Elder Abuse and The Conception of Helpless Adults Being Protected

This assignment will address the conception of helpless adults being protected. A case study will be implemented, analyses, evaluations, definitions and signs and indices of abuse will be provided to the readers. Policies that underpin the role of health practitioners in identifying and responding to abuse will also be discussed, as well as identifying and analysing factors that inhibit and help partnership work in protecting vulnerable adults. According to the NHS Kings College Hospital, safeguarding adult is defined as defending the health and well-being of people and the rights of the human being to guarantee that they live free of any damage, negligence and abuse. Those most in need of safeguarding protection include adults and young individuals, such as those who receive care at home, individuals with physical, sensory and mental disabilities, and individuals with learning disabilities. According to Collins Dictionary, vulnerable adult is when a person is exposed to physical or emotional harm. However, the Southampton Hospital Charity, (2016) is when a person is unable to care or protect themselves against harm or exploitation.

Abuse is an action that deliberately harms or violates a person’s civil and humans rights that in some causes can result in death. There are different categories of abuse these are: financial or material, physical, psychological, modern slavery and human trafficking, organisational, neglect and act omission, self- neglect, female genital mutilation (FGM) and forced marriage. A couple of categories of abuse more prominent in safeguarding adult will be defined. For each of the categories of abuse there is a behaviour behind it as to physical abuse is when the perpetrator makes physical contact with an individual with the intent of causing harm, be the signs for this type of abuse are bruising, abrasion on the skin, burns, fractures, the behaviour are force feeding, over medicating someone, roughly handling. Abuse in general is very predominant in care homes institutions and person own home, in relation to this categories of abuse is the Winterbourne view Care home scandal, where residents were subjected to both physical and mental abuse. Modern Slavery and Human Trafficking its an act of both slavery and trafficking of human’s beings on the basis that slavery masters force labours and domestic services, coercing and deceit individuals to a life od abuse and unhuman treatment. This Act was created by the UK Government to protect citizens from being exploiting by the slavery masters and give severe sanctions on any individual trying to committee this type of abuse. Modern slavery has a big impact on the individual state of mind this can be associated with anxiety and stress, post traumatic disorder and depression. It also has physical injuries these might be associated with sexual exploitation, forced labour, sexual transmitted infection, e.g. HIV, STDs. To implement services and support victims it cost the UK government between £3.3-£4.3 billion per year.

One person can experience more than one category of abuse at the same time, it is extremely important that as health professional to be very alert in spotting abuse. Sometimes the signs of abuse are not visible because of that it does not mean that it is not happening, it can happen in care homes, the persons own home, hospitals and day care settings and prisons. People tend to be subjected to abuse when their health condition are deemed as vulnerable for example: learning disability, frailty or elderly age, mental and physical health conditions. Safeguarding is so imperative as abuse is still very much prominent, it is frequently happening to that most vulnerable adult who are at risk of abuse. Mr. X 76 years male who lives at home with his only adult son, was admitted onto an orthopaedic ward after a fall, on admission the nurse realised that the patient might be subjected to self-neglect as he was presented with unkept appearance and dirty clothes. Also, physical abuse was noted bruises on the patient’s body. When asked about the nature of the bruises the patient appeared nervous and scared to justifying them. Some studies have been conducted by Chadwick in (2002), and it was found that elderly abuse has a greater consequence however people calling for help are significantly reduced. One of the reasons that people are adamant to report abuse is because they are made to feel guilt and shame. To prevent abuse, it is important to raise awareness and putting programmes in places for health professionals to enable them to spot and screen elderly abuse and subsequently take the prevention measurement. As the admission went on it was mentioned by the patient that his son had his credit cards and was withdrawing funds without the patients consent the nurse listened calmly to the patients concerns. According to the World Health Organisation (2002), defines elderly abuse as single or recurrent act happening in any connection where an elderly individual has hope and confidence that creates damage or distress.

According to Care Act (2014), it is important to consider when it comes to safeguarding issues to ensure that the safety of the individual in case is maintained, the trust policy is followed accordingly. It is also important that the knowledge of the patient is assessed regarding safeguarding issue and information is passed to patient that as to the nature of the issue information will be shared and the multidisciplinary team would be involved. Safeguarding Adults at Risk (2018) this policy is from a local in Manchester. The policy aims inform all staff working within the Trust to follow the safeguarding procedure. On the case of Mr X the nurse had to rise a concern to the Ward manager, the ward manager then escalated to the safeguarding team of that trust. As to Mr X he had no capacity and was unable to give consent therefore a best interest meeting was arranged with the trust social worker team Leader and a safeguarding Named Nurse. The trust safeguarding policy states that should the staff looking after Mr X wish to discuss any concerns raised with relatives or cares they must first seek guidance and advice from the ward manager and Mr X named Social worker. Mr X discharge planning should be implemented and agreed by the multidisciplinary Team and it is important that all recommendations or guidance from the outcome from the best interest meeting for ensuring safe discharge. The manager and the social worker team will decide whether the allegation/incident should be reported to the police and also if the incident/allegation are classified as a serious Untoward Incident. There are national, regional and local policies that underpin safeguarding adults these are the “Statement Government policy, (2013)” on Adult Safeguarding the aim of this policy is to update everybody on the Government’s policy on safeguarding adults vulnerable to abuse and neglect. It embraces the statement of values for Local Authority, Social Services and housing, health, the police and other agencies to use, for both evolving and evaluating the efficiency of local safeguarding provisions. Also defines the outcomes for adult safeguarding provision for both individuals and organisations. This document was first published in 2011. The policy has six main principles which are proportionality, prevention, protection, empowerment, accountability and partnership in safeguarding. The Care Act (2014) this policy was created in 2014 but only came into place in 2015, since then three more protective items have been added such as modern slavery, arranged marriage and human trafficking. This policy states that it’s the responsibility of all health professionals ensuring the safety and wellbeing of all patients and colleagues. In safeguarding issues there are several government legislation be considered and to protect and prevent any type of abuses these are the Humans Rights Acts (1998) which is a significant piece of legislation that ensures the powers of the 'state' are not imbalanced against the powers of the individual. This means that anyone who works for the state, such as Police, Nurses, Dr's etc., cannot overuse their powers to prevent someone's right to carry out their daily business of life or deprive them of their liberty.

The Mental Capacity Act (2005) it is the ability to decide at a given particularly time, it is a question of function. These police promote people’s human rights to make their own decision or to have their best interest at heart to where decisions must be made on their behalf. 

According to the NHS Kings College Hospital it defines safeguarding as protecting individual’s health and wellbeing and the human’s rights to ensure them to live free from any type of harm, neglect and abuse. Those most in need of protection include: children and young people adults, such as those receiving care in their own home, people with physical, sensory and mental impairments, and those with learning disabilities. Over the past century, adult protection has become a focus of England's domestic policy and social work practices. This is to a large extent a concern about the extent of abuse of vulnerable adults, especially the elderly and adults with learning disabilities (Hadwin,2009). Despite a recent national study knowledge about the nature of elder abuse and effective adult protection responses by local administrations remains limited. Key lessons for agencies charged with protecting older people from abuse and the management of data about vulnerability and risk are identified, alongside pointers for developing protective systems in the European context.

Safeguarding adults is all about obeying certain guidelines and procedures and working together with the multidisciplinary team in practice and community settings and respond, responding and preventing to allegations of either abuse, negligence or harm for people at danger. People who are living in care homes or individuals with little family support are the people who need safeguarding support. Safeguarding ensures that the security of a person is endorsed considering the persons’ requirements and believes regarded they have the capacity. People who is at risk of any type of abuse are protected, which is why safeguarding is in placу. Over the past century, adult protection has become a focus of England's domestic policy and social work practices. This is largely concerned about the extent of abuse of vulnerable adults, especially elderly people and adults with learning disabilities (Cambridge et al., 2010). Despite latest domestic research understanding of the nature of the abuse of the elderly and efficient reactions to adult protection by local authorities continues restricted. Policy Context Adult protection policies and processes in England and locally constitute a risk management scheme perpetrated against vulnerable individuals, sometimes referred to as safeguarding in the UK context.

Policy defines a vulnerable adult as an individual who is unable to take care of himself or herself due to mental or other impairment, age or disease, or unable to safeguard him or herself from harm or exploitation. However, vulnerability is commonly regarded as a product of a circumstance or connection as it is an individual's feature. Elder abuse is described as a single or repeated act or absence of suitable action in any relationship where there is a trust expectation that causes damage or distress to the elderly. Abuse can take many forms, including physical, sexual, psychological, economic, discrimination and constant negligence, and can occur in hospitals and day care settings, care homes, community persons own house and family environments (World Health Organization, 2002; Age UK, 2010). Although there is no specific adult protection legislation in England and Wales, provided guidance to social service departments in the policy document No Secrets, issued in 2000. Its primary aim was to ensure that local agencies particularly but not solely social services, health authorities and the police work together to protect vulnerable adults from abuse,. National responses to elder abuse and mistreatment vary considerably across Europe; they are at different stages of formulation and implementation. It is, however, widely recognised by policymakers that more attention needs to be given to elder abuse both inside and outside the care system. Strengthening the evidence base would make a key contribution to improving policy and practice responses. Several global sources provide estimates of the incidence and prevalence of elder abuse. In the USA, Canada and Europe, randomized community-based epidemiological surveys reported annual levels of between 2% and 4%. A latest representative study in the UK proposed that 2.6% of individuals aged 66 or over in the society have been' mistreated' over the previous year by a family member, friend or care worker, rising to 4% if neighbours and acquaintances are included; this mirrors evidence from previous work. Evidence also indicates that 1.1% of elderly individuals are overlooked, 0.7% experience economic abuse, 0.4% psychological abuse, 0.4% physical abuse and 0.25% sexual abuse, with a prior research identifying as victims of physical or economic abuse up to 2% of elderly individuals. Recent World Health Organization proof indicates that every year four million elderly people in Europe experience violence or maltreatment. Recent evidence from the World Health Organisation suggests that four million older people in Europe experience abuse or mistreatment every year. 

In though the government is working hard in putting policies and legislations in place to help to radicalise or reduce the number of people suffering from abuse there are still barriers to overcome. Safeguarding it is everyone’s problem it is important when abuse is identified.

During 2017-18, 394,655 issues about abuse were raised, an increase of 8.2% over the past year. There were 150,070 protective inquiries that began in the year; a decrease of 1,090 (0.7 percent) in 2016-17. The amount of Section 42 inquiries that began during the year dropped to 131,860 by 1.1 percent, involving 107,550 people. During the same period, the amount of other inquiries improved by 1.8% to 18,210. Older people are much more probable to be the topic of a Section 42 security enquiry; one in every 43 adolescents aged 85 and older than one in every 862 adults aged 18-64. The most prevalent form of danger in Section 42 surveys concluded in the year was neglect and Omission Acts, which accounted for 32.1% of hazards, and the most prevalent risk place was the person's home at 43.5%. A risk was recognized in 68.5 percent of Section 42 inquiries and action was takenю

The purpose of this guide is to define the problems that usually lead to the protection of referrals from care homes. Also recognised are the underlying causes; neither is in order of incidence. Checklists for prevention are given to assist commissioners and suppliers work towards reducing the incidence of these problems. Additional connections to resources are available. The proof behind this job has been gathered officials, caregivers, representatives, service suppliers, lead safeguards and the Independent Safeguarding Authority (ISA). It obviously demonstrates that most care-related activity happens because of bad practice and bad service quality rather than malicious intent. The effect of bad exercise and negligence can be just as important as deliberate abuse and yet it is arguably far easier to prevent.

Local multi-agency policies and processes should be followed in all instances of alleged negligence or damage. The safety of the person involved should be of paramount significance, and all actions taken should be obviously documented and choices taken. Local protocols should determine when and when a problem should be addressed through safeguarding processes mechanisms for oversight, training and other enhancement practices. We provide several examples of country-wide decision-making tools.

The United Nations has predicted by 2050 there will be more than two billion elder population across the globe. The countries affected with a greater increase of elderly population, in order to prepare the United Nation have begun several worldwide papers highlighting the wellbeing of the elderly. For example, Malaysia and Bangladesh have been influenced by these papers in tackling elder problems including abuse. Jointly both nations have announced approaches which aims to prevent elderly abuse through policy and legal framework. This paper highlights and examines the issue of elder abuse and the strategies undertaken by both countries to overcome the issue.

The victim relies on the abuser for care and if they report, they are endangered with the loss of their independence. The danger of having to alter their living condition is quite real when there is no one else to provide the care the elder needs. If the abuse is perpetrated by a loved one or family member, the victim may need to overcome several emotional reactions before feeling to tell somebody comfortably enough. The elder may be afraid the abuser will get into difficulty and may feel guilty or blame for the abuse in some way. The victim may be afraid of the reaction of the scheme; this fear may be based on misunderstanding, absence of options awareness, or absence of alternatives. The victim may be afraid of retaliation and worry if the abuse gets worse report. The victim is separated from society. The victim may be in denial of being abused or unaware of the abuse or neglect they are experiencing. Generational values can lead a victim to think that what they experience is normal, or to not share a 'family issue' with community service suppliers. The victim may be afraid to grow old. 

In conclusion, this assignment has discussed about the conception of helpless adults being protected. A case study has been implemented, analyses, evaluations, definitions and signs and indices of abuse will be provided to the readers. Policies which underpinned the role of health practitioners in identifying and responding to abuse have also been discussed, as well as being identified and factors being analyse which inhibit and help partnership work in protecting vulnerable adults. It also included the barriers in preventing elderly abuse and the global statistics in safeguarding. It has defined safeguarding and vulnerable adults and vulnerable adults. It has defined and analysed different type of abuse. Furthermore, it highlighted and discussed physiological effects of abuse. In a nutshell, this essay has found a big gap on preventing any category of abuse as the policy guidelines that the global, national and local government are put in place to reduce and prevent abuse or safeguarding issues is not enough so far. There is more and more abuse being registered and less services are available to protect vulnerable adults. The government is trying their best to minimize and reduce any kind of abuse; however, safeguarding is everybody’s problem. If we do not report it when it has been raised, it will be difficult to resolve the problem in the future.