Preventing and stopping abuse
Mary Cox, Safeguarding Advisor for Age UK will be speaking at the British Geriatrics Society Autumn conference in November 2013. Her work involves helping older people, their family, carers, and professionals to prevent and stop abuse. Her presentation will include narratives that demonstrate the dilemmas of speaking out about abuse and the impact harm has on people’s lives.
Adults suffer abuse when their human or civil rights are breached. The absolute human right ‘not to be tortured or treated in an inhuman or degrading way’ should be promoted by us all and be reflected in the quality of the services we provide. It is Important that we enable people to have control over their own lives, treat them with dignity, support them to have the best physical and mental health possible, and facilitate their financial security.
Greater longevity increases the risks of physical, functional and cognitive impairments that can affect older people’s capacity to manage their own affairs without help. People in later life can be put into a vulnerable position when they are reliant on others to undertake daily tasks concerned with personal care, domestic routines and finances. This can lead to abusive behaviour from family, ‘friends’, paid carers and professionals.
Reading about abuse in the media, acknowledging the reality of its existence, does not mean that older people identify the topic as being relevant to their own circumstances. They may not feel able to speak out about bad things happening in their own lives, or the fear of the consequences of doing so may stop them.
Lynne Phair and Jill Manthrope wrote, concerning a small audit undertaken for the DH in 2010-2011, to review disciplinary outcomes and NHS systems that collect data about adverse events,
“Within and beyond the NHS, there are many opinions expressed about why its workers are apparently not disciplined appropriately or why harm is apparently not dealt with appropriately by the NHS (Manthrope et al., 2011). These debates go for beyond the Trusts that participated in this audit. These comments need to be borne in mind when considering the reasons why numbers of referrals to the ISA by NHS employers are lower than might be expected or why workers are not disciplined in the numbers some may think are warranted.”
Stephen James, who has worked in the field of adult protection / safeguarding as a practitioner and manager within local authority and NHS settings for over 25 years, wrote comments on Professor Sir Bruce Keogh’s review of the quality of care and treatment provided by the fourteen NHS trusts that were persistent outliers on mortality indicators.
“… ’abuse’ is generally not identified/acknowledged, and the issues are grouped under serious untoward incidents or complaints processes, which do not fit with current national adult safeguarding reporting data set requirements. All of this translates to a current national picture of a two tier system, where local authorities have a lead coordinating role regarding adult safeguarding, and hospital trusts are operating (no pun intended) within a different organisational culture, using different terminology, which all goes towards distorting the reality of what is now emerging via Francis and Keogh as serious failures of care.”
How would you respond if a patient told you about a colleague mistreating somebody? Is it credible that abuse could take place in the community where you live or work? Do you have to witness harm being done before you will take any action?