Violence in care: an issue that needs prevention and oversight

In January the German press featured an article on violence against older people in two residential care homes. While residential care homes can have many advantages that older people might cherish – opportunities for socialising, the belonging to a community, autonomy without having to rely on the family, access to healthy food and adapted sports programmes – they can also foster a climate of conflict between carers and residents. The article has the merit to stir a debate on violence in care homes, and should be read without overlooking another challenge: maltreatment and abuse of older people living at home.

Cases of elder abuse in Germany

The German newspaper ‘Die ZEIT’ explains several of the causes that might lead to elder abuse in residential settings. One might be the lack of resources and the high amount of stress placed on professional carers, an issue that is important in the light of tightened public budgets allocated to long-term care. Another is the lack of communication and understanding between professional carers and doctors: the care staff might not understand measures taken by medical doctors to prolong life, if this inevitably prolongs suffering. They might have the idea that by taking action to shorten lives of residents, they are doing them a favour. The article also highlights the problems related to whistleblowing: a professional working as a carer in a Berlin clinic has signalled abuse against older residents in her structure in 2007. The judicial procedure is still ongoing, but meanwhile the carer in question has lost her job and does not find a new one.

Proposed solutions: oversight and prevention

The article proposes a number of solutions that could prevent and deal with cases of elder abuse in residential settings: it highlights the importance of protecting ‘whistleblowers’ who bring cases of abuse to the attention of the authorities. Also, the prevention actions could focus on training carers, both professionals and informal carers, as well as family members on signs of elder abuse, so that cases can come to light more quickly. Also, the article calls for the creation of regional ombudsmen to oversee residential care.

AGE proposals: quality framework for long-term care services, support for carers

AGE welcomes the highlight placed on the issue of elder abuse. However, violence and elder abuse is not an exclusive feature of residential homes: it often also happens in family contexts and home care settings. The reasons for elder abuse at home can be the same as in residential care settings: lack of participation of the cared-for person in decisions that concern them, misunderstanding of medical decisions, overburdening and lack of support in terms of time, money and access to professional care services.

AGE has been calling for binding European quality standards for long-term care services, which adopt a human rights-based approach and can help prevent elder abuse. The European Quality Framework for long-term care services developed by the WeDO European partnership, led by AGE, shows the principles that should be respected in delivering quality, dignified care to older people. AGE also calls for more data collection on the incidence of elder abuse in all settings, and for better mechanisms to detect abuse and protect victims.

Further information:

• Die ZEIT: Whistleblower im Altenheim. Gewalt in der Pflege, 29 January 2017 (in German)
• WeDO project, European Quality Framework for Long-Term Care Services