Care workers’ abusive behavior to residents in care homes: a qualitative study of types of abuse, barriers, and facilitators to good care and development of an instrument for reporting of abuse anonymously

Cooper, Claudia; Dow, Briony; Hay, Susan M.; Livingston, Deborah; Livingston, Gill

doi:10.1017/s104161021200227x

Cited by 44 publications

(55 citation statements)

References 12 publications

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“…35,36 Several factors are involved in the presence of abuse in older people such as socioeconomic, sociodemographic and psychological ones, quality of life, and the presence of comorbidities. [37][38][39][40] Some of these factors are also described in our study as being associated with abuse. Thus, the presence of malnutrition, neurocognitive disorders, depression, and anxiety syndrome are associated with the presence of abuse.…”

Section: Discussionsupporting

confidence: 64%

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Elder abuse and associated factors in eastern romania

et al. 2019

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Background This article explores elder abuse in a hospitalised population. We wanted to identify details related to psychological and emotional abuse in the older population in our region and to determine the importance of the Elderly Abuse Suspicion Index (EASI©) in comprehensive geriatric assessments. Methods This cross‐sectional study conducted between March 2015 and May 2016 included 386 consecutive hospitalised patients over 65 years of age. All patients underwent a geriatric assessment, data were collected about their medical history, and the EASI© was administered to each. The main outcome was identifying the presence, the type of abuse and the factors associated with abuse. Results There were 21.5% of patients who suffered any form of abuse. Women were more frequently abused than men. Emotional abuse was the most common (60.2%) followed by neglect (53%) and physical abuse (22.91%); sexual abuse was absent in our study group. The abused patients had an impaired cognitive function (P = 0.034). They were also malnourished (P ≤ 0.001) and depressed (P = 0.001). The presence of peripheral artery disease, stroke, pneumonia, chronic kidney disease, musculoskeletal diseases and anxiety correlated with the presence of abuse. No statistically significant correlation was found between the degree of independence in instrumental activities of daily living and the presence of abuse (r = 0.105, P = 0.051). Conclusions EASI is a tool for detecting elder abuse and should be included in the standard geriatric assessment to prevent ageism. The number of abused elderly patients is significant, and the multiple factors associated with abuse are diverse.

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Section: Discussionsupporting

confidence: 64%

“…Several factors are involved in the presence of abuse in older people such as socioeconomic, sociodemographic and psychological ones, quality of life, and the presence of comorbidities . Some of these factors are also described in our study as being associated with abuse.…”

Section: Discussionsupporting

confidence: 53%

Elder abuse and associated factors in eastern romania

et al. 2019

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“…Difficulties in estimating prevalence and incidence of institutional elder abuse is referred in various studies, 6,14,15 with underreport being the justification found for this fact. 1,2,16 Possible explanations for underreport have been proposed, such as elderly feeling of shame and fear of retaliation after disclosing the abuse to the authorities, 6,14,17,18 lack of elderly knowledge on how to do it 6 or their inability to communicate, due to mental disability or other, 6,18 this corresponding to 47.2% of our sample. Another explanation would be fear of reprisal and criminal consequences experienced by nursing homes' staff when admitting an abusive behaviour or denunciating one perpetrated by their co-workers.…”

Section: Discussionmentioning

confidence: 87%

“…Cooper et al also suggested the establishment of caregivers' education on mental illnesses, such as dementia, team work and management of challenging behaviours, as a preventive strategy at potential abuser's level. 18 Understanding why institutional abuse occurs might prove to be more important than making out its prevalence, in order to elaborate preventive strategies. 6 So, it is important to study the characteristics of the nursing homes, in a way to potentially promote modifications to the legislation and proposals on educational programs attended by institutional caregivers.…”

Section: Limitations and Suggestionsmentioning

confidence: 99%

Physical abuse against elderly persons in institutional settings

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Correia

Norton

et al. 2015

Journal of Forensic and Legal Medicine

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a b s t r a c tIntroduction: People over 65 years old are expected to be an increasing group exposed to abuse. Despite the well-studied intra-familial abuse, institutional abuse still lacks a proper understanding about its determinants and characteristics. Aim: The general objective of this study is to provide a better knowledge about physical abuse against elderly people in institutional settings, in order to contribute to a timely detection, correct forensic diagnosis and prevention of these cases. Methods: A retrospective study was conducted through the analysis of forensic medical exams performed in the North Forensic Medical Services of Portugal, between 2004 and 2013, to elderly persons allegedly victims of physical abuse in an institutional setting by a caregiver (n ¼ 59). Results: All the alleged cases occurred in nursing homes and in most of them (93.2%) the charges were against the institution and not focussing on a particular individual. The alleged victims were mainly female (79.7%), 75 years or older (75.9%), presenting a severe disability (55.9%) and 47.2% being unable to communicate. No injuries or post-traumatic pain were found in 55.9% of the cases to support the charge of physical abuse. Only in 6.8% of the cases were the forensic medical findings suggestive of physical abuse and, although this was not the object of the examination, 69.1% were considered suggestive or highly suggestive of neglect. A statistically significant association was found between the alleged victim's degree of disability and the occurrence of neglect (p ¼ 0.003). Conclusion: The sample's size seems to be underestimated, probably due to lack of detection and/or reporting. The condition of these persons, mainly related with their inability to perceive abusive behaviours and/or to disclose them (mostly by physical and/or mental disability), as well as their reluctance to press charges due to fear of reprisal, affects significantly the detection and diagnosis of physical abuse, particularly in whom injuries are not obvious. In anticipation to the rapid ageing of the population, it is urgent to analyse and understand this emerging issue so that social policies and regulation may be developed, in an effort to protect the elderly, as well as to make improvements in the professionals' skills.

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“…While the majority of research focuses on elder abuse within the family, elder abuse in residential aged care facilities (RACFs) is an increasing area of concern . As with familial elder abuse, obtaining accurate data on the prevalence of abuse in RACFs remains an ongoing challenge . Older people regardless of setting may not recognise certain behaviours as abusive and/or may be scared or reluctant to report it.…”

Section: Introductionmentioning

confidence: 99%