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The perceptions of elder abuse by care staff in round-the-clock care units

Public examination of a doctoral dissertation in the field of Nursing Science¨

Doctoral candidate: MHSc Heidi Sipiläinen

Date and venue: 17.6.2016 at 12 noon, Medistudia MS300, Kuopio Campus

Language of the public examination: Finnish

The purpose of this study was to describe the occurrence of elder abuse in round-the-clock care units as assessed by care staff and to explain why elder abuse occurs. In addition, the study described te predisposing factors for elder abuse, its identification and interventions, and the factors associated with them.

The data were collected in autumn 2011 by means of a survey of 50 round-the-clock care units. A total of 697 responses were received from people working in these care units (response rate 41 %). The data were statistically analysed ant the occurrence of elder abuse was modeled using logistic regression analysis. The answers to the survey’s open-ended questions were analysed by using inductive content analysis.

The most prevalent forms of elder abuse were psychological and social abuse and these manifested themselves by neglecting the elderly person’s wishes and requests. 85% of the respondents had witnessed psychological and social abuse int the past year. Oral and dental care was the most common form of treatment failure, 80% having witnessed such incidents during the year. Physical abuse was less common, however, as many as 63% felt it had occurred. The study found that financial and sexual abuse were not widespread; the most common manifestation was ridiculing the older person’s sexuality. The occurrence od elder abuse was associated with poor work atmosphere, large care units and the lack of guidance relating to prevention of elder abuse.

The predisposing factors for elder abuse were related to the residents, the care staff and the organization. Older people with cognitive impairment were most vulnerable to abuse, The predisposing factors linked to the care staff were issues relating to well-being in the work-place, lack of skills, and personal characteristics, such as inability to tolerate resident’s aggressive behavior. Tha factors linked to to organization were low staff levels, conflicts in the work place and various other factors that resulted in increase workload or which had an impact on the physical environment and the way care was delivered.

Guidance how to deal with abuse rarely existed in the work place. About half of the respondents were of the opinion that the abuse is easy to recognize. Obstacles to intervening to prevent abuse were identified as fear of consequences to self and that there would be no consequences to the perpetrator. Intervening to prevent abuse was easier if the work-place hd a supportive work environment and guidance on elder abuse existed.

As a result of this study it can be concluded that elder abuse can be prevented by ensuring the well-being of the care staff and by paying attention to creating a positive work environment. In addition, the occurrence of elder abuse can also be prevented by ensuring that sufficient numbers of care staff possess the right skills and are equipped with instructions on how to deal with abuse situations.

The doctoral dissertation of Master of Health Sciences Heidi Sipiläinen, entitled The perceptions of elder abuse by care staff in round-the-clock care units will be examined at the Faculty of Health Sciences. The Opponent in the public examination will be Docent Päivi Voutilainen of the Ministry of the Ministry of Social Affaits and Health, and the Custos will be Docent Päivi Kankkunen of the University of Eastern Finland.

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