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Professional decision making on elder abuse: systematic narrative review
- Authors:
- KILLICK Campbell, TAYLOR Brian J.
- Journal article citation:
- Journal of Elder Abuse and Neglect, 21(3), July 2009, pp.211-238.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Nine bibliographic databases were searched for studies on professional decision making regarding abuse of older people. The findings of the 19 articles meeting the inclusion criteria were synthesised using a structured narrative approach. Common themes identified were abuse factors, situational factors, and broader contextual factors. Abuse factors relating to risk levels and client vulnerability were central; age, gender, and health status were considered as key indicators of vulnerability. The opinion of adult protection workers about the potential effectiveness of their intervention was a factor in deciding about responding to alleged or suspected abuse. Professionals struggled with complex ethical dilemmas created by elder abuse, particularly when the victim did not want an investigation. A structured approach to narrative synthesis of a diverse range of studies retrieved through an explicit search and inclusion process provided a useful summary of key issues for practice and identified gaps in the research literature.
Professional perspectives on decision making about the long-term care of older people
- Authors:
- TAYLOR Brian J., DONNELLY Michael
- Journal article citation:
- British Journal of Social Work, 36(5), June 2006, pp.807-826.
- Publisher:
- Oxford University Press
With the increasing pressure on social and health care resources, professionals have to be more explicit in their decision making regarding the long-term care of older people. This grounded theory study used 19 focus groups and nine semi-structured interviews (99 staff in total) in Northern Ireland to explore professional perspectives on this decision making. Focus group participants and interviewees comprised care managers, social workers, consultant geriatricians, general medical practitioners, community nurses, home care managers, occupational therapists and hospital discharge support staff. The emerging themes spanned context, clients, families and services. Decisions were often prompted by a crisis, hindering professionals seeking to make a measured assessment. Fear of burglary and assault, and the willingness and availability of family to help were major factors in decisions about living at home. Service availability in terms of public funding for community care, the availability of home care workers and workload pressures on primary care services influenced decision ‘thresholds’ regarding admission to institutional care. Assessment tools designed to assist decision making about the long-term care of older people need to take into account the critical aspects of individual fears and motivation, family support and the availability of publicly funded services as well as functional and medical needs.