What’s in a word? The importance of the concept of “values” in the prevention of abuse of older people in care homes

Abstract

Purpose The purpose of this paper is to present some of the findings from an empirical, mixed methods research project that reveal the importance of the personal value frameworks held by individual staff in the prevention of abuse of older people in private sector care homes. Design/methodology/approach Semi-structured interviews were undertaken with a sample of 36 care home personnel, including proprietors, care managers and care staff. Findings A significant number of respondents identified the importance of personal value frameworks among staff providing care as a potential contributory factor in the prevention of abuse of older people. Research limitations/implications Though the research draws upon the experiences of only 36 care home personnel through interviews, data suggest that the personal evaluations of staff towards those in their care is a significant contributory factor to the occurrence of abuse. Originality/value The research has identified individual staff value frameworks as a causal factor in the occurrence of abuse. The research also confirms that the perceptions of “values” among respondents directly involved in the provision of care are at odds with common understanding of “values” often cited elsewhere in connection with staff recruitment and training as a means of preventing the occurrence of abuse.

Contextual factors influencing talk in Australian residential aged care

“…This insight demonstrates the influence of carers' predisposition, extending an understanding of the role of carer values and attitudes (e.g. Moore, 2017;Stans et al, 2013).…”

“…Seen through a lens of person-centred care, the personal values of carers are thus essential to support residents' individual communication requirements. Moore's (2017) argument that the personal values of carers, including their perception of residents' "worth", can contribute to discriminatory practices is also reflected.…”

“…The effectiveness of verbal communication in aged care can be affected by influencing factors. Factors impeding communication may relate to the individual providing service, including their values, attitudes and a prioritisation of task completion (Moore, 2017) or underdeveloped communication skills, a lack of commitment to person-centred communication and ageist attitudes and language (Storlie, 2015). Nursing staff may lack the skills, knowledge or inner drive to effectively communicate residents or may not adequately know residents (Stans et al, 2013).…”

The road goes ever on: evidence of the continuing abuse of older people in care homes

“…Though inspectors and contract monitoring staff, if suitably experienced and qualified (sometimes they are not, see Moore, 2018b), can provide some direction to care home owners, managers and care staff, what they impart often fails to have any impact because the essential foundations of good, safe care are in part, or in whole, absent. If the personal value frameworks of many staff who are employed in care homes to provide care are incompatible with the work they undertake (Moore, 2017b;Kirkley et al, 2011;Kitwood, 1997), the possibility that abuse will occur and remain unreported endures (Greve, 2008, p. 152;Moore, 2016b, p. 16). Similarly, the long-established challenges of providing care in care homes that affect the staff that work there, for example, the constant tension between the tasks required and the time available in which to complete them and the subjective stress that this and other factors may generate, currently remain largely unaddressed and may conceivably lead those staff who do possess personal value frameworks commensurate with the work that they do to suspend the operation of their value systems, either temporarily or permanently, further creating conditions under which abuse is more likely to occur.…”

“…Overcoming these characteristics of care home work, the latter of which in particular is the responsibility of central government by means of prescribing in unequivocal numerical terms the numbers of staff required to be on shift at any given time, is crucial if abuse of older people is ever to be eliminated. Care home operators themselves would also be wise to begin recruiting their staff based on the personal value frameworks held by them, thereby not only ensuring that their workers are compatible with the often difficult and stressful work required of them, but also that they can truly derive pleasure and satisfaction from providing care to older people (see Moore, 2017b for a pertinent discussion of the importance of the personal values held by staff, as opposed to organisational values). Further, providers should deploy additional means of monitoring staff activity and behaviours using the surveillance technology that has been developed for this purpose and that is likely to significantly reduce the occurrence of abuse (see Fisk, 2015;Padilla-Lopez et al, 2014 for relevant discussions) by strengthening the "deterrence environment", the perceived certainty of detection combined with the perceived severity of punishment among those who may commit transgression (Harris and Benson, 2006, p. 35).…”