The mistreatment of older people extends well beyond the confines of the hospital ward when we consider research suggests up to 500,000 older people are abused or neglected in the community each year (Action onElder Abuse, 2007) and older people routinely receive inhumane and degrading treatment in residential care (Joint Committee on Human Rights, 2007).
Six years on from both these reports not much seems to have changed, even though cries of indignation from both government and society continue, so does the abuse.
Any attempts to raise awareness and improve care provision for older people is to be welcomed, however, the introduction of voluntary dignity codes and trip advisor type systems alone is not enough to address an issue that goes to the very heart of society; our indifference to older people. The Health Service Ombudsman (Abraham, 2011) highlights the culture of indifference that exists in the health sector citing incidences of older people leaving hospital with numerous physical injuries, mentally confused and soaked in urine, whilst research suggests older people living in the community dominate the abuse landscape, yet are invisible to wider society (Mansell et al,2009). The conviction of carers charged with abusing older residents with demnetia at Hillcroft Nursing Home confirms how little has changed.
The level of our indifference can be measured by the difference in response following the case of ‘Baby P’.
The tragic case of ‘Baby P’ not only provoked outrage, but a commitment from government to change the system, with ProfessorEileen Munro outlining how structural and organisational change was required to improve services for vulnerable children. Surely, it is time to undertake such a review in the provision of health and social care for older people?
We need to start from a very basic level before we reach the same level of response as that seen in childcare. The prevention of mistreatment of older people requires firstly a change in society’s attitude. A dignity code may help, eventually, but hard legislation would work faster and send a message that the mistreatment of older people will not be tolerated. Legislation relating to the mistreatment of children demonstrates the value of specific legislation. Whilst child abuse has not been eradicated legislation has changed society’s response to child abuse i.e. there is a broad consensus that it is not acceptable. Other examples of where legislation can moderate attitudes and behaviour to vulnerable groups can be seen in legislation related to racism and homophobia, whilst, again, it is acknowledged racism and homophobia have not been eradicated, it has arguably changed wider society’s response to groups who have been traditionally vulnerable to abuse in British society.
Munro’s review has highlighted significant flaws in the organisational structures and practices that exist in childrens’ services, many within adult services would suggest those same flaws also exist within the provision of health and social care to older people. This involves not just looking at individual workers but also the organisational culture they work in, what use is it having someone sign a dignity code if the processes and procedures within the organisation they work prevent them adhering to them?
Our current system of care provision leaves many older people vulnerable to mistreatment, this has to change, a voluntary code could help, but on its own it will do nothing to soften the hardened heart of government and society who express outrage but just as soon forget the plight of many older people.