Recently released figures by the Department of Health and Ageing show a continuing increase in levels of sexual and physical assault of elderly people in aged care in Australia.
2007-8 925 2008-9 1411 2009-10 1488Such a steady increase is disturbing and prompts me to ask if we are getting any better at both monitoring and preventing this abuse. The compulsory reporting legislation was designed to uncover the levels of abuse. It has done this by making it mandatory to report such events within 24 hours of occurring.
However, prevention of this behaviour is not addressed. Elderly people in care are obviously just as vulnerable to being assaulted as they were before compulsory reporting was introduced.
The prosecution of staff who have sexually assaulted elderly residents is small discouragement when we look at the levels of continuing assault. Where is the deterrent effect?
Better to improve screening of employees with psychological assessment and better background checks. Education is also needed in person-centred care values, attitudes and behaviour and on what constitutes abusive behaviour. The current meagre amount of dementia education and exposure to solid person-centred education is hopelessly inadequate in providing the industry with qualified and skilled carers. Qualified maybe when they leave school but not skilled. Providers skimp too often on this area and think they have satisfied their statutory requirements by providing one session per annum on “behaviour management”. Its not good enough any more and the public will call providers to task on this before too long by asking them what training they provide thier staff in dementia care and the person-centred approach.
Finally, where is the accountability of colleagues who see abuse occurring and say nothing? I have heard too often of staff remaining silent for fear of retribution or simply being ignorant that what they are seeing is unacceptable. The plea that they didn’t know it was abuse can no longer stand scrutiny. If you see it happening you have a responsibility both legally and morally to do something about it by reporting it.
These figures tell me that compulsory reporting is not yet working effectively to protect our vulnerable elderly people in care. We need a better strategic approach to prevention and its not happening from government nor from providers.
Hi Bernie,
Well done for raising these challenging issues.
I am also aware that, apart from staff and family abusing elders, other elders in care can also abuse each other either intentionally or unintentionally.
A culture of dialogue is foundational to opening up any difficult conversation … any evidence-based research needs to also attend to workplace culture.
Qualitative research may be an additional option to discern a workplace’s culture, as emotions ARE involved in the construction and maintenance of each workplace culture.
I recently participated in a university ethics-approved study on meeting the sexual needs of disabled people. I participated in the study as a professional who has been involved in dialogue and responding appropriately to this matter within my work context.
It is NO easy task to raise & deal with issues of a sexual nature … it is imperative that critical self-reflection occurs on a regular basis, as self-awareness and dialogue are the keys to making appropriate decisions in this area.
I was subjected to some pretty awful reactions when other colleagues were invited to be involved in the dialogue too. Speaking truth to power is Never without consequences … a committed, authentic learning community may be able to transcend this suppression of truth.
I suggest that it depends on the leadership in that organisation.
Bernie, your article does yourself a dis-service and smacks of self interest as a learning provider.That the data includes “allegations” proves that consumers and are “calling providers” to account and “colleagues” are in fact holding others accountable. That few allegations are proven suggestd providers might be improving. I might be so bold as to suggest you aslo include learning providers in your last comment as well, because just maybe the message is off-song and being lost in translation. Personally I would like to see some evidence based research instead of emotive statements.
John
Thank you for your comments. I appreciate that you took the time to respond to my post and I welcome discussion about this issue. It is such an important one. The more discussion there is around this topic to increase the wellbeing of vulnerable aged people within care, the better.
In addition to being an educator I am a clinician and in my role as a clinical psychologist I am frequently called upon by aged care providers to respond to situations where abuse either has occurred or there is risk of abuse occurring. My comments are informed by the figures from the Commonwealth and by my clinical experience in responding to such situations and more importantly from unsolicited comments from staff and management.
Sometimes the abuse involves residents and staff, sometimes it’s family members acting inappropriately. I have been doing this for 15 years and I have seen a rising awareness of the problem. This has led to better employment practices and consequently fewer staff abusing residents. But abuse still happens. Some staff still do not “get” that their behaviour is abusive and that it is not OK to talk to or act with a resident in the way they do. They do not understand what “reasonable force” means. They are the minority and they spoil the work of the effective and well-motivated care staff and nurses who do a great job of caring for little social or monetary reward.
I would like to see more study of abuse in care by universities that have access to funding to conduct such large scale studies. And I would like to see more education of staff as this is a key driver to stopping residents being abused by staff and by family members. Educated and supported staff will be aware and empowered to speak up when they see abuse occurring.
You suggested my blog was motivated by self-interest. My primary concern is the wellbeing of vulnerable older people in care. The fact that I receive payment for the training and consulting I am asked to carry out is important because I need to balance the books as we all do.
John, I welcome your comments on any of our blogs. Thanks once again for your input. It is always valuable to receive a range of viewpoints.
Noted that the Agency spokesperson in the media release actually stated they did not know how many were substantiated because they do not know what the police do when they follow up. That was a lie as they do know, as they follow up the police inquiry.I would suggest it is because the figure of substantiated cases of abuse is very low indeed. Many of the cases we have had reported have been relatives not staff who are perpetrating the abuse.That was not shown in the figures either. we need the information that is disseminated to the media to be a lot more accurate and actually informative.
Hi,
To me now people are reporting a lot with Compulsory legislation but still at some sites its not up to the mark.
Bernie, the more interesting question would be how many of the reports were actually substantiated In our organisation we have got better at dealing with issues and hence less reporting/incidences – however in two reported incidences there was absolutely no substance!