Elder abuse observed by nearly half of the operating units of services for older people – in home care, the abuser is most often a relative
Nearly half (47%) of the operating units of services for older people reported they had noticed abuse of their clients. Based on a survey conducted by the Finnish Institute for Health and Welfare (THL), in home care, the abuser is typically the client's relative or loved one.
Abuse can take the form of physical violence, emotional or social abuse, sexual abuse, economic abuse, neglect of care or assistance, or other restriction or violation of rights, or treatment that degrades the dignity of the older person.
43% of home care units reported that they had observed abuse by relatives or loved ones. In 24-hour care units, abuse by another client was most common (observed in 44% of the 24-hour units).
Abuse by personnel was reported by 3% of home care units and 7% of 24-hour care units.
Supervisors or persons in charge of 2,742 units answered the THL survey in May. The responses provide a general estimate of the prevalence of the phenomenon, but do not provide information on the number of cases of abuse, for example.
Elevated need for care may expose older people to abuse
Clients of services for older people are in many respects a vulnerable group, and their elevated need for care may expose them to abuse.
"Previous studies have found that rushing caused by shortage of staff and insufficient numbers of permanent personnel increase the risk of abuse in care units. Incomplete instructions and gaps in professional competence also pose a risk," says Minna-Liisa Luoma, Chief Specialist in the Horizontal Function.
In home care, abuse may be the result of stress experienced by the relative.
"The service system has been streamlined by increasing the use of home care services, which has led to more advanced memory disorders being treated at home. The growing workload of family members may not have been sufficiently well addressed. Based on the results of the survey, relatives ought to be provided more support," says Chief Specialist Anna-Mari Aalto.
Relatives of memory disorder patients may be burdened by, for example, their spouse's constant need of assistance or changes in their behaviour.
"It would be important for the carer to have breaks to support their coping. Day activities for patients provide relatives with opportunities for much needed breaks. Peer support is also important for many relatives of memory disorder patients," says Aalto.
Abuse can be prevented
In order to prevent abuse, it is important for operating units to develop evidence-based practices or guidelines for addressing abuse. According to the survey, one third of the units had not provided their personnel with sufficient instructions for addressing elder abuse cases and the related cooperation between authorities. Abuse is a weighty reason to report the need for social welfare services, and in such cases, the personal worker assigned for the person must be a social worker.
"Much of the abuse still goes unnoticed. Victims of abuse often do not dare or want to bring up the matter themselves. Their close relationships may have involved domestic or intimate partner violence even before they became a client of services for older people, and the abuse is first noticed when a home care professional begins to regularly observe the situation. It is essential that the personnel have the skills and professional competence required to anticipate and prepare for risk situations and identify abuse. Instructions for what to do in the actual situation are also needed," says Minna-Liisa Luoma.
The high prevalence of abuse observed requires further investigation.
"It should be determined in more detail what kind of help victims of abuse have received and whether situations are adequately identified. It is essential to find ways to prevent abuse and identify risk situations and persons at risk. Every older person must have the right to live a safe life," says Anna-Mari Aalto.
Contact information
Minna-Liisa Luoma
Chief Specialist in the Horizontal Function
THL
Tel. +358 29 524 7260
E-mail: [email protected]
