Safeguarding the Elderly in Home Care

What does safeguarding entail?

People with care and support needs, such as those with disabilities, health conditions, or mental illnesses, may face an elevated risk of abuse and neglect, and they might be less capable of shielding themselves from potential harm.

Safeguarding is the proactive protection of the rights of those vulnerable to such risks. The Care Act 2014 mandates local councils to conduct investigations when concerns about abuse or neglect surface. The primary objective of a safeguarding enquiry is to determine whether intervention is necessary to protect an adult and, if so, what specific actions are required.

Common types of abuse in the elderly 

Psychological Abuse

Psychological abuse may arise from family member/full time carer burnout, emotional stress, or a lack of awareness about the impact of their words and actions. It could also result from unresolved conflicts within the family or family dynamics.

Physical Abuse

Physical abuse can occur due to a family member being under extreme stress, frustration, or lack of coping mechanisms. In some cases, it may be unintentional, stemming from inadequate training in proper handling or care techniques.

Financial Exploitation

Financial exploitation often occurs due to financial pressures within the family's life. Economic difficulties, debts, or a lack of resources may drive a caregiver to misuse the person's finances, sometimes without realising the consequences.

Neglect/Omission

Neglect can result from family carer fatigue, lack of training, or overwhelming responsibilities. In some cases, it may be unintentional, stemming from a lack of awareness of the person's needs or changes in their condition.

Sexual Abuse

Sexual abuse can be driven by power imbalances, lack of awareness of boundaries, or, in some cases, distorted beliefs about appropriate behavior. Mental health issues or substance abuse may also contribute.

Risk Factors for Elder Abuse

These factors contribute to the complexity of elder abuse, and understanding them helps in developing effective prevention and intervention strategies.

Individual level characteristics which increase the risk of becoming a victim of abuse include:

1. Functional dependence/disability
2. Poor physical health
3. Cognitive impairment
4. Poor mental health
5. Low income
   
   

Characteristics which increase the risk of becoming a perpetrator of abuse include:

1. Mental illness
2. Substance abuse and dependency
3. Financial dependency of the abuser on the victim
   
   

Community and society factors linked to elder abuse may include:

1. Ageism against older people
2. Cultural norms (e.g., normalisation of violence)
   
   

Factors that reduce the likelihood of elder abuse:

1. Social support
2. Living with others
   
   

Complexity of Abuse and Neglect

Instances of abuse and neglect often intertwine, exposing older people to various forms simultaneously. For instance, financial abuse might involve elements of physical harm, while neglect can be linked to coercive control.

Perpetrators in Trusted Positions

Perpetrators are frequently people in positions of trust, including family members or caregiving staff. The breach of trust is not limited to familial relationships, as it can extend to situations like susceptibility to scams.

Wide Range of Offenders

Safeguarding is essential as anyone, regardless of their relationship to the older person, can be involved in abuse or neglect. It extends beyond breaches of trust and encompasses scenarios where older individuals may be at risk of falling victim to scams.

Vulnerability of the Elderly

Official reports indicate that individuals aged 85 and above are significantly more likely to be the subject of safeguarding enquiries compared to other age groups.

Addressing Abuse and Neglect in Professional Care Settings

For Concerned Individuals

If you have apprehensions about an older person facing abuse or neglect within a professional care environment, such as a care home or through domiciliary care services, take immediate action. Contact the local authority or reach out to the Care Quality Commission (CQC) for assistance. 

For Professionals

If you find yourself in a professional capacity and suspect abuse or neglect in a care setting, it is recommended to consult with your manager promptly. Early discussion allows for swift resolution of the issue. Remember, no professional should assume that someone else will relay critical information related to the safety and well-being of an adult.

Key Steps for Professionals

Discuss with Your Manager

Share your concerns with your manager to initiate prompt action.

Collaborate to address the situation effectively.

Avoid Assumptions

Don't assume that someone else will report crucial information. Take personal responsibility for sharing relevant details.

Reporting Concerns

 If you have concerns about abuse or neglect, report them to the local authority and/or the police, depending on the nature of the situation.

Training and Safeguarding Procedures

   - Ensure you have received appropriate training based on agreed safeguarding procedures.

   - Familiarise yourself with protocols to confidently respond to such situations.