Abuse of Elderly in a care Home- the Effects on Health and Social Care Industry
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Introduction
There has been an increase in the cases of adult abuse in care homes over the years and studies show that this menace is causing a lot of intolerance at these homes (Alzheimer, 2015).This review aims at exploring previous knowledge on the existing levels of adult abuse in care homes and their suggested causes. Fortinash (2014) explains that prevalent adult is not unidirectional as previous studies shows. He attributes the abuse staff penetration and constant strife between the residents themselves and family-related abuse. A survey conducted by, WHO (2015) most of the research conducted on the past basis its argument on resident harassment by the staff only. He shed a new light on the new look of things such as family neglect and psychological distress factors affecting the adults in the adult homes.
The Extent of Adult Abuse in Care Homes
Care homes are refined institutions that are set up to take care of aged people with special needs, mental impairments and other disabilities (Fortinash, 2014). Instead, adult abuse is predominantly grown in these institutions invalidating the concept of actual care.
Recent research conducted by Ulsperger and Knottnerus (2015) shows that the magnitude of elderly abuse differs in various care homes. Different homes attend different types of needs and therefore mistreatment varies in nature in those homes. The psychologists revert to the study conducted by Payne and add that practically there is a difference in the level of adult abuse in various types of care home (Payne, 2017). Braye (2016) reports that the problem of adult abuse frequently afflicts the resident homes as compared others. He associates the primary cause of the prevalent abuse to the increased sharing of facilities and other amenities in these resident care homes.
There are four types of care home that are designed for adults with certain traits and different level of needs.These are the residential care homes, nursing care homes, the registered care home and the special dementia care homes for people with mental instability. In his report, Kendall (2016) found out that most people are not assertive when choosing the relevant home to take their elderly. Most people take little time to evaluate the needs of the elders and end up pushing them into the wrong homes. Piredda (2015) reveals that residential homes are most populated because people value convenience over quality of what they get from these homes. Other times the elders resist alienation from their families thus ending up in residential homes in the neighborhood. Residential homes aim at helping the elderly complete simple tasks such as routine chores and other activities of convenience such as bathing and recreation (Young, 2015). Confusing the function of homes is the primary cause of adult abuse in care homes (Piredda, et al. 2015). Tosangwarn (2016) reports that most people are afraid of taking their elderly to dementia homes for fear of social stigma, even though they are aware of their mental condition. People fear public opinion over their social status hence compromising their choices. He further compares the population ratios in the four different types of adult care home and classifies the population in the demographic spectrum of individual income capabilities, gender, and age. He finds that people with low-income base mostly occupy the specialist dementia homes. Otherwise, most of these people are either very old and have a critical mental impairment or middle age adult with manageable mental health conditions but from deprived families. Yet another research by Vandervoort (2014) proves that nursing homes and dementia home are commonly mistaken for roles they offer. People for various reasons prefer taking the “needy adults” to the nursing care homes even when the problems are mental stability.
Either way, the beneficiary is the commercial organization in charge of the profits generated from the “patients” fees. Recently, Payne (2017) asserts that the gap in the specialist dementia care homes is associable to the mandatory assessment and reports that sometimes land into unauthorized hand exposing the confidentiality of the elderly with special mental needs to the public. Vandervoort (2014) argues that dementia homes and the nursing homes record minimal cases of adult abuse due to low adult intake. Managing a huge number of people is among the enigma situation facing most social organizations today. To make matters worse, learning to manage different personalities may take a long time slowing down the rate of improvement in the status of the adults.
Types of Adult Abuse in the Care Home and their Effects
According to Braye (2016), adult abuse levels are increasing every day in the care home since they are difficult to track unlike other forms of abuse such as child abuse. This research is based on the cause of age discrimination factors. From the empirical evidence gathered by researchers, adult abuse experienced in care homes can be categorized into either financial, discriminatory, psychological, neglect, physical abuse, sexual, or verbal abuse.
Neglect is the dominant type of adult abuse that is detected in care homes. Annals of Internal Medicine (2016) published an article invalidating the statement “care homes”. These researchers argue that pushing the aged and elderly with other disabilities into these care homes makes them feel abandoned in this new domiciliary environment. Pillemer (2016) endorses that neglect case is predominant in the special dementia home whereby the family takes the elderly to these homes and abandon them. Dr. Bobbie (2017) says that some of the adults in her home have stayed for more than a year without anyone from the family paying an in-visit to check on their progress. She adds that most of the problem the home is facing is the resistance by the adults who feel that it is a “human dumping site”. She asserts that most of her patients suffer psychosis and dementia but are still sociable people that need warmth and to associate with others and feel owned by their families. Bobbie’s report shows that neglect links to many health issues by the older adults including loss of appetite, induced introversion, and sometimes breathing problems.
Moreover, Johannesen (2013) outlines psychological adult abuse as the central point of all the other identified types of abuse in the adult care homes. Journal of Occupational and Organizational Psychology ( 2010) argues that introversion encroaches with the rate of maturation of a person giving an analogy of how people grow to forget their early age schoolmates to becoming less talkative and less sociable. He asserts that most adults are less likely to report matters affecting them as they feel they are minor and sometimes fear the triviality perception by their caregiver. Other psychologists such as Pillemer and colleague (2016) seconds that psychological abuse in the care home is the hardest to detect and perhaps it is the most dominant type. Unlike physical and verbal abuse, psychological abuse is hard to detect as it runs within the mind of the victim. According to Charlotte (2016), the condition of some of the elders requiring special attention may end up deteriorating rather than improve. American Journal of public health (2013) documents psychological abuse as the point of centrality to all types of abuse since whenever a person is abused, the first get offended or afflicted in the brains. The brains interpret the extent of abuse and generate the possible reaction from the offended person. Since older adults lack the physical strength to react, thus most opt to remain silent, a phenomenon which is commonly mistaken to tolerance (Hatzenbuehler, et al. 2013)
Pillemer (2016) state that staff negligence cannot be the scapegoat to all the types of adult abuse that occur in the adult homes. Though most of the time circumstantial factors lead people to wrong careers, Beus’ research invalidates the facts care home caregivers are in wrong workplaces (Beus, 2015). Conversely, Kallinen (2017) believe that most of the abuse from the staff to the adults is possibly caused by trivial misunderstandings or else demotivating working routines. According to McCord (2015), workers develop different perceptions of their workplaces due to personality factors and emotional consciousness and these two factors can significantly lead to malpractices in work. For instance, district nurses visit residents to check on the older adults in this domiciliary environment. Currently, about 8% of the staff abuse on the adults comes from the outsourced human power.
In addition to that, resident-resident abuse is another commonly reported form of adult abuse in the care homes. This phenomenon occurs especially where the care home offers most facilities as shared amenities such as dining areas, areas of relief and recreational facilities such as the swimming pools and theatres. Resident-resident is a form of abuse that occurs between two counterparts receiving similar attention in the care homes. This form of abuse reveals itself in form of either physical or verbal abuse. Pillemer (2016) adds that in specialist dementia and nursing care homes where most of the elderly people have a mental impairment and poor judgment physical violence and verbal attacks occur at very high rates. Sometimes the patients might be suffering hallucination and end up passing the effects to other innocent people. Physical abuse may include burning, bites, swellings, and strangling. People suffering dementia often involve in activities they did not intend to and the consequence of such activities may physically hurt those around (Napoli, et al. 2013)
Recent research has shown an increase in the rate of sexual abuse. According to Napoli (2013), this one of the abuses that has recorded minimal frequency rates. Her research shows that sexual abuse is not so rampant in these homes; however, it occurs in rare cases. An adult with mental held in nursing homes for various reasons cannot get their conjugal rights, which might strain their sexual life and deny them the pleasure they are entitled. On the contrary, Bauer (2013) argue that most of these care home residents lack the ability to involve themselves in active sex possibly due to old age and mental state. He thus invalidates the concept of conjugal rights denial based on age and inability to make a proper judgment by the care home residents. Resident-resident sexual assault or flirting cases are minimal in the care homes since the integration of psychological therapy at a personal level. About 20 percent of adult care homes report some types of harassment by fellow residents. However, previous researchers have been basing their hypotheses on the abuse perpetrated by the staff and forget that residents too can cause chaos in these homes. Most of the workers in these homes do not have adequate psychological knowledge, as most of them are just nurses with mere technical skills to treat diseases (Zabalegui, et al. 2014)
Another form of adult abuse highly reported is the discriminatory abuse. This form of adult abuse often affects residential homes. Report by WHO and the UN published on Medical Daily Magazine (2016) reveal that the district nurses and the staff who often visit these homes mistreat these adults since they are not permanent workers in those domicile environment (Annals of Internal Medicine, 2016). Perhaps these nurses find it hard to adjust to this typically stressing workplace. Ethics report for adult care homes reveals that discriminatory abuse by the staff has escalated 5% in from 2010. The report attributes this phenomenon to absorption of the youthful workforce in the domiciliary homes where the duties require tolerance and empathy as opposed to school-based skills (Harris, 2015).
Generally, adult care homes face a number of both controllable and uncontrollable types of abuse. Most of these affect the psychological state of the patients / older adults, which eventually changes the self-concept of these individuals (American Psychiatric Association, 2013). For instance, some of these people hate the reality that at some point in their lives they could carry out routine activities without depending on the help of the caregivers.
Indicators of Adult Abuse in care homes
Different forms of adult abuse are detectable while several others are hard to detect. The easiest of all being verbal, physical abuse and neglect (Pillemer, et al. 2016). However, neglect can be hard to figure out in some cases. Psychological abuse poses a great problem to the adult yet it is not easily identifiable. Recent studies show that there is a various indicator of each type of abuse to some extent. Since adults may not report mistreatment always to the caregivers, indicators such as bruises, burns, and blue faces may be translated as resident-resident physical abuse (Alzheimer's Society, 2015). These residents share common amenities such as recreation areas, dining rooms, and facilities. Such conflicts often occur in cases where there is a scarce supply of these facilities and some individuals want to take advantage of others. Although researchers suggest that introversion and other personality traits change as people grow, very rapid changes in behavioral patterns and instant introversion may be because of psychological abuse. Sexual abuse, other than direct resident-resident or staff-resident may be hard to detect (Maiuro, 2015).
Conclusion
It is evident that various authors and researchers already document much of the prevailing forms of adult abuse. Care homes are now adopting a cognitive psychology to run most of their indoor activities (Reisberg, 2013). This approach aims to understand the traits of both the staff and the residents in order to reduce counterpart conflicts in these homes. In nutshell, care home play a major role assisting older adult and the gap that prevails is refurbishing the amenities and the increasing ratio of shared amenities.
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