimacy or free choice; in case they be involved in the prevention of the
Elders from meeting the people they want to see and from making their simple decisions.
The current state of knowledge on the Elderly mistreatment.
The phenomena of Population aging is currently one of the most significant demographic trends and is becoming a worldwide problem. At present, the old age is burdened with high levels of sickness and comorbidity, worsening of the physical fitness and loss of independence. Despite the longer life expectancy, overall results lead to worsened health and disability in the elderly population. The resulting frailty of the elderly people who depend on the help of others can be a potential risk factor for the various forms of elder abuse from close relatives or the caregivers. (Morgan and Suzanne, 2001)
In the 1980s the experts became more systematically concerned with this issue of aging and elderly mistreatment, especially in the USA, Canada and UK. Modern Researchers have focused especially on the domestic violence. A few studies have dealt with the elderly abuse in the institutional care. However in most cases there is the lack of an authoritative study especially at the national level, although elder abuse worldwide is estimated to be at least 3-6% of elderly people,
In countries such as Finland, the USA and Canada, it is estimated to that about 4% of the elderly population are exposed to abuse. Currently 3 to 4 in every group of 10 Professionals now draw more o attention to
Such abuse institutional abuse to the elderly. Data from the research in the USA showed that 10% of the nursing staff committed physical abuse and 40% confessed to having psychological abused the Elderly people under their care.
Action on Elder Abuse-In this article, safeguarding the Adults is arguably the most important issue, as it reflects the experience of those who are charged with the implementation and the guidance, this article does away with the language of vulnerability and protection. The idea of “Safeguarding” replaces “protection” in line with the efforts for the welfare of the Elderly people ,”Vulnerability” in this article has ceased to be the criterion for the eligibility for services under the long term care and was replaced by the criterion of the “level of risk to the independence”.
In another article “The Risk factors” The risks have been categorized into two levels, A critical level (prioritized as 1) which implies that a “serious abuse or neglect has occurred or will occur”; while a substantial level (prioritized as 2), this implies that “an abuse or neglect has occurred or will occur”. Most elderly people who are the beneficiaries of the social care services falls under the “substantial level” This article does not provide the best means of which the Elderly will be receiving the services.
Safeguarding Adults-In this article, the term Adults means all persons who is may be eligible for the community care services in order to retain the independence, wellbeing and the choice and to access their human right to live a life that is free from abuse and neglect. According to the article, this definition specifically includes those people who are assessed as being able to purchase all or part of their community care services, as well as those who are eligible for the community care services but specifically the Elderly people whose needs in relation to safeguarding is for gaining access to the mainstream services such as the police.
In this article the most vulnerable people may be easily and mistakenly put in the category of those who are abused, this label of vulnerability can be easily misunderstood, because it seems to associate the cause of abuse with the victims, it is supposed to place the responsibility with either the actions or the omissions of others.
There should be the extension of the services to enable working in partnerships against the problem of Elderly mistreatment and the firm linkage to Safeguarding the Adults.
Mistreatment in Elderly people-In this article, adults are perceived be at the highest risk because they are susceptible to be affected by disability, mental disorders, illness, ageing, the elderly are unable to provide themselves with protection from abuse and are vulnerable to abused than young persons.
Abuse therefore should be defined to mean any conduct which can harm or exploit an individual be it physically, psychologically or through actions such as theft, embezzlement, fraud and extortion.
Self-abuse in Elderly people- Self-abuse is also a serious issue that should be addressed together with any other conduct which may cause fear, an alarm or a lot of distress.
Elderly neglect should be grouped into three main categories which include;
The day to day activities such as shopping for food or clothing, preparation of meals, carrying out routine housework, traveling or transportation
The Personal care and hygiene such as washing, bathing, dressing, undressing, and eating
Help when it comes to correct dosage and the timing of medication.
For those elderly people who live alone, or in receipt of elderly services, those with a worsened health status, the elderly men, and divorced women, separated, or lonely. The risk of financial abuse is very high.
Depression in older people
The research under this article on United Kingdom’s GPs indicated that one of the strongest factors that can predict the diagnosis of elderly abuse was the acquisition of knowledge on the risk situations, according to the research above the GPs who frequently read articles with topics on abuse elderly people had the highest preference in diagnosing elderly abuse as compared to those who did not do the same. In the cases of long-term care, the residents’ are always in need for assistance in their day to day living activities, therefore in such cases the caregivers are overloaded, the elderly people are then exposed to very abusive situations. Hughes(2006)
Knowledge with respect to the heterogeneity of the population (race/ ethnicity/ gender)
Elder abuse and neglect (elder mistreatment) are increasingly being acknowledged as a social problem especially in the UK and the world all over. The Knowledge of the extent of mistreatment has improved globally over the past 25 years with very high prevalence surveys in the USA and Canada. In 2005, the National Centre for Social Research (NatCen) and the Institute of Gerontology at King’s College London (KCL) were mandated by the Comic Relief and the UK Department of Health to carry out the Research Study of Abuse and Neglect of the elder People. This was the first dedicated type of study in the UK, and its aim is to provide data at a national representative prevalence level on the elderly mistreatment in the UK. (O’Keeffe Et al 2007).
It is important for the long-term care facilities to cultivate an organizational culture that respects and applies ethical principles in the elderly care units. Initiating the preventive programs that would focus on these principles could contribute to the minimization of elderly mistreatment in the residential settings. This requires very active participation of the individual institutions, their founders and the public authorities. It is also necessary in the monitoring of the relationships between the employees and the clients. There is enough evidence that good relationships between the residents and employees can reduce the risk of violence, in which case, the employees respect the residents’ choices more willingly and frequently.
The gender issues in this context have been a major issue, since it is very difficult for the Researchers to sub-categorize the aging population into groups based on gender. Women are more likely to say that they had experienced mistreatment than men. Men aged 85 and over were more likely to have experienced financial abuse than men in the younger age groups, whereas women aged 85 and over were more likely to have been neglected.
The links between theoretical assumptions and empirical research on the topics
Theoretically, the Incidents that may be defined as neglect or psychological abuse may occur more often than those that are associated with other forms of mistreatment and could be assumed to occur in the context of a non abusive relationship. This assumption can be seen to have three components; these are the behavior, relationship and impact. Impact has been the central point of investigation in all the surveys.
However, for the purposes of estimating the prevalence rates, the empirical research normally focuses on the clear definitions of the behaviors and relationship components. As the first UK attempt to develop definitions that could be easily operationalized, in a field where there are only a handful of existing studies, the different versions used in the empirical research are unlikely to be the final the most correct.
The behavioral components that followed the contemporary research and the policy guidance in covering five different types of mistreatment which includes; financial, physical, psychological and sexual abuse, and neglect. The relationship component on the other hand attempted to use the notion of an “expectation of trust”, in distinguishing the behavior which takes place in the context of the relationships from harmful behavior by the perpetrators, self-neglect or harm and all other kinds of abuse which elderly people may perceive as those which arise at the societal level, such as the long waits for the healthcare treatment or ineligibility for the social care provisions. The key people identified for estimating prevalence were the family members, close friends and the caregivers. However, through the empirical research information is also given about mistreatment which is perpetrated by the neighbors and acquaintances.
This research does not have an explicit insight into all the questions and therefore the following questions were left unanswered.
What are employees’ and residents’ lived experiences of elder abuse perpetrated by nursing staff and family members in residential homes?
Are family members’, employees’ and residents’ experiences of elder abuse in institutional care as detailed in complaints filed