PANICOA – the Prevention of Abuse and Neglect in the Institutional Care of Older Adults

shutterstock_105457523Laura Izzard is an Specialty Trainee in Geriatric Medicine at Kings College Hospital, London

PANICOA – the Prevention of Abuse and Neglect in the Institutional Care of Older Adults – is a joint research initiative between Comic Relief and the Department of Health.

Published in December 2013, the PANICOA report ‘Respect and Protect’ draws together the findings of eleven individual research studies commissioned to examine the complex issue of mistreatment of older people in hospitals and care homes. It outlines three vantage points i.e. “narratives” reflecting the perspectives of residents and patients, care staff and care organisations. Themes emerging from the PANICOA Narratives were used by the authors to produce a number of recommendations intended to reinforce and/or improve current practice.

PANICOA Recommendations:
In line with some of the findings of the Francis report and those commissioned in the wake of it; the PANICOA studies highlighted poor standards of care and mistreatment of older adults in institutional settings. The incidence of reported or observed physical abuse in the PANICOA studies was low. However the cumulative effect of serial neglect was prevalent in both care settings, as was poor performance in observing the principles of dignity and privacy in personal care, and the use of patronising language. There were of course reports on the provision of good, sometimes excellent basic patient-centred care, however the delivery of this was variable and sometimes unsustainable, secondary to the multifactorial and numerous pressures experienced by care staff and care organisations.

The report authors highlighted specific areas of institutional care experience that would benefit from policy and practice attention under the following headings:

Residents and patients:

  • Hospitals in particular need to become more ‘age attuned’.
  • Both care settings need to focus their attention on preventing harm resulting from ongoing ‘systemic’ forms of neglect (e.g. delays, omissions of care, unsafe physical environments)
  •  Performance on privacy and dignity in personal care must be improved
  • Ageism and the use of patronising language must be obliterated.

Care staff:

  • Managers must become more attuned to professional development, training and wellbeing of care staff; and need to recognise and reduce the risk of staff ‘burn out’ as well as assault from care recipients or relatives; and discriminatory behaviour from colleagues towards staff members.

Care provider organisations:

  • Care commissioners must evaluate whether current funding matches the increased challenges faced by care providers
  • Regulators, commissioners, and care providers need to gain understanding of the way in which the organisational culture of institutions can impact (positively and negatively) on the older persons care experience.

On the care culture:

  • ‘person-centeredness’ is a core value
  • staff should feel valued and protected

On working together:

  • relevant organisations need to align systems, standards and information gathering, establishing stronger‘connectivity’ between organisations.
  • the sharing of good (and less desirable) practice and innovative ideas, across the health and care system needs to be done more proactively.

Learn more about the PANICOA project and read the full report here


3 thoughts on “PANICOA – the Prevention of Abuse and Neglect in the Institutional Care of Older Adults

  1. Why oh why are relatives excluded? Are we marginal to the protection of adults in institutional care, or is there an assumption that we are potential/actual abusers. Somebody please help me understand……then ” I’ll tell you a story…” !

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