Hi Norman,

I believe your difficulty relates to your use of terms. In the United States, elder abuse in nursing homes is not referred to as institutional abuse - even though it is! Try using "elder abuse" or "elder neglect."

Hi Neva

THat's exactly what I found in using search terms and your reply indicates, to some degree, that the term "institutional abuse" does not apply in the US. The follow on from this is the social construction behind the term and whether that makes it a Euro- or UK-centric term.

I wonder if anyone else has a view?

Hi Neva

I was wondering if you could shed a little light on the US position when dealing with such abuses that are wide-spread within a care setting and are part of the culture and operational basis of the care setting? Generally, when using the term 'institutional abuse' it relates to a specific type of abuse. This might be termed (and has been) when the "wishes, choices and needs of the elders are sacrificed for the operational priorities of the organisation". This would mean it is not a single member of staff or a single resident that is affected by the abuse and it may be condoned or at best not condemned and acted on by the management. An example would be where the quality of care and is so poor it is abusive because the home is permanently operated on a skeleton staff with little or no training.

HI Norman

You might try to confine your search to abuse of older adults residing in... nursing homes, the community. In institutional long term care settings, the states have an appointed ombudsman who is sanctioned by law to ensure and monitor, there is no abuse happening. they do this through the state departments of health and have a team of highly trained individuals who perform routine investigations - punitive fines are levied as well as the possibility criminal action. this is for various types of abuse from financial to assaults, theft, deception etc.. In the community, we have the office of Adult Protective Services. they too are have roles, respond within 24 hours to suspected neglect and abuse.

Hope this helps

Deanna

Hi Deanna

That is very helpful. There is an organisation in the UK called the Care Quality Commission which has the inspection and regulation remit - but appears to have fewer 'teeth' than the ombudsman you describe. We have also had a similar role to the Adult Protective Services given to Adult Social Care in the local government in the UK.

As for the term 'institutional abuse', with the definition I refer to above, does that term get used or would the ombudsman be likely to prosecute the management and owner of the care home?

Hi Norman

Glad my description was helpful. The state ombudsman in NJ, can prosecute- they have a direct line item to do so, inclusive of all offenders- from the owner to staff.

I do know of legal sanctions levied to facility management across the US, and can refer you to person who may be of help.

There are 2 individuals I could refer you to- one is an attorney- in the US and the other is the state ombudsman, a colleague of mine. They are not academicians or researchers- but may be of some help to you. You can email me off site, and I can provide details, [email protected].

Just let me know..

Deanna

Most definitely institutional abuse is not just a European problem.  While estimates of prevalence in community samples are in the range of 10% there are few solid studies of prevalence in instiutions but the projected proportions are much higher for instiutional settings with many care facility staff reporting that they have seen abuse or perpetrated it themselves.  Resident-to-resident aggression is another problem, more recently recognized, in instiutional settings. For more information on the international picture I would suggest  1) that you read review paper written by McDonald et al for the Canadian Govt. in 2010 and 2) that you join the International Network for Prevention of Elder Abuse (INPEA). To do so and vote in upcoming election which several persons from UK are nominated to fill positions for (e.g. Mary Gilhooley - Brunel U, Amanda Phelan - Ireland - visit  www.inpea.net and join before July 31.

G. Gutman President INPEA

Thanks Gloria for your feedback.  In the UK the term "institutional abuse" is used mainly to indicate those abuses that arise as a result of the organisational modus operandi, practices or systems and can affect many people simultaneously.  An example would be deliberate understaffing leading to neglect of several residents.  The issue of an individual (working within an institutional setting) being abusive would be dealt with under the heading of the type of abuse - physical sexual, neglect - and the sanctions would be to the individual.

I will check out the McDonald paper.  I am aware of INPEA's work and need to update myself there.

I believe what you are calling "institutional abuse" is called "systemic abuse" in N America.  We really must come to terms with the issue of differing definitions. It has held the field back by not doing so. If re-elected I will propose a consensus conference to take place in conjunction with the IAGG European Region conference in Dublin in April which many of us will be attending.

That is an interesting term to use which, perhaps, more accurately describes the problem, Gloria.  Thank you for that - I shall get to work using it as a search term.