Neglect and Abuse - it’s time to put a stop to it

A closer look at practices long-term care workers know are Neglect & Abuse

Within Care of the Elderly there is a situation whereby abuse and neglect occurs daily yet no one reports on it or records it.  

Why?

Because it has become accepted practice.

In a recent article published in The Gerontologist – Abuse of the Elderly is said to be “recognized internationally as an extensive and serious problem, urgently requiring the attention of healthcare systems, social welfare agencies, policy makers and the general public.”

Nevertheless, the authors write that they are unable to cover the prevalence of Abuse of the Elderly in institutional settings “because of the lack of research in this area; no reliable prevalence studies have been conducted of such mistreatment in nursing homes or other long-term care facilities.”

Lack of research does not mean that Abuse of the Elderly does not occur in such institutions.

In fact, based on personal experience and observations as well and the anecdotal evidence of countless others around the world, my sense is that many elders in care, particularly those who live with dementia, are subject to neglect and abuse on a daily basis.

We recently published a number of articles on Safeguarding and Abuse they can be found here

I believe that neglect and abuse, again particularly with respect to older people who live with dementia, have become normalised in the cultures of many long-term care facilities not just in the UK but Globally. 

This despite the fact that care workers seem able to identify the kinds of practices that constitute neglect and abuse.

Here are some named by care workers themselves:

1.       Being aggressive with a resident

2.       Handling a resident roughly

3.       Pulling too hard on a resident

4.       Threatening a resident

5.       Pushing, shoving, grabbing or pinching a resident

6.       Punching, slapping, hitting, or kicking a resident

7.       Speaking in a harsh tone to a resident

8.       Saying mean things to a resident

9.       Yelling at a resident in anger

10.   Insulting or swearing at a resident

11.   Using excessive physical restraints

12.   Throwing something at a resident

13.   Not providing oral/dental care

14.   Not doing range of motion exercises

15.   Not changing residents each time, they are wet or soiled

16.   Ignoring residents who are bedbound

17.   Not offering activities to residents

18.   Not doing prescribed wound care

19.   Not giving residents regular baths

20.  Doing a one-person transfer when the resident requires a two-person transfer

21.  Not providing cuing or task segmentation to residents who need that kind of assistance to maximize their independence

22.   Skipping schedule toileting (but also having scheduled toileting)

23.   Not helping residents when they ask

24.   Not keeping residents hydrated

25.   Turning off a call light and taking no action on the resident’s request

Noteworthy by its absence is the inappropriate use of medications such as antipsychotic drugs that act as a chemical restraint.  Unfortunately, behavioural expressions that result from people with dementia being misunderstood at best, and neglected and abused at worst, are more often than not blamed on them rather than on the real causes for what is viewed by medical professionals as problematic behaviour.

It’s time to take a closer look at this tragic and completely unacceptable state of affairs, demand research into the nature and prevalence of neglect and abuse in long-term care, and most important, to immediately implement steps stop it.