Neglect in this instance is a sanitised word for abuse. If patients aren’t fed, not given prescribed medication when it’s due, told to use their bed as a toilet instead of being taken to the bathroom or provided with a bedside commode and help to use it - that is abuse.
If these events are happening where the perpetrators are being paid to dispense care, what is going on behind closed doors where relatives are the main carers? Relatives who are often overstretched and overstressed, with other responsibilities jostling for attention. Place a dependent elderly spouse, parent, neighbour, friend or a more distant relative into the mix and it can become a volatile environment.
I know from personal experience that abuse can take many forms and can happen in the home, in a care home or, as has been reported on this week, in a hospital. My mother was a victim of abuse both by me, as her carer and by staff in the nursing home that was entrusted with her care because ironically I felt I couldn’t be. I knew what I’d done, there was no grey area and I immediately reported it to the doctor and begged for the responsibility of care to be transferred to a residential home because I could no longer trust myself. My action was unequivocally abusive and I knew it. I was frightened and appalled by what I’d done, but is abuse always that clear cut?
I wonder if all carers are fully aware of what the term “abuse” covers.
The following is a list of the main types of abuse. This is just an extract taken from the Age Concern Factsheet 78 issued August 2013 “Safeguarding older people from abuse”. I’ve read this leaflet in full, it holds a few surprises and should be essential reading for all carers in whatever capacity.
I'm focusing on neglect because this was the prevalent but not the only form of abuse my mum was subjected to for more than two years in the nursing home responsible for her welfare.
“Neglect is a form of abuse in which the perpetrator is responsible for providing care for someone who is unable to care for him or herself, but fails to provide adequate care to meet their needs. Neglect can be deliberate or can occur as a result of not understanding what someone’s needs are. Examples of this could include not giving someone proper food or assistance with eating or drinking. It may be a failure to provide a warm, safe and comfortable environment. It could be failure to prevent physical harm such as not providing appropriate equipment to avoid excessive risks to mobility or transfers from a bed or chair. A carer or support worker could fail to record incidents appropriately, fail to read and follow a care plan or fail to provide basic standards of care. Someone’s health needs may be ignored, for example by not allowing them to go to the doctor for treatment, not arranging regular check-ups, or not giving medication in accordance with what the doctor has prescribed. Calls for assistance could be ignored for long periods of time or someone could not be assisted to keep clean in the way that they would choose, for example if they have incontinence.
Possible indicators of neglect
Dirt, urine or faecal smell in a person’s environment
Prolonged isolation or lack of stimulation
Person has dishevelled appearance or is dressed inappropriately
Person has an untreated medical condition
Under or over medication
Home environment does not meet basic needs, for example no heating
Signs of malnourishment or dehydration
Person who is not able to look after him or herself is left unattended and so put at risk
Not being helped to the toilet when assistance is requested.
Abuse is unacceptable and we all have a right to live a life free from abuse and to be treated with dignity and respect wherever we live or whatever our circumstances.
Safeguarding is everyone's business.”