Older People in Residential Care Settings: Results of a National Survey on Staff-Resident Interactions and Conflicts
The National Centre for the Protection of Older People (NCPOP) at University College Dublin, with funding provided by the Health Service Executive, has undertaken a major study on staff-resident interactions and conflicts in residential care settings for older people. The study was launched on 06 December 2012 at the UCD Health Sciences Centre.
Dr Jonathan Drennan, the lead author of the study, presented the key findings, which are based on research conducted among public, voluntary and private nursing homes over the past two years. Other speakers at the study launch included Professor Karl Pillemer, Director of the Cornell Institute for Translational Research on Ageing, New York, and Mr Frank Murphy, Chair of the HSE National Elder Abuse Steering Committee.
The aim of the study was to measure the extent to which staff working in residential care homes experienced conflict with residents, observed potentially neglectful or abusive behaviours towards older people, or themselves engaged in neglectful or abusive behaviours towards residents in their care.
The study was based on a survey of over 1,300 registered nurses and healthcare assistants from 64 nursing homes (69% private nursing homes, and 31% public and voluntary) in the Republic of Ireland.
The study found that staff working in residential settings for older people reported that they had both observed and had perpetrated acts of neglect and physical, psychological, financial and sexual abuse. Approximately 57% of staff reported that they had observed one or more neglectful acts and 27% reported that they had been involved in at least one neglectful act within the preceding year.
In addition, approximately 12% of staff reported that they had observed another member of staff physically abuse a resident in the preceding year. The most frequently observed forms of physical abuse were restraining a resident beyond what was needed and pushing, grabbing, shoving or pinching a resident. In relation to physical abuse engaged in by staff, 3% of staff reported that they themselves had committed one or more acts of physical abuse on a resident.
Approximately a quarter (27%) of respondents had observed another member of staff psychologically abuse a resident. The most frequently observed types of psychological abuse were shouting at a resident in anger, insulting or swearing at a resident and isolating a resident beyond what was required. Approximately 8% of staff reported that they themselves had engaged in psychological abuse, with shouting at a resident in anger being the most frequently reported type of psychological abuse engaged in.
A very small minority of staff reported that they had observed or perpetrated financial or sexual abuse. Overall 1.2% of respondents reported that they had seen another staff member taking valuables or property from a resident on at least one occasion, with a small minority (0.7%) reporting that they had stolen from a resident. A small proportion of respondents (0.7%) also reported that they had observed inappropriate sexual behaviour by a staff member with a resident, with 0.2% of staff reporting that they themselves had engaged in inappropriate sexual behaviour with an older person in their care.
A number of factors were found to be associated with the risk of neglect and abusive behaviours in residential care settings for older people. These included low levels of job satisfaction, staff experiencing emotional exhaustion and burnout, poor staff commitment to their organisation and experiences of stress in the organisation. The psychological and physical well-being of staff were other factors associated with the physical and psychological abuse of older people in residential care.
Commenting on the findings, Dr Drennan of the UCD School of Nursing, Midwifery and Health Systems, and the National Centre for the Protection of Older People (NCPOP) at UCD said: “When compared with international research into staff-resident interactions and conflicts, this study found that the extent of staff-reported abuse in residential care settings in Ireland was lower than that reported in other countries. In addition, a number of initiatives and safeguards have been put in place by the HSE and HIQA to protect older people receiving care in the residential sector.”
“However, as there is evidence that older people receiving care in the nursing home sector in Ireland do experience neglect and various forms of abuse, there is a need to intensify efforts to protect older people receiving care through multi-faceted approaches. These approaches include: giving older people a voice in their care and decisions surrounding their care, educating staff and relatives about abuse and the consequences of abuse, and providing supports for staff working with older people. At a national level all agencies that have an interest in the protection of older people should continue to be involved in the further development of strategies that both prevent and identify the abuse and neglect of older people receiving residential care”.
Mr Frank Murphy, Chair of the HSE National Elder Abuse Steering Committee, commended the NCPOP on the research. He said: “The HSE commissioned this report to further enhance our understanding of elder abuse in Ireland and on the factors that can lead to abuse. Understanding the experiences of staff and their unique perspective helps us to develop effective preventative programmes. In 2011, the HSE’s dedicated elder abuse service received 2,302 referrals which is the largest number in any year since the service began in 2007. It is a positive development that more people are coming forward for help. We urge older people who are being abused to seek help by contacting their local GP or public health nurse or phoning the HSE’s information line at 1850 24 1850 (Monday to Saturday, 8am to 8pm) to get contact details for their elder abuse case worker.“
Health Service Executive (HSE) Information Line
Anyone experiencing elder abuse can call the HSE INFORMATION LINE on 1850 24 1850 Monday to Saturday, 8am-8pm or contact a health professional such as GP, Public Health Nurse or Social Worker. For more information visit: www.hse.ie
Don’t be silent. Tell someone. Get support and stop the abuse.
Elder abuse has been defined as: ‘a single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person or violates their human and civil rights’.
About The National Centre for the Protection of Older People (NCPOP)
The National Centre for the Protection of Older People (NCPOP) at UCD was established in response to issues of elder abuse and the recommendations of Protecting Our Future: Report of the Working Group on Elder Abuse. The aim of NCPOP is to help policymakers understand, locate and tackle elder abuse in Ireland.
The NCPOP at UCD brings together leading experts from across the fields of nursing, medicine, economics, social science, and public health and was established by the Health Service Executive in 2008. Further information about the National Centre for the Protection of Older People (NCPOP) at UCD can be found at www.ncpop.ie.
(Produced by UCD University Relations)