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Safeguarding older people from abuse

Safeguarding older people from abuse: Critical contexts to policy and practice

Angie Ash
Copyright Date: 2014
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  • Book Info
    Safeguarding older people from abuse
    Book Description:

    The mistreatment of older people is increasingly recognised internationally as a significant abuse of elders’ human rights. ‘Scandals’ and inquiries into the failure to protect older people from abuse in health and social care systems rarely address, and still less challenge, the social, economic and cultural context to the abuse of older people. This critical and challenging book makes a strong case for the development of ethically-driven, research-informed policy and practice to safeguard older people from abuse. Drawing on findings of original UK research and framed in an international context, it illustrates ways in which ageism, under-resourced services to older people, target-driven health and social care policy and services, and organisational cultures of blame and scapegoating, are a powerful yet invisible backcloth to elder abuse. Safeguarding older people from abuse will be essential reading for policy makers, politicians, professionals, campaigners, researchers and educators, and those working in criminal justice fields.

    eISBN: 978-1-4473-0568-2
    Subjects: Sociology

Table of Contents

  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-v)
  3. Acronyms
    (pp. vi-vi)
  4. About the author
    (pp. vii-viii)
  5. Acknowledgements
    (pp. ix-x)
  6. ONE Contexts to safeguarding older people from abuse
    (pp. 1-8)

    These are three of the ten cases reported by the Parliamentary and Health Service Ombudsman for England on 14 February 2011. Nine of the ten people discussed in the Ombudsman’s report – titledCare and Compassion?– died during, or shortly after, the events considered occurred. The Ombudsman observed that ‘the circumstances of their deaths have added to the distress of their families and friends, many of whom continue to live with anger and regret’ (Parliamentary and Health Service Ombudsman, 2011, p 8).

    This book is about safeguarding older people from abuse. Notwithstanding reference to the Parliamentary and Health Service Ombudsman cases...

  7. TWO The need for theory, critical thinking and practice
    (pp. 9-22)

    This book is concerned with theory, policy and practice in safeguarding older people from abuse. The theoretical bolstering to this includes social gerontology and policy studies. The present chapter does not develop a case for one theoretical perspective over another. Rather its purpose is to make a case for theory-informed and critically driven understandings and interventions in safeguarding older people from abuse. The chapter’s first section sets out ‘the case for theory’, describing what is meant in this context by ‘theory’ and why it matters. Its second section makes a call for critical perspectives, thinking and practice in elder abuse...

  8. THREE The abuse of older people
    (pp. 23-50)

    This chapter considers the process and outcome of the ‘naming of elder abuse’ in the UK and internationally, and the focus and findings of some research on the prevalence and nature of elder abuse. This material is indicative of themes and findings: it is not intended to be systematic or comprehensive. This chapter trails the book’s later discussion of an apparentde factoblindness to abuse in a lifeless jabbering of the ‘choice’ refrain in public policy and professional safeguarding practice. Finally, ageism and its manifestations and consequences for older people who are at risk of abuse are discussed. The...

  9. FOUR Adult protection, safeguarding and personalisation
    (pp. 51-72)

    The development of policy and practice, and adult protection and safeguarding older people from abuse, has taken place against a backdrop of the unrolling of personalisation and individualisation of care. This chapter considers, first, adult protection legal and policy development in the UK, and the various terms in use to refer to the abuse of adults. Second, features of the development of personalisation policy, in its various guises and manifestations, is considered across the four UK nations. Third, the chapter discusses the impacts on older people of this policy trajectory, and on safeguarding older people and other adults at risk....

  10. FIVE Public policy implementation in street-level bureaucracies
    (pp. 73-88)

    What happens to an older person when abuse is alleged will depend to a considerable extent on the way in which professionals and practitioners such as social workers, police officers or nurses understand, use and implement safeguarding policy. This chapter seeks to lay out a conceptual backcloth to the research reported in Chapters Six and Seven. This sought to identify the constraints and dilemmas social workers and their managers faced when implementing public policy on adult safeguarding. The resonance Lipsky’s theory of street-level bureaucracy has to understanding professional dilemmas in adult safeguarding has been reported by Ash (2013). The present...

  11. SIX A case study of street-level policy implementation to protect older people from abuse
    (pp. 89-110)

    For the older person at risk of abuse, the ins and outs of adult safeguarding policy are likely to be of less immediate concern than the impact on them of the actions or behaviour of professionals and staff who are paid to implement it. As described in Chapter One, the case study reported below arose directly from the findings of a number of cases the author had been asked to review since the agreement of national policy on adult protection in England and Wales (DH, 2000; NAfW, 2000). In these cases, two common themes seemed to be present. First, professionals...

  12. SEVEN Discretion and dissonance in adult protection work
    (pp. 111-120)

    The case study described in the previous chapter threw light on the real, lived, sometimes messy and frequently contradictory world of adult safeguarding by social workers, with adult protection staff and their multi-agency partners. The influences on decision-making, the day-today constraints and the lived reality of this work bring into focus what otherwise remains in shadow: the financial, cultural and organisational context to work with older people. This contextual backcloth has a powerful, but usually invisible (certainly to performance monitoring and adult protection data collection systems and processes) impact on professional understanding of elder abuse.

    This chapter reviews and reflects...

  13. EIGHT Cultures and contexts of complicity
    (pp. 121-152)

    The case study Department, described in Chapters Six and Seven, had a unifiedesprit de corps. The practice of its street-level bureaucrats (to use Lipsky’s language) was not poor; its management was considerate and professional; staff and managers operated as best they could in the adult safeguarding system they were part of. But social workers did not challenge the poor practice they knew about in the care and protection of some older people. They often juggled the least worst options when planning care to meet an older person’s needs. Social workers and their managers tolerated delays in police investigations into...

  14. TEN Safeguarding older people from abuse: ethical futures
    (pp. 153-160)

    This book opened with cases reported by the Parliamentary and Health Service Ombudsman (2011). These were not isolated or exceptional cases. Almost one fifth (18%) of the complaints about the NHS made to the Ombudsman’s office in 2009 concerned the care older people received. In the language of adult safeguarding, many involved neglect, emotional and physical abuse. The Ombudsman found it ‘incomprehensible’ that she needed ‘to hold the NHS to account for the most fundamental aspects of care: clean, comfortable surroundings, assistance with eating if needed, drinking water available and the ability to call someone who will respond’. The Parliamentary...

  15. References
    (pp. 161-184)
  16. Index
    (pp. 185-190)
  17. Back Matter
    (pp. 191-191)