Archive for October, 2013

Keeping Older People Safe From Elder Abuse – Institutional abuse

Elder abuse has again caught media attention. It seems that far from improving, the situation has got worse. This post is part of a series on elder abuse to keep you my reader informed about the signs to look out for.

It is about institutional abuse which can occur in any setting where one or more people receive a service on a daily or residential basis, for example in a person’s own home, a day centre, care home or hospital ward. Places where we trust staff to care for our vulnerable elderly ones with care and compassion.We all have the right to feel and be safe, regardless of our age or circumstances. We therefore need to be vigilant to ensure older people, their property and belongings are safe and they are treated with the dignity and respect they have a right to and deserve.

What is institutional abuse?

Institutional abuse arises from repeated instances of poor care of individuals or groups of individuals. It occurs when there is poor professional practice as a result of routines, systems and policies within a care setting, which override the needs of the people it is there to support. The service may not meet the necessary professional standards or there is a training need for a more personalised approach.MP900178843

Examples of behaviour

These include: inflexible routines set around the needs of staff rather than people using the service, for example requiring everyone to eat together at specific times, limiting bathing to times that suit staff rather than the individual and no doors on toilets. These situations can arise through lax, uninformed or punitive management regimes. The behaviour is cultural and not specific to a particular member of staff.

Possible signs of institutional abuse are:

  • Set times for refreshments with no opportunity to make alternative arrangements outside these hours
  • Inappropriate approaches to continence issues such as toileting at prescribed times as opposed to when a person wishes to use the toilet
  • No evidence of care plans that focus on an individual’s specific needs
  • Staff not following care plans
  • Lack of privacy for example leaving the door open when someone is
  • taken to the toilet
  • Dehumanising language that does not treat a person with dignity and respect
  • Overuse and abuse of medication
  • Locking people in rooms
  • Failure to promote or support an individual’s religious or cultural needs
  • No access to personal allowance or personal possessions
  • Failure to knock on a person’s door before entering for example their bedroom or bathroom
  • A couple being prevented from living together.
  • Inflexible visiting times

Maisey’s Story

Maisey is confined to a wheelchair and lives in a care home. She needs to be taken to the toilet as soon as she feels the need to go, to avoid having an accident and does not like wearing pads. While this is made clear in Maisey’s care plan, staff regularly ignore her requests to use the toilet until it is too late. When she complains about this to staff she is told it’s because she always asks when they are busy and, while they respect her choice not to war pads, if she did so accidents could be avoided.

If you are concerned

If you have a concern about someone else involving harm or abuse and think the danger is immediate phone the police now on 999!

If it is less urgent, you can either:

Phone the police on 101 or

Contact the older person’s Local Authority Social Services Department

If you are not sure, ask yourself whether you would report it if it were a child. If the answer is Yes, report it

Ode Of A Self-Funder

‘Self Funder’ is the term used for older people who have to pay for their own care because they do not meet the eligibility criteria of their local authority.

“I have worked hard all my life. Things were not easy in the early days and I was brought up to ‘earn a pound and save a penny’

I therefore had some modest savings and my own little bungalow when I needed care at the age of 86.

I am on my own now as I lost my husband the day after my 60th birthday and my son was killed in a car accident two years ago.

When my arthritis became worse and I was unable to process information for day-to-day tasks it was decided that I should be looked after in a care home. fron2

Social Services found me a care home with nursing for people living with dementia. My savings are only moderate but if they had asked my solicitor to consult a specialist financial advisor on my behalf, I could have afforded something better than this institution; with it’s long dark corridors, bare walls and stained, shabby carpet. If only they had found the time to find out how much I would miss looking onto a garden, how important it was for me to have a bath, rather than a shower, how I have always colour coordinated my clothes and hate wearing skirts. It feels as though no-body cares.

No one knows my personal history, the things that are important to me, my likes and dislikes and how I would like to be supported. I therefore have no chance of receiving anything that even resembles person- centred care. How can they know I like my tea and coffee hot rather than luke warm, that I hate plain water to drink and loathe watching Jeremy Kyle on the television? Worst of all, they call me Margie rather than Marjorie, leave me in wet pads for what seems like hours and speak to me is if I am deaf and stupid. I have lost my memory and my dignity appears to have gone with it. It feels as though nobody cares.

I am paying a lot more than residents who are funded by the Local Authority yet no-one comes to check the care being delivered is still meeting my needs and whether I am getting the welfare benefits and funding that I am entitled to, now my needs have increased. As a self-funder, I am not even protected by the Human Rights Act, as people who are funded by the Local Authority are. It feels as though not even the people who make the law care about self-funders.

I heard the other day that there are independent professionals to help people who have to fund their own care. However social workers appear to feel threatened by them and I wasn’t told I could choose to pay for someone to ensure I was getting care tailored to my likes and preferences. I am also denied choice and it feels as though no-body cares.

As I sit in God’s waiting room, I wonder what I have done to deserve being cared for as if I am invisible. I live in the western world in the 21st century and it feels as though no-body cares.”