Have we reached the point of ‘compassion fatigue’ when it comes to the abuse of older people?

The BBC will broadcast shocking images of abuse on Panorama whilst the Telegraph suggested last year the treatment of older people in care is now so bad that it meets the legal definition of torture according to the Governments own human rights watchdog (John Bingham, 5th March 2012). How many more news reports do we have to watch and read before society and government decide to react with more than short lived outrage or have we reached the point of ‘compassion fatigue’ when it comes to the abuse of older people?

The BBC’s Panorama (17th June 2013) will make for shocking, and saddening,  viewing on the care of older people in Britain today. Sadly this is not new to many of us who have worked in the care sector. Yet our voices have gone unheard, leading to many, such as myself, leaving the profession.

Unfortunately the abuse of older people is not confined to hospital and residential settings, it is estimated up to 340,000 older people in the UK are abused each year in their own homes. The abuse of older people now parallels that of children with many experiencing emotional, psychological, physical, sexual and financial abuse perpetrated against them by those charged with providing care and support, for example, partners, wider family and professional carers.

This most recent report of abuse appears after many others, highlighting the disgraceful treatment older people experience from those supposed to be proving their care, whether at home, in hospital or residential care. A report by the Health Service Ombudsman on the abuse of older people in hospital settings suggests there is a culture of indifference from both government and staff to the abuse of older people.

The Independent commented:

“For a while we may pause to express outrage. But we then move on to the urgent business of our daily lives. Spot checks and hit squads may arrest the worst practice…..But they will not do much about a society that has hardened its heart against the elderly.”

Doing nothing is not an option. The review of adult social care law undertaken by the Law Commission in 2011 made clear to government the law pertaining to the protection of vulnerable older people requires strengthening as the current framework is clearly not working. However, this alone will not address the issue. The current discourse on the care of older people also needs to change, we have reached the point where ‘cost’ is king, every aspect of care for the elderly is framed in the language of economics. Government and society are so focused on the cost of care they have lost sight of the value of caring to society, from a moral and ethical perspective. Replacing values such as dignity and respect in care with ‘value for money’ has reduced older people to a percentile of spending of tax payers money, rather than being viewed as actual people, people who at some point may require additional help and support, through no fault of their own but as a natural process of ageing. Indeed the focus on cost diverts our attention from the real issue, we as a society are, at best, indifferent to the plight of older people.

Our ability to watch abuse captured on film in care settings and read report after report yet do nothing to change our attitude is disturbing, maybe society is experiencing ‘compassion fatigue’? If this is the case old age is to be more feared than death!

Real change can only occur if built on a foundation of respect for older people. Developing a culture of dignity and respect for older people requires more than codes of practice to guide the carers who look after our older people. We all have to develop a much deeper understanding of what ‘dignity’ and ‘respect’ actually mean and how we demonstrate dignity and respect to one another, starting firstly with ourselves. Arguably if individuals respected themselves they would not allow themselves to act in such a way that is abusive to those they care for. It would also help if we respected carers by paying them a wage that genuinely reflects the complex nature of the work they do.

It is with shame that we should read the treatment of older people in care is now so bad that it meets the legal definition of torture according to the Governments own human rights watchdog. How many more programmes showing carers abusing those most vulnerable must we watch, how many more people have to suffer before society and government decide to react with more than short lived outrage?

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About digalpin

I gained my social work qualification from the University of Southampton and worked for 14 years in mental health, disability and older people services. I am currently a senior lecturer in post-qualifying social work at Bournemouth University and am conducting research on government and societal attitudes and responses to the mistreatment of older people in health and social care provision for my doctorate. My views are my own.

6 thoughts on “Have we reached the point of ‘compassion fatigue’ when it comes to the abuse of older people?

  1. *In response to a tweet I received stating “Trouble is that we have “bad care porn” with no one grasping the nettle of finding real solutions”* – Sorry twitter word limit does not suffice!

    Thanks for this response. My feeling is a lot of people do care, and really want to change the situation, however, our responses are not co-ordinated, so have limited impact at a wider level. A strong lead is required from someone with a genuine commitment and grasp of the issue, dare I suggest Government might be that ‘someone’. Come on Mr Burstow, Mr Cameron and co step outside of your ideological boxes, sometimes a ‘big state’ is necessary!

  2. Yes.
    What we have seen over the last few years is a massive attack on individual organisations and sectors, with regard to the poor care that does occur.

    This has got tangled up with ideological arguments about who can deliver care best, and financial arguments about who should pay for it.

    We need to find ways to stand back from this, to re-imagine what it is that we actually want from end of life care, and to ask the difficult questions about how this can be delivered, paid for & monitored.

    What I am keen to do is to work with a number of individuals who are committed to these issues to present this case to the press, and to stimulate wider debate. Would be interesting to work with you on this.

  3. Yes a right old tangled web has been weaved!!! I’m out of the office for a few days Diana, but will catch up with you later in the week.

    Thanks again for your comments.

  4. Di, its interesting that you talk about “cost is King” and replacing morale values with things like “value for money”. Whilst I agree with your views I wonder if it is the whole story and, sometimes, work pressures or shortage of staff can be almost an excuse.

    You go on to say “Real change can only occur if built on a foundation of respect for older people.” I think this is it. Why do we find child abuse or (dare I say it) animal abuse, more abhorant that adult abuse? It seems to sell more papers? What is it about our society today that doesnt have a zero tolerance to adult abuse?

    Its also about the person delivering the care. I train a lot of front-line staff and the issue of time and work pressures often comes up. I am not disputing that it is an issue. Often in training I use real-time video clips. Some of these are not more that 3-5 mins long. These are clips of bad care. Someone not annoucing their arrival, ignoring what the person wants, explaining that they haven’t got long, etc. Examples of the lack of dignity and respect. I realise these are training video’s but, it does strike me that it demonstrates it is easy to get a lot wrong in just few minutes.

    The other thing to consider is that the experience of care (the client) is primarily down to the person delivering it. The “product” if you like, is actually the worker in front of me. So, the way I (the client) experience my care that day, that half-hour that 5 mins, has a lot to do with the person delivering that care to me. I may not have as much time as I would like as the carer but, I can choose to ensure that waht care I do give is compassionate.

    So, while cost is a big factor (not forgetting the amount these staff get paid and how that might equate to the value we place on the role), its also worth noting that I (the carer/nurse/support worker) have an extraodinary amount of power in determining if the clients next 30 min experience is a poor one or a supportive and dignified one.

    1. Hi Bill

      thanks for the comments, its a complicated picture and I think we have to get our foundations right first, then move on to address the other issues, read one of the other blogs Bill, the ‘mistreatment of older people in hospitals’, its on some of the same point you make re working practices. I’m doing some research at the mo, e-mail me if you want to know more. thanks again for your thoughtful comments.

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