Elder Abuse – Neglect in Care Homes

Often, when referring to that term, people tend to think about physical or financial abuse. However, in care homes and nursing homes, the most common form of abuse is through neglect.

This is a short excerpt from an interview with Sian, a newly appointed manager of a registered care home in Hull.
‘I have only been here a few weeks and it’s a real change for me. This is the first time I have worked with this age group. Previously, I have always worked with adults with learning difficulties. I have a lot of experience of being a manager of a care home and I believe the skills and knowledge I have gained could be transferred to a different setting and client group.

I applied for this job as I felt it would be an exciting challenge and help me to develop professionally. I was quite surprised when they offered me the job as I did think they would be looking for someone who had been working in older people’s services. However, I accepted and was really looking forward to starting.

Nothing could have prepared me for the reality of this. In learning difficulties, you have quite a high staff ratio and a huge amount of importance is placed on helping people to be as independent as possible. The funding is very good and there is money available to do activities, go out on trips and visits and most importantly, there is money in the budget to pay staff to support service users to do these things.

Here, there is none of that. Our staffing levels are sufficient to meet inspection requirements, but the dependency levels of the residents are so high, that the staff spend the majority of time just managing personal care needs such as dressing, toileting, feeding and moving people from one room to another. The residents are well cared for physically, their physiological needs are met, but there is very little intellectual stimulation for them. The staff seem to view the residents as a series of tasks to be done.

For example, I went into the upstairs lounge today, there were 5 residents sitting in chairs and 2 members of staff serving drinks and biscuits to them. The Stereo was on quite loudly and it was playing Radio One. I called the two carers over and asked which of the residents had asked for Radio One on. Well, they just looked at me and didn’t answer. I spent a few minutes taking to them about it and they acknowledged that Radio One was playing because the carers liked it. That is just total lack of awareness and thought.

I am doing a lot of shadowing at the moment to observe care practice. I tell the staff, if they have a quiet time, don’t stand chatting to each other, inter-act with the residents, take them into the garden for half an hour. It’s as though they don’t think in a pro-active manner. You know every morning, the first thing the day shift used to do was turn the televisions on in all the lounges. Then put the remote out of reach.  The average age of our residents here is eighty-one. They are not of the generation that watches Breakfast TV and the Jeremy Kyle show – again it’s about the carers. So now, the televisions stay off unless the residents ask for them to be switched on and we have one lounge that is a television-free zone.

None of the care staff are bad people, they don’t intend to be abusive but saying “I didn’t think” isn’t an excuse in my book. ‘

Whilst neglect can certainly be construed as neglect of personal care, such as feeding and maintaining hygiene, the most common form of neglect in the care home setting is through lack of social stimulation. Often this neglect is not intentional, it stems from institutionalised practices and lack of knowledge and appropriate training of staff. Time constraints is not an excuse. No matter how busy and pressured the staff, they can still carry out their tasks in a client-centred manner. To do otherwise is abusive and oppressive.

With World Elder Abuse Day on the 15th June, now is a great time to highlight this issue even further.