50 Shades of Safeguarding

function in frail older peopleThe recent furore and general brouhaha over the book and film of the moment appears to be sweeping the public away on a tidal wave of excitement and hype.

The story rings alarm bells for healthcare professionals; stalking, abuse of power, psychological and physical domination, all packaged up in a parcel of glitz, glamour and glossy veneer of sophisticated respectability.

The truth is that any kind of abuse is, as many know firsthand, a different tale. One of despair, anguish, unhappiness and often concealment and unfortunately, not a stranger to the realm of older person healthcare.

Yet such a story heralds an opportunity to bring traditionally taboo issues of abuse into the public arena for discussion to be aired and discussed so we as a civilised society can advance and develop.

The Care Act (2014) comes into force in April 2015 as a response to Mid Staffordshire and Winterbourne view and addresses ‘ill treatment or wilful neglect’ with AgeUK  publishing a fact sheet containing advice and help.

Recent events have caused a seismic shift in the care industry with angry and exasperated relatives and members of the public calling for advice on how to install cctv cameras in care homes so they can monitor carers around the clock for signs of abuse of their loved ones. Such a knee jerk reaction to the fear of enduring grim and unspeakable offenses is understandable.

Yet no amount of surveillance will be of any use if we do not create a climate of trust and openness within which to discuss the underlying issues, striving to work in collaboration and partnership with families, the patient at the heart of the process. Older people with dementia and delirium are vulnerable and subsequently at increased risk of abuse due to cognitive impairment. Doctors and nurses may practice in a defensive way to guard against accusations of abuse and neglect and monitor the patient for signs of abuse. This results in safeguarding issues becoming a two way street, often creating a downward cycle of suspicion between families and healthcare professionals. Such misgivings create an atmosphere of doubt and uncertainty which undermines the development of confidence and trust, the general mood being one of disquiet and trepidation on both sides.

Openness, debate and frank discussion of safeguarding issues will serve to raise awareness of abuse of older people in society. Colleagues need support and clear guidelines of how to deal with suspected abuse. The blurring of lines are unhelpful and misleading, we all need to remind ourselves that abuse is unacceptable, whatever the reasons given and whatever the type, there are no shades of grey in the sphere of abuse, it remains black and white.

Liz Charalambous

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