Older adults neglected by their caregivers: vulnerabilities and risks identified in an adult protective services sample
| Date | 07 March 2019 |
| Published date | 07 March 2019 |
| Pages | 5-15 |
| DOI | https://doi.org/10.1108/JAP-07-2018-0014 |
| Author | Joy Swanson Ernst |
| Subject Matter | Health & social care,Vulnerable groups,Adult protection,Safeguarding,Sociology,Sociology of the family,Abuse |
Older adults neglected by their caregivers:
vulnerabilities and risks identified in an
adult protective services sample
Joy Swanson Ernst
Abstract
Purpose –Using a riskand vulnerability framework,the purpose of this paper is to describethe characteristics
of older adultsthat Adult Protective Services(APS) substantiatedfor neglect by caregivers, theircaregivers and
the interrelationships between them.
Design/methodology/approach –The paper uses a qualitative study of 21 APS case record narratives
using a template analysis.
Findings –Neglect related to withholding or refusing medicalcare was the most common. The older adults
had multiplehealth conditionsand geriatric syndromes.Caregivers had difficultiesin carrying out caregivingrole
due to health and mental health issues, work responsibilities and lack of insight into older adults’needs.
The refusalto access or accept servicesby both the older adults andthe caregivers was a predominanttheme.
Research limitations/implications –The sample size was small, limited to one geographical area, and
non-representative of all neglect cases. The data were extracted from written case narratives and not directly
from the older adults and their family members. Case records varied in the case detail provided.
Practical implications –To protect vulnerable older adults and improve quality of life, APS involvement in
cases of caregiver neglect needs strategies to get people to accept help and access services to address
multiple health and psychosocial problems for both older adult victims and their caregivers.
Originality/value –This study provides in-depth information on APS cases involving caregiver neglect that
add to understanding of this complex problem and points to areas for further study.
Keywords Older people, Safeguarding, Neglect, Risk factors, Elder mistreatment, Caregiving,
Adult Protective Services
Paper type Research paper
Elder mistreatment is a serious social problem that affects an estimated one in ten older adults
each year (Acierno et al., 2010). Elder neglect is the “failure by a careg iver or other person in a
trust relationship to protect an elder from harm or the failure to meet needs for essential
medical care, nutrition, hydration, hygiene, clothing, basic activities of daily living or shelter,
which results in a serious risk of compromised health and/or safety, relative to age, health
status, and cultural norms”(Hall et al., 2016, p. 34). In the USA, caregiver neglectis the second
to self-neglect as t he most common type o f mistreatment rep orted to and substan tiated by
Adult Protective Services (APS) (Acker et al., 2018).
Despite the serious risks to well-being of frail olderadults, neglect by caregiversis difficult to study,
characterize and understand (Strasser and Fulmer, 2007). Evidence on risk factors and for the
effectivenessof interventions(including APS)that target elder neglectis lacking (Ayalon et al., 2016).
Indeed, “the number and type of services needed by type of elder abuse, or by victim-offender
relationship, has not been assessed in the elder abuse field”(Jackson, 2017, p. 221).
Research on elder mistreatment including neglect presents ethical and practical challenges
(Dresser, 2003). The research subjects are often vulnerable older adults who may be cognitively
impaired. Participation in research may have negative legal, social and financial repercussions for
older adults and their caregivers. Research on neglect assessment in emergency departments
Received 16 July 2018
Revised 10 October 2018
Accepted 19 October 2018
The author would like to thank
Ellen Livingston and Kimberly
Vocke for their assistance with
this research.
Joy Swanson Ernst is
Associate Professor of Social
Work at the Wayne State
University, Detroit,
Michigan, USA.
DOI 10.1108/JAP-07-2018-0014 VOL. 21 NO. 1 2019, pp. 5-15, © Emerald Publishing Limited, ISSN 1466-8203
j
THE JOURNAL OF ADULT PROTECTION
j
PAG E 5
To continue reading
Request your trial