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Elder abuse and neglect in nursing homes as a reciprocal process: the view from the perspective of care workers
- Authors:
- GIL Ana Paula, CAPELAS Manuel Luis
- Journal article citation:
- Journal of Adult Protection, 24(1), 2022, pp.22-42.
- Publisher:
- Emerald
Purpose: Reciprocal abuse inside care practices remain under-studied due to their invisibility and further research is required. The purpose of this paper is to explore different levels of conflicts inside organisations. Design/methodology/approach: The paper is based on a self-administered questionnaire filled out by care workers (n = 150), in 16 Portuguese care homes. Findings: Results indicated that, overall, 54.7% of care workers had observed abuse, in their daily practice, in the preceding 12 months: 48.7% psychological; 36.0% neglectful care practices; 14.0% physical and 3.3% financial abuse. The figures decreased significantly as regards abuse committed themselves, with 16.7% of those admitting to having committed at least one of these behaviours. The highest figures were also recorded for psychological abuse (13.3%) and neglect (6.7%). However, there is a statistically significant relationship between abuse committed by care workers and abuse committed by residents. Overall, 52.0% of care workers reported having been the target of at least one such behaviour by residents. Research limitations/implications: This paper has its limitations as the sample consisted of only 16 nursing homes (12 not-for-profit and 4 for-profit nursing homes). The fact that only 4 of the 16 LTC homes were for-profit is a potential limitation both in general and in particular because research has shown that lower quality of care and elder abuse and neglect are more common in for-profit nursing homes at least in Portugal. The results were also based on self-reported measures. Practical implications: A reactive behaviour, the risk of retaliation, after a complaint, the difficulty in dealing with dementia and the residents' aggressive behaviour, an absence of a training and support policy in an environment where difficult working conditions prevail, are factors enhancing a reciprocal process of abuse. The analysis followed by a discussion of potential implications to prevent institutional elder abuse and neglect, based on communication and social recognition, including better working conditions and training, and a cooperative work environment. Social implications: Conflict is much more than reducing an interpersonal relationship problem between residents and staff (care workers, professional staff, managers) and extending to the whole organisation. Therefore, there are still uncertainties on how organisations, staff and residents interact between themselves, and affect care practises. Originality/value: Reciprocal abuse in nursing homes is an important area of research and this paper enabled a discussion of potential implications concerning the quality of care, which required the identification of levels of conflict, in an organisational system, including interactions, the context where care is provided, difficult working conditions, lack of training and levels of support. All these factors are important when considering elder abuse and neglect and this calls for special attention by policymakers and researchers. (Edited publisher abstract)
Remote support to victims of violence against women and domestic violence during the COVID-19 pandemic
- Authors:
- CARIDADE Sonia Maria Martins, et al
- Journal article citation:
- Journal of Adult Protection, 23(5), 2021, pp.302-316.
- Publisher:
- Emerald
Purpose: This paper aims to characterize the type of support provided to victims of violence against women and domestic violence (VAWDV) during the first lockdown, assessing the training of professionals to use remote support (RS). Design/methodology/approach: This cross-sectional study involves a sample of 196 support professionals, mainly women (91.8%) and who integrate the Portuguese National Support Network for victims of domestic violence (NSNVDV) (Mean age = 36.49; SD = 10.52). Findings: Telephone emerges as the main RS communication media used in the lockdown (43.9%) and the emergency state periods (57.1%). Participants reported to have never used any social applications (41.8% vs 41.8%) or videoconference (46.4% vs 58.2%), in both periods assessed, i.e. lockdown and emergency state, respectively, and 82.7% assumed to have no training with RS to assist VAWDV victims. However, support professionals recognized several advantages in using RS such as dealing with isolation, reducing inhibition, fear and shame and in promoting the victims’ empowerment. Research limitations/implications: Given the exploratory nature of this study, only descriptive analyzes were conducted. Originality/value: During the COVID-19 pandemic, little is known about effective RS given by professionals to victims of VAWDV in the Portuguese context. The paper aims to add knowledge to the studied field. (Edited publisher abstract)
The ageing process in older adults’ narratives of family violence
- Authors:
- SANTOS Ana Joao, GIL Ana Paula Martins, RIBEIRO Oscar
- Journal article citation:
- Quality in Ageing and Older Adults, 20(2), 2019, pp.56-66.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to examine, through a qualitative lens, how community elder abuse and the ageing process are represented in the older adults’ narratives reporting abuse perpetrated by family members. Design/methodology/approach: A qualitative study of a convenience sample of 22 interviews from 24 older adults (two couples) aged 60 years or older who had experienced one or more types of abuse and had sought help about the victimisation experience. A general inductive approach of thematic content analysis was employed. Findings: The four main emergent themes related to the passage of time or the perception of becoming old within the process of abuse were: abuse grown old, abuse after entering later life, vulnerability to abuse and responses to abuse. Ageing was found to be associated with an increase vulnerability to abuse and an important element in shaping how older adults experience, report and cope with victimization. The social and contextual issues of being older also influenced the decision of ending (or not) the abuse and the victims’ repertoire of responses. Originality/value: Despite the little suitability of chronological age to define and delimit elder abuse, understanding the phenomenon demands the recognition of ageing (both as a process and as a product) in order to more accurately identify aetiology processes and develop interventions. (Edited publisher abstract)
A process to evaluate an iTV platform to enhance seniors’ access to information about public and social services
- Authors:
- SILVA Telmo, et al
- Journal article citation:
- Working with Older People, 22(4), 2018, pp.224-233.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to present a process to evaluate the usability and usefulness of a high-fidelity prototype of the +TV4E platform (removed for blind review), an iTV service which aims to promote the info-inclusion and quality of life of Portuguese seniors by delivering informative contents about public and social services. Design/methodology/approach: The research presented in this study is qualitative and uses an inclusive and participatory co-design process involving seniors to evaluate usability of an iTV service with support of the Post-Study System Usability Questionnaire (PSSUQ) tool and a questionnaire survey. The participants were 11 individuals, over 65 years enrolled in an adult day care center in Aveiro city, Portugal (removed for blind review). Findings: Findings from this study allowed to assess some key aspects in the +TV4E platform implementation that should be addressed in its final version. Using the PSSUQ tool as well as a questionnaire survey confirmed the relevance of this platform to meet seniors’ informational needs. Originality/value: This original research offers insights on how valuable is including potential users in the development and test phases of an innovative technology which intends to offer more adequate tools to improve seniors’ info-inclusion and quality of life. Also, it is possible to understand what should be considered when evaluating a prototype intended to be used by seniors. (Publisher abstract)
Therapeutic alliance dimensions and dropout in a therapeutic community: “Bond with me and I will stay”
- Authors:
- JANEIRO Luís, et al
- Journal article citation:
- Therapeutic Communities: the International Journal of Therapeutic Communities, 39(2), 2018, pp.72-82.
- Publisher:
- Emerald
Purpose: A better therapeutic alliance at the beginning of treatment for addictive behaviours has been found to prevent dropout. The purpose of this paper is to evaluate how the development of therapeutic alliance dimensions was associated with the dropout prevention. Design/methodology/approach: A total of 23 participants presented a substance use disorder related to heroin or cocaine and were in three distinct treatment phases of a therapeutic community. Each participant filled in the therapeutic alliance measures once a week after mini-groups. A naturalistic prospective research design was used to collate 198 repeated alliance measures. Findings: Participants who presented stable bond development at higher levels tended to stay in treatment, whereas those who developed stable bonds at lower levels tended to drop out. The goals and tasks dimension increased significantly across the phases and was not associated with dropout. Practical implications: To prevent dropout, therapists should pay special attention to residents who manifest difficulties in establishing stable and secure bonds and not overestimate the impact of the goals and tasks alliance dimension, as it is not a failsafe indicator of treatment retention. Originality/value: The alliance dimensions were differentiated (bond, goals and tasks) and studied throughout the treatment, pointing out the importance of therapeutic relationship dynamic variables to prevent dropout. (Edited publisher abstract)
Perception of risk of adverse outcomes of older people: comparison between nursing homes, day centers and home care services
- Authors:
- TEIXEIRA Laetitia, et al
- Journal article citation:
- Quality in Ageing and Older Adults, 18(3), 2017, pp.212-220.
- Publisher:
- Emerald
Purpose: In Portugal, the three main kinds of care services available for older people are nursing homes, day centres and home care services. The use of these care services is mostly based on complex socioeconomic and functional criteria; however it is not clear if this placement corresponds to a higher/lower risk of adverse outcomes. The purposes of this paper are: to characterise clients of each type of service; to estimate the proportion of individuals at perceived risk of each adverse outcome according to type of service; to assess the ability of the Risk Instrument for Screening in the Community (RISC) to identify the risk profiles according to type of service. Design/methodology/approach: The sample comprised individuals aged 65+ (n=224), receiving care at home, in day centres or in nursing homes. The identification of individuals at risk for three adverse outcomes (institutionalisation, hospitalisation and death) was performed using a short pre-screen instrument (RISC). Findings: The RISC identified mental state issues as the unique factor that differentiated clients according the type of care services (χ2 (6, N=224)=20.96, p=0.002), with day centre presenting the lowest percentage of mental health concerns and nursing home presenting the highest percentage (44.44 and 71.91 percent, respectively). Additionally, a gradient was found between perceived risk of adverse outcomes (institutionalisation and hospitalisation) and care of levels required. Originality/value: The RISC can be used to discriminate people in different settings of care and can be helpful in the selection of groups at risk that will benefit more from available services. (Publisher abstract)
Belief systems enforcing female genital mutilation in Europe
- Authors:
- ALHASSAN Yussif Nagumse, et al
- Journal article citation:
- International Journal of Human Rights in Healthcare, 9(1), 2016, pp.29-40.
- Publisher:
- Emerald
Purpose: Despite numerous studies on FGM, little is known about belief systems that support FGM in the EU. The purpose of this paper is to explore the dynamic nature of belief systems and enforcement mechanisms that perpetuate FGM among three African migrant communities in the EU. Design/methodology/approach: This paper is based on data collected through community-based participatory action research in three communities: Eritrean and Ethiopian community in Palermo, Italy; Guinea Bissauan community in Lisbon, Portugal; and Senegalese and Gambian community in Banyoles, Spain. A total of 24 FGDs and 70 in-depth narrative interviews were conducted for the research. Findings: The research finds that belief systems supporting the practice of FGM among African migrants in the European diaspora are similar to those in their home countries. Beliefs structured around religion, sexuality, decency, marriage and socialisation are particularly significant in perpetuating FGM in the study migrant communities. These are enforced through sanctions and social expectations from the migrants’ home and host communities. Research limitations/implications: Members of the migrant communities that were the focus of this research are ethnically diverse; therefore it is possible that differences in the practice of and views on FGM by various ethnicities may have been masked. Also, due to close linkages between the migrants and their home countries it was hard to delineate beliefs that are specific to the host countries. In addition, it was difficult to assess the level of education of the migrants and how this may have impacted on their beliefs due to their contrasting and inconsistent educational backgrounds. Originality/value: This paper provides evidence to show that the practice of FGM among migrants in the EU is driven by both social norms and individual (parent) behaviour and therefore there is a need for interventions to focus on individual behaviour change and social norm transformation techniques. It also suggests that beliefs around FGM have remained socially significant among migrants despite their exposure to European culture because such beliefs are used to promote the moral standards of girls, marriageability of women, respectability of families, and the assertion of cultural and religious identity in the migrants’ new environment. The paper further underscores the role of migrants’ European context as well as the home country in strengthening beliefs that perpetuate FGM in the EU. (Publisher abstract)
Training needs in the area of aging for social professionals and senior population in Portugal
- Authors:
- GONCLAVES Marta, CARAMELO Sergio, RIBEIRO Jose Almeida
- Journal article citation:
- Working with Older People, 20(1), 2016, pp.23-29.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to understand how the Institute of Public and Social Policies could be useful for Portuguese society in terms of post-graduate training in the area of ageing. Design/methodology/approach: The authors have conducted two focus groups (n=11), one with professionals of one large and three medium size social organisations, and the other with managers of three large, two medium and two small size social, health and civil rights organisations which support the elderly population. While the specific aim of the first focus group was to identify the ageing training needs of professionals, who work with assistance/support to the elderly population, the aim of the second group was to identify the training interests of the retired or pre-retired elderly population. Findings: The results show on the one hand professional’s main challenges in working with elderly population in Portugal, their training needs and what exactly could be an adequate training for them in the area of aging as compared to the existing ones, and on the other hand who are the strongly committed elderly people, what are their training needs and what could exactly be for them an adequate training in the area of ageing as compared to the existing ones. Research limitations/implications: The authors can conclude that both social professionals and senior population in Portugal have a need for a post-graduate training in the area of aging. Practical implications: Only by humanisation at multilevel and a specific training for professionals and for families will we be able to deliver the opportunities and support that the citizens will need to enable them to age well across the life course. Social implications: Given the rapidly changing and complex demography of Portugal it is essential to give attention to training in rethinking the support of the elderly population in Portugal. Originality/value: The authors need to develop empowerment and social inclusion of the elderly population in the society. (Edited publisher abstract)
The chronicity and severity of abuse among older persons by country: a European study
- Author:
- SOARES Joaquim J.F.
- Journal article citation:
- Journal of Aggression Conflict and Peace Research, 6(1), 2014, pp.3-25.
- Publisher:
- Emerald
Using a cross-sectional study design, this study investigates the chronicity (frequency) in different abuse types and overall abuse by severity in seven European cities, and scrutinize factors associated with high chronicity levels in psychological and overall abuse by severity. The sample consisted of 4,467 randomly selected women/men (2,559 women) aged 60-84 years from seven European cities, and data were analysed with bivariate and multivariate methods. Chronicity varied across country and by abuse type. Germany had the highest chronicity means in physical and sexual abuse; Greece in physical, injury, sexual and overall abuse; Lithuania in physical, injury, financial and overall abuse; Portugal in physical abuse; Spain in physical, sexual and financial abuse; and Sweden in psychological, injury, financial and overall abuse. In general, Italy had the lowest chronicity means. The main perpetrators were people close to the respondents and women (in some cases). Independent relationship between chronicity/severity of abuse, country and other variables (e.g. depression) was examined only for psychological and overall abuse. More research into this issue with other types of abuse, for example sexual abuse is warranted. (Edited publisher abstract)
Methodological problems of sampling young homeless people in four European societies with different levels of service provision and definitions of homelessness
- Author:
- SMITH Joan
- Journal article citation:
- Housing Care and Support, 16(2), 2013, pp.64-75.
- Publisher:
- Emerald
Purpose – This article aims to describe methodological issues in relation to the definition of homelessness and the drawing of samples of young homeless people in four European countries. The purposes of the research project were, first, to make a comparison of different homeless situations facing young people in these four countries, and second, to introduce early intervention and action planning methodologies developed in the UK and The Netherlands to other countries in the study – Portugal (a family welfare society) and the Czech Republic (an ex-communist regime redeveloping its welfare policies). Design/methodology/approach – After extensive discussions and key worker interviews with local agencies, 54 homeless young people were interviewed in each country. Each sample was intended to be purposive in that it should recruit homeless young men and women from those born in that country from the dominant (white) ethnic group, born in that country from minority ethnic groups, and young people not born in that country. A major issue was how to define homelessness in order to be able to recruit across the spectrum of homeless youth. Findings – The purposive samples recruited in the four countries reflected the availability of services in those countries and levels of family support. Whilst young homeless people in The Netherlands and the UK were mostly living in supported housing, in Portugal they were living as “hidden homeless” and in the Czech Republic on the streets or in squats. Research limitations/implications – The methodological difficulties encountered during the project are themselves a useful lesson learnt, for the creation of trans-national understanding and politicy. Practical implications – Nevertheless, despite the very different circumstances of limited services in Portugal and the Czech Republic, it appeared that both early intervention methods and key working approaches could be applied broadly across the EU. Originality/value – Transnational studies of youth homelessness are rare and therefore produce particularly useful insights for research, policy and practice. (Publisher abstract)