Dealing with Institutional Abuse in a Multicultural South African Society

SUMMARY

The climate of socio-political transformation in South Africa together with a society of complex multicultural diversities creates enormous challenges regarding the care of the elderly in institutions. Institutional abuse in South Africa may present in a unique way, as a result of issues relating to policy and legislation and care delivery systems. The need for previously segregated groups to integrate and understand the various cultural practices of people from different socio-economic backgrounds further compounds the opportunity for abuse in homes for the aged which are undergoing transformation.     

Meeting the Needs of Visually Impaired People Living in Lifetime Homes

ABSTRACT

This article explores perceptions on the suitability and effectiveness of Lifetime Homes standards (LTHS) for those with visual impairment in Northern Ireland. LTHS are a series of mandatory United Kingdom public-sector housing design interventions, providing a model for ensuring accessible and adaptable homes throughout an occupant's life span. An aging demographic with increasing incidence of diabetes has led to rising numbers of elderly, visually impaired people wanting to remain in their homes for longer. Qualitative semi-structured interviews were conducted with 13 key stakeholders and thematically analyzed. Although findings show that employing LTHS offers benefits to visually impaired residents, shortcomings were also identified. Evidence indicates a need for policy makers, health-care professionals, and housing associations to modify practices to better meet the housing needs of visually impaired people. Findings may also be applicable to those with other impairments and disabilities in relation to housing for elderly residents.     

Job demands,emotional dissonance and elderly abuse: The moderating role of organizational resources

ABSTRACT

The present study focuses on elderly abuse committed by caregivers in nursing homes. It aimed at a better understanding of neglect and abusive behaviors by considering the working context and the emotional dissonance of these professionals. To achieve this goal, direct effects of emotional dissonance, job demands (workload and emotional demands) and organizational resources (high-quality relationships with the colleagues and the supervisor) on neglect and abusive behaviors were analyzed. Moreover, the moderating role of organizational resources was explored. The study was conducted among 481 nurses and healthcare assistants from different French nursing homes. Overall, results contributed to the literature by pointing out the impact of emotional dissonance and caregivers’ working context on neglect and abusive behaviors. Moreover, results highlighted the moderating effect of high-quality relationships with the colleagues and the supervisor and give rise to potential implications in preventing elderly abuse in nursing homes.     

Risk Indicators of Elder Mistreatment in the Community

ABSTRACT

This study examined risk indicators of chronic verbal aggression, physical aggression, and financial mistreatment in a population-based sample of 1,797 independently living elderly in Amsterdam, The Netherlands. Included were socio-demographic characteristics, physical and psychological health, and functional capacity. The data were collected using standardized interviews that took place in the homes of the respondents. The results showed that chronic verbal aggression was associated with an elder living with a partner or other(s) and in poor or bad health. Physical aggression was associated with an elder living with a partner or other(s) and having depressive symptoms. Finally, financial mistreatment was associated with being male, living alone, being partially dependent in instrumental activities of daily living and having depressive symptoms. The results indicate that the risk indicators of victims of financial mistreatment differ from those of chronic verbal aggression and physical aggression, suggesting that financial mistreatment may occur more often as a single form of abuse whereas verbal and physical aggression may more frequently occur together.     

Scandalous Care: Interpreting Public Enquiry Reports of Scandals in Residential Care

ABSTRACT

This article reviews an earlier study written for the Wagner Committee (1988) on scandals in residential care. That review was based on a study of ten enquiry reports, only two of which were about homes for older people. The main events that were described are grouped as: institutionalised practices, indifference and neglect, physical cruelty, humiliation, too authoritarian a life-style, a dull and depressing life-style, an overcrowded and run down environment, disharmony amongst the staff team, and staff misappropriating goods or money. Now, more weight should be given to: residents' abuse of residents and of staff, an improper influence on the life-style of others, and sexual abuse. Explanations proposed are: structural, environmental, and individual and worker style. Abuse is considered in the context of the nature of direct care and the acts of intimate caring of others.     

An Ecological Framework for Contextual Risk Factors in Elder Abuse by Adult Children

ABSTRACT

Future trends suggest both a continued growth of the elderly population, as well as the likelihood of increased demand for family caregiving which may, in turn, be associated with increasing rates of elder abuse. It is important to consider issues related to such caregiving, including potential abuse from an ecological perspective which, in turn, provides a fruitful basis for framing the problem of abuse as a set of contextually-based risk factors. This paper focuses on the contextual risk factors using an applied ecological model, a useful framework for understanding the intergenerational character of elder abuse in families, for developing recommendations for empirically-based action research, and for the development of community-based prevention and intervention strategies.     

Mental Health and Criminal Justice Issues Among Perpetrators of Elder Abuse

ABSTRACT

Recent studies on elder abuse suggest that the pathology or impairment of the abuser may be a stronger predictor of elder abuse than characteristics of the victim. To examine the relationship between elder abuse, abuser pathology, and the criminal justice system, the New York City Department for the Aging (DFTA) undertook a survey of older victims of reported domestic abuse seeking assistance from the DFTA Elderly Crime Victims Resource Center. Preliminary findings from the survey indicate that impaired abusers were significantly younger than unimpaired abusers and more likely to live with their elderly victims, to be unemployed, and to have a history of involvement with the criminal justice system.     

The Collective Turkish Home in Vienna: Aesthetic Narratives of Migration and Belonging

ABSTRACT

This article explores how Turkish people in Vienna create a collective sense of belonging and position themselves in a complex web of diasporic relations, through the materiality and aesthetics of their homes. It aims to show how the efforts of displaced people to construct a belonging to the new place of dwelling are intertwined with the aesthetic and material practices of making homes. Based on ethnographic research, it will be argued that a particular “Turkish home” is collectively created through shared aesthetic practices and discourses and serves as a material and social medium both for imagining and building collectivities and for constructing and expressing ambiguities, conflicts, multiplicities and contests, played out in the aesthetics of the everyday. Challenging the common view that homes in diasporic or migratory resettlements reflect past lives and locations or a mixture of two cultures and two sets of different objects associated with them, it will be argued that Turkish homes in Vienna are made through a new and particular aesthetic, which serves to produce and reproduce a communal Turkish narrative of migration to and dwelling in Vienna.     

A Fit Person to Run a Home: Registered Homes Tribunal Interpretations of the ‘Fit Person’ Concept in the United Kingdom

ABSTRACT

The abuse of people living in residential care in the UK is well documented. A further wealth of information is available in the form of anecdotal accounts of those who have been employed in this sector but who, in a climate which is still somewhat hostile to ‘whistle blowers,’ are not prepared to formally report their concerns. A small but significant amount of hard evidence of abuse exists in the reports of the Registered Homes Tribunal decisions. This body has the jurisdiction to hear appeals concerning the running of registered and nursing homes in the UK. The circumstances portrayed range from issues of ‘bad practice’ to abuse which may be physical, psychological, or sexual, perpetrated by staff, home owners, residents, or visitors. Many of the cases which concern the tribunal focus on whether a given individual is a ‘fit person’ to run a home. It is the aim of this article to consider and reflect on the tribunals’ interpretation of that term, in relation to the operation and decisions of the tribunal.     

Elder Abuse in Nursing Homes: The Theft of Patients' Possessions

ABSTRACT

Although there has been an increasing concern about physical and psychological abuse in nursing homes, one aspect of elder abuse that has been relatively overlooked and understudied is theft of nursing home patients' property. This paper discusses the nature of this type of abuse and explores some theoretical explanations for it. In addition, some theft-reducing techniques ranging from simple target hardening to formal and informal surveillance are suggested.     

The Design of Mainstream Housing for Downsizers

ABSTRACT

In the United Kingdom, the supply of new homes to the housing market tends to be focused either on “general-needs” housing on the one hand, or on special-needs housing for the elderly on the other, with relatively few people moving into homes that will support their independence as they age. Against the backdrop of the UK's chronic housing shortage and the UK government's recent Housing Standards Review, this case study of a mainstream housing development—which meets so-called “Lifetime Homes” in “Lifetime Neighborhoods” standards—identifies specific design and locational features that have attracted “downsizers” to buy into it, as well as those they subsequently found problematic.     

Chapter 6. Post-Occupancy Evaluation of a Life-Care Community for the Aged in Israel

ABSTRACT

This paper presents an advanced housing arrangement for elderly people and an innovative method of Combined Post-Occupancy Evaluation to evaluate it. The method is based on what we developed and found to be a useful checklist of housing-related needs-physical-functional and psycho-social-of elderly people. According to our findings, the fulfillment of the psycho-social needs has first priority in determining the satisfaction of the elderly with their environment. The evaluation method combines a two-fold professional evaluation and an evaluation by the users. The results of the evaluation lead to several practical recommendations, including a recommended reduction of the resources devoted to public areas in old-age homes and an increase of the investments in the individual housing units, in which most of the needs of the residents are fulfilled.     

Tolerance of Elder Abuse and Attitudes Toward Third-Party Intervention Among African American,Korean American,and White Elderly

SUMMARY

Studies have found that professionals and the lay public differ consistently from one another in the ways in which they perceive elder abuse. A potential variable that may explain this observed difference is cultural norms among ethnic groups. Using 18 statements, this study examined similarities and differences among elderly from three ethnic groups in their tolerance for potential elder abuse, perceptions regarding perpetrators and the causes of elder abuse, and attitudes toward third-party intervention and reporting of elder abuse to the authorities. Results suggest that while African American and White elderly are remarkably similar in their responses to most statements, Korean American elderly differed significantly from the other two groups in their tolerance for medical mistreatment, financial exploitation and neglect, perceptions of causes, and attitudes toward reporting elder abuse. These findings have implications for understanding potential barriers to preventive outreach efforts, investigation, and intervention in cases of elder abuse in a culturally diverse community.     

Korean American Elderly's Knowledge and Perceptions of Elder Abuse

ABSTRACT

“This study examines Korean American elders” perceptions of elder abuse and its perpetrators and explores cultural, as well as non-cultural influences on such perceptions. Face-to-face interviews were conducted with 100 elderly Korean Americans, 60 years of age or older, residing in Los Angeles County. Respondents reported 46 abuse cases, categorized into the following six types: financial abuse (36%), psychological abuse (24%), culturally specific abuse (17%), neglect (15%), physical abuse (4%), and other (4%). Most respondents identified elder abuse in terms of abrogation of filial piety, suggesting the centrality of “children” in Korean American elders⁵ lives and well-being. Findings demonstrate that employing a uniform definition of elder abuse across all cultures and ethnic groups without attending to the cultural and subjective aspects of a given situation may result in missing problems and needs identified as important by the elderly themselves. Implications for social work practice and program development are discussed.     

Chapter 2. Housing and Household Movement in Later Life

ABSTRACT

In most developed countries housing policies are focusing on enabling elderly and very elderly people to remain in their own homes. Attention is also turning to people in the Third Age to see how their housing needs to be different from earlier stages of their lives but also as a preparation for old age. This paper presents evidence from the United Kingdom (UK) about choices and policies at different stages of middle and old age and on the developing range of housing options to meet these needs.     

Out-of-home maltreatment: An analysis of risk in various settings for children

Abuse and neglect of children in out-of-home care are common, but comparisons of relative risk among such facilities are rare. Data from Indiana for the period 1984–1990 permit an examination of maltreatment in various settings and computations of rates of physical and sexual abuse and neglect. Findings suggest that children in daycare homes and centers and schools are less likely to be maltreated than those in foster homes, residential homes, or state institutions and hospitals. These differences in risk may reflect variation in staff morale and turnover, different ages and experiences of children, alternative emphases on custody, control or nurturance by the home or institution, and different approaches to substantiating abuse. However, in three of the seven out-of-home settings, there are higher rates of maltreatment than for children in their own homes. Some implications of these findings are explored.     

Violence Experiences in Care: Some Methodological Remarks based on the Finnish Child Victim Survey

The article examines violence experienced by children in substitute care and at home based on the survey results of the Finnish Child Victim Survey carried out in schools in 2008. The focus is on physical and psychological violence in conflict situations. Of the 13 459 respondents, pupils between 12 and 16 years of age, 233 children reported living in care or having lived in care. Children living in care were asked the same questions as children living at home about violence experienced by their care‐taking adults. The analysis compares the answers between those two groups and examines them in relation to information about children's psychosocial problems and measures of emotional wellbeing.

‘The focus is on physical and psychological violence in conflict situations’

According to the study, children report more physical and psychological violence by adults in their homes than children do in residential homes or foster homes. Substitute care is not, however, free of violence. Children with psychosocial problems experienced more violence at home than in substitute care. The article suggests a more thorough conceptual and methodological analysis of abuse in care. The conceptual and methodological tools employed should be sensitive to the particular nature of abuse in care and the studies should pay attention to a variety of forms and practices of violence. Copyright © 2011 John Wiley & Sons, Ltd.     

Fractured Relationships and the Potential for Abuse of Older Men

SUMMARY

Elderly men are an understudied population in the area of abuse and neglect. The typical elder abuse or neglect victim is described as a frail woman. The National Elder Abuse Incidence Study shows men to be victims as well and at higher risk than women for abandonment, the most extreme form of neglect. A qualitative study of older widowed men did not specifically explore issues of abuse and neglect, but found several of the men experiencing alienation from one or more of their adult children. This paper explores the dynamics of these “fractured relationships” and finds several patterns that may increase an older man's risk of being neglected when his needs for support increase. Many men are not functioning in a kinkeeper role and are not attempting to repair fractured relationships. Minimizing their own feelings may prevent men from understanding the extent of alienation felt by an adult child.