APPENDIX 12
Memorandum by the National Pensioners
Convention (EA16)
INTRODUCTION
The National Pensioners Convention is the largest
organisation of older people in Britain, with an affiliated membership
of over 1.5 million. The Convention co-ordinates the policies,
activities and campaigns of pensioners and their groups throughout
the country with the aim of improving the financial security,
dignity and well being of all older people.
The following submission is based on the inquiry's
terms of reference:
How Prevalent is Elder Abuse?
Abuse of older people is very frequently hidden,
and not always obvious even to the victim. For this reason, robust
evidence is very difficult to obtain and our submission is therefore
largely anecdotal. Nevertheless, by way of illustration, we would
like to submit the following case studies:
— Abuse in a small cottage
hospital where the patients are mainly elderly
Doris was admitted for a minor fracture of the
pelvis and for rehabilitation. She was unable to get to the toilet
on her own and consequently wet the bed, for which she received
a strong rebuke from the staff. Doris was clearly frightened of
the nurses. There were no bedside bells to call for assistance
and one night she was forgotten and left in the lounge of the
ward until midnight. Her treatment eventually led to a formal
complaint by her family after her death.
— Abuse in a private nursing
home
Alice was in a private nursing home. When she
visited her sister who lived nearby, she was frightened to drink
because of the difficulty in obtaining help to go to the toilet
and was therefore subjected to a hidden restriction on her liberty.
Alice has since died.
— Abuse in the person's own
home
Geoffrey converted his home into an annex for
himself, with the remainder going to his daughter and her husband.
Recently on a very cold night, when his daughter's family was
away, it appeared that the heating was not working. As the boiler
is situated in his daughter's side of the house, Geoffrey did
not feel that he would be allowed to turn on the heating. In fact,
he never knows when the boiler is on and has no control over its
use.
Nancy is dependent on a private carer to clean
her house for her three times a week. This carer is believed to
be stealing quite large amounts of money from Nancy, but she has
not complained as she feels there is no-one else who can carry
out these essential tasks for her. The carer has previously been
dismissed from two institutions because of stealing, but no action
seems to have been taken other than to dismiss her.
WHAT ARE
THE CAUSES
OF ELDER
ABUSE AND
WHO ARE
THE PERPETRATORS?
The Convention is not equipped to adequately
outline the causes of elder abuse, which are in themselves complex
and difficult to quantify. However, the abusers in the above four
examples were members of staff of the hospital and nursing home,
a care worker and a family member. In short, abusers can be any
of those providing either formal or informal care.
THE SETTINGS
OF ELDER
ABUSE
The Convention believes that abuse can take
place whenever the perpetrator has power over the older person.
This effectively means that the setting in which the abuse takes
place is only relevant if it directly shapes the relationship
between the older person and those who are providing their care.
For example, institutional factors such as gross
failures of management and intimidation of staff may create a
culture in which individuals are frightened to complain for the
fear of the consequences.
WHAT CAN
BE DONE?
The Convention would like to suggest the following
action:
— The National Service Framework for
older people and clinical and care guidelines are inadequate because
they are not enshrined in legislation. This should be addressed
as a matter of urgency.
— The treatment of the elderly should
be included in the "star" rating system for NHS and
Primary Care Trusts.
— Instances of elder abuse that have
been detected should be brought before the courts, possibly under
the Human Rights Act.
— District nurses, health visitors
and care workers should be actively encouraged to look out for
abusive situations in domiciliary care. Staff training can play
a part in the detection and prevention of elder abuse, provided
that the management are fully motivated to prevent this happening
and to deal with it when it occurs.
— Family members should be encouraged
to intervene in the care of their loved ones, if they feel abuse
is present.
— Awareness of the problem in both
domiciliary and institutional settings can be raised through publicity
and strenuous efforts to change our attitudes towards elderly
persons who are unable to defend themselves.
— Inspections of care homes and small
cottage hospitals need to be rigorous and include surprise visits
by lay assessors who have been trained to detect possible hidden
abuse.
— All care workers, whether employed
in care homes, hospitals or domestic settings should be police
checked before they are allowed to begin work.
— All care workers employed in domestic
settings should be required to meet certain standards and register
with the local authority. That register should then be made available
to the public.
— Under the freedom offered by the
direct payment system, individuals often need advice and guidance
as to how to employ a care worker in their home. Consideration
should be given to the creation of a local advice service for
people in this position.
— Consideration should be given to
the setting up of a freephone careline—similar to those
available to children—through which older people and their
relatives can report instances of abuse.
November 2003
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