A number of things came together this week. After doing a webinar which among other issues addressed elder abuse I was dealing with an actual complaint of elder abuse. There was evidence of coercion being involved to force a senior to hand over their financial powers to a family member who was experiencing financial difficulties and who had made a number of requests for the family home to be mortgaged to provide money.
To do so was not of course in the best interest of the home owner who was retired and living on a fixed income. Previous requests had been refused and the situation had escalated to now include threats of family breakdown. The matter was resolved through family discussion and widening the circle of awareness among the whole family. The potential for these demands to be deemed criminal was a bit of a shock to the person seeking financial powers. That person had merely seen it as the most obvious and logical solution to their problem and felt the statements made were justified in “making them (home owner) see reason”.
In spite of the matter being resolved there are of course some residual negative effects on the wider family dynamics. Unlike many situations involving elder abuse this one was at least exposed and explored.
One of the cases discussed in the webinar related to the horrific story of a woman admitted to hospital 12 weeks after breaking her leg in a terrible state of physical and mental distress. The case generated some discussion among participants when they found out the carer had not been charged or prosecuted for what was considered by the coroner evidence of neglect. Police in Queensland had in fact contemplated charges of manslaughter, failure to provide the necessities of life, negligent acts causing harm, torture. “But they decided the doctors couldn’t say beyond a reasonable doubt that the daughters care had caused Cynthia’s death” (Sarah Elks, The Australian 2013).
This case had considerable media coverage in Australia and overseas at the time. The inevitable demands for better protections, legislation and closer scrutiny of those who were receiving carer support payments in return for caring for the vulnerable in our community were made in many articles. However it isn’t very easy to implement either investigations or prosecutions.
The complexity, the medical, financial and emotional issues, the special needs of many likely complainants and the ability to gather sufficient evidence to discharge the criminal onus may dissuade police and prosecutors from taking a matter forward (Eileen Webb, Professor, Faculty of Law, University of Western Australia).
The Hon Susan Ryan AO, Age Discrimination Commissioner speaking at an Elder Abuse forum in 2015 gave a number of examples of elder abuse, two in particular should resonate with every nurse. “In Australia, two nurses were sacked after engaging in a crude game of photographing the genitals of nursing home residents and making sport from guessing which resident the photographs belonged to. An elderly man in a nursing home was denied food because “he was going to die anyway”. One of her many recommendations was a call for “Coordinated training of aged care staff to be a top priority to deal with problems of poor working conditions: low wages, inadequate staff numbers and insecure work”.
This statement was the key to my own research into abuse that arises in aged care environments. The webinar discussion touched on this issue so I was particularly alert to a Nursing Times report yesterday revealing the extent of elder abuse in UK nursing homes. There have been studies in most western countries, including Australia that show just how great the risk is for abuse in these environments. In spite of the fact Nursing home care facilities owe both the elderly individual and their family members a duty of care, which if breached by way of negligence or criminal intent, compensation is potentially assignable to the nursing home facility and staff, very few families complain.
We however have a mandatory responsibility to report abuse and a professional responsibility to protect our elders. The causes of abuse have been linked to inadequate or inappropriate staffing, client behaviours and staff education. If an environment has a culture or pattern of ignoring abuse we need to accept and understand that professionally liability and responsibility to both report, correct and eliminate it is part of our duty.
There are some fabulous webinar recordings by Pam Savage regarding Nurses and the Law on the Nurses for Nurses Network . The Nurses for Nurses Network provides good information and CPD on an array of nursing topics in a range of easy learning ways including webinars and quizzes on the latest information that Nurses need to know – remember the Nurses for Nurses Network was created by Australian Nurses for Nurses ! www.nursesfornurses.com.au