Best-Practice Guideline on the Prevention of Abuse and Neglect of Older Adults

Abstract

RÉSUMÉUne revue systématique de la littérature a été effectuée afi n d'identifi er des moyens effi caces pour prévenir et combattre l'abus et la négligence envers les adultes âgés dans les établissements de soins de santé au Canada. L'examen a été fait en utilisant les bases de données qui ont été recherchés à partir de janvier 2000 à avril / mai 2013. En outre, les membres des groupes d'experts ont présenté les citations d'articles tirés des archives personnelles. Deux associés de recherche infi rmier (ARI) ont selectionné chaque titre et chaque résumé pour l'inclusion. Après le coeffi cient d'objectivité a été déterminé entre les ARI (score Kappa de 0,76), les dossiers ont été divisés, évalués et les données extraites indépendamment. L'examen a révélé 62 études portant sur l'identifi cation, l'évaluation et la réponse à l'abus et la négligence des personnes âgées; stratégies d'éducation, de prévention et de promotion de la santé; et soutien organisationnel au niveau du système pour prévenir et combattre ce type de maltraitance et de négligence. L'abus et la négligence envers les aînés demeure peu exploré en termes d'études fondées sur des preuves; par conséquent, il faut davantage de recherche dans tous les domaines décrites. ABSTRACTA systematic review of the literature was conducted to identify effective approaches to preventing and addressing abuse and neglect of older adults within health care settings in Canada. The review was conducted using databases searched from January 2000-April-May 2013. Additionally, expert panel members submitted article citations from personal archives. Two research associates (NRA) screened each title and abstract for inclusion. After inter-rater reliability was determined between the NRAs (Kappa score of 0.76), the records were divided, appraised, and data extracted independently. The review resulted in 62 studies that focused on identifying, assessing, and responding to abuse and neglect of older adults; education, prevention, and health promotion strategies; and organizational and system-level supports to prevent and respond to abuse and neglect. Abuse and neglect of older adults remains under-explored in terms of evidence-based studies; consequently, further research in all of the areas described in the results is needed.

<p>Preventing The Abuse Of Residents With Dementia Or Alzheimer’s Disease In The Long-Term Care Setting: A Systematic Review</p>

“…Caregiver emotional distress measured on scale from 0 (not at all) to 5 (extremely).Caregivers need training to help reduce caregiving burden which can contribute to elder abuse.Hirst/October 2015 [25]Defining what is known about resident-to-resident abuse and what gerontological nurses can do about the widespread problem.Residents in long-term care facilities.Collecting a body of research literature regarding aggression and violence between long-term care residents.Previous research and literature.Resident-to-resident abuse is more prevalent than staff-to-resident abuse, but it is researched much less.RRA tends to target those residents with cognitive impairment.Staff needs to be educated on RRA to facilitate recognition. Guidelines should be provided to staff when RRA occurs.Ensure accurate and complete documentation to facilitate reporting.Aggression and violence between long-term care residents has been largely overlooked by researchers.Hirst/August 2015 [26]To identify effective approaches to preventing and addressing abuse and neglect of older adults within health care settings.62 studies focusing on identifying, assessing, and responding to abuse and neglect of older adults.Systematic review of literature and submittal of article citations from expert panel members. Additionally, screening of literature for inclusion and reliability.Expert panel and guided questions to determine appropriate study selection and data sources.“Abuse and neglect of older adults remains under-explored.”Abuse and neglect of older adults is more likely more prevalent than reported.There exists a knowledge and training deficit around the abuse and neglect of older adults.The continued culture of de-valuing older adults will continue to allow these older adults to remain highly susceptible to all forms of abuse.Dempsey/March 2015 [27]There should be improvements to enhance a person’s quality of life with dignity in an appropriate setting of palliative care.Dementia patients in a clinical setting.Advanced planning to the specific care of the diseases.Training to clinical staff.People with dementia often do not receive the palliative care as do other terminally ill patients.Ferrah/January 2015 [28]To examine the published research on the frequency, nature, contributing factors, and outcomes of RRA in nursing homes.Studies and data from articles related to older adults.This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Key terms were reviewed independently by each researcher.RRA is ubiquitous with serious consequences for residents.…”

“…The theme most often mentioned was policies/programs; identified in 24/64 of total occurrences (41%) 13,14,17,20–23,26,28,29,32,34,36,38,41. Policies/programs refer to the implementation of any new type of company policy or any program initiated within the facility or by local or federal means intended to enable the ability to reduce abuse of residents with either dementia or Alzheimer’s 13,20,26,36. Administrators should have an open-door policy to allow residents and family members to discuss issues freely, including any potential abuse by staff members 13.…”

Omsorg på vranga

“…Studier fra USA (Pillemer & Moore, 1989), Canada (Hirst, 2002), Sverige (Saveman, Åstrøm, Bucht & Norberg, 1999), Finland (Isola, Backman, Voutilainen & Rautsiala, 2003), Tyskland (Goergen, 2001) og Irland (Drennan et al, 2012) har vist at sykehjemsansatte har både observert handlinger av utilstrekkelig omsorg og selv innrømmet å begå slike handlinger. De hyppigst observerte handlingene har vaert forsømmelser og handlinger av psykisk karakter.…”

“…De hyppigst observerte handlingene har vaert forsømmelser og handlinger av psykisk karakter. De er ofte relatert til omsorgsaktiviteter, som at en forlater en beboer alene eller unnlater å skifte bleie (Isola et al, 2003), at en med vilje overser eller avviser en beboer (Drennan et al, 2012), at en fysisk tar tak i en beboer utover det som er nødvendig (Drennan et al, 2012), eller at en ikke tilstrekkelig setter i verk forebyggende tiltak for å hindre trykksår hos sengeliggende beboere (Goergen, 2001).…”

Review of Programs to Combat Elder Mistreatment: Focus on Hospitals and Level of Resources Needed

“…Programs to combat elder mistreatment have been developed and implemented for more than three decades, and many vulnerable older adults, as well as families and professionals who serve them, have benefitted. Despite this, previous systematic literature reviews examining programs have found few that systematically analyzed outcomes and even fewer that demonstrated measurable impact. This is partly because of the complexity of designing and evaluating elder mistreatment programs and because the relatively young field includes collaborative teams with various levels of funding and research sophistication.…”