Mother abuse: a matter of youth justice, child welfare or domestic violence?

International evidence suggests that in advanced welfare states the abuse of parents, most particularly mothers, by their (most frequently male) adolescent children is increasingly prevalent. In the United Kingdom, however, child-to-mother abuse remains one of the most under-acknowledged and under-researched forms of family violence. Although it is an issue shrouded in silence, stigma, and shame, the authors' work in the youth justice sphere, focusing on interventions to deal with anti-social behaviour, suggests that adolescent violence toward mothers is a topical and prevalent issue. We identify different ways of conceptualizing it in the policy realms of youth justice, child welfare, and domestic violence. The behaviour of both child/young person and mother is constructed in ways which inform the assignment of blame and responsibility. The paper highlights the silence that surrounds the issue in both the policy and wider academic spheres, hiding the failure of service providers to respond to this very destructive form of intimate interpersonal violence.

Banned from working in social care: a secondary analysis of staff characteristics and reasons for their referrals to the POVA list in England and Wales

Since July 2004, employers of social care staff working with vulnerable adults in England and Wales have been legally required to refer workers or volunteers dismissed for misconduct because they have harmed vulnerable adults or placed them at risk of harm to the Protection of Vulnerable Adults (POVA) list. The POVA list is unique to England and Wales, and is a powerful tool of quality assurance for the care sector and for the safeguarding of vulnerable adults. This article reports on part of a multi-method study including quantitative and qualitative elements to produce a rounded picture of the factors involved in decisions to place staff members on the POVA list. Based on secondary data analysis of all records of POVA referrals from August 2004 to November 2006 (5294 records) as well as a detailed sample of 298 referrals, this article focuses on the prevalence of different types of alleged harm and their association with various staff, employer and service-users' characteristics. The most common form of alleged abuse was physical abuse (33%), while the least was sexual abuse (6%). Some of the other key findings are the over-representation of men referred (31% compared to an average of 15% in the workforce) and significantly different types of abuse in care home and domiciliary settings, where financial abuse was less likely in care homes [odds ratio (OR) 0.17; P < 0.001], while physical abuse more likely in the same setting (OR 3.60; P < 0.001).

The use of public policy analysis to enhance the Nursing Home Reform Act of 1987

Given the prevalence of abuse and neglect in nursing home care delivery vis-à-vis elderly and frail residents, and despite the advent and implementation of the Nursing Home Reform Act of 1987 (a policy that sought to diminish such conduct in such institutional settings), deficiency citations in nursing home care and services remain both problematic and common. By employing public policy analysis, and by analyzing various social science theories applicable to the improvement of care delivery and quality, this article seeks to develop methods to enhance compliance with the Nursing Home Reform Act and reduce care deficiencies in nursing homes.

Perceived educational needs and preparation of adult protective services workers for practice with end-of-life issues

As the number of older adults in the United States increases, so will the expected number of allegations of elder abuse. Adult protective services (APS) staff are likely to handle much more complex situations, and in growing numbers, due to the presence of chronic and life-limiting conditions of their clients. The APS workers, in this national study, identified frequent encounters with older adults with serious illnesses. However, less than one half received educational content about issues of death and dying in their degree programs, and only slightly more than one half reported ever attending a continuing education program on these topics. They perceived the greatest educational need for content about practical resources, the use of advance directives, and making end-of-life decisions. The indication also given by these respondents was that end-of-life issues were among the most difficult situations they faced in practice. This warrants a call for increased end-of-life content in educational degree programs and continuing education.

Consortium for research in elder self-neglect of Texas research: advancing the field for practitioners

An external advisory board consisting of members from the fields of geriatric internal medicine, family practice geriatrics, criminal prosecution, civil law, police force, adult protective services, and victims advocacy was created to advise and guide the research conducted by the Consortium for Research in Elder Self-neglect of Texas (CREST). This panel of experts performed site visits and facilitated the research through responses to every-other-week fact sheets and quarterly conference calls. This paper provides the perspective of five of the board members regarding the research findings that were presented at the CREST National Conference in 2006. The discussions outline the successes of the CREST research, describe obstacles and the necessary next steps for continuance of the scientific exploration of this syndrome, and highlight the practice implications of the current and proposed research.

Nursing in the aged care sector: resident abuse and the reporting obligations

Elder abuse is recognised in many countries as a significant social, medical and legal issue. In an attempt to address this issue the Australian Government has recently enacted legislative amendments to the Aged Care Act 1997 (Cth). These amendments apply to providers in the residential aged care sector who are in receipt of Commonwealth Government subsidies. Among a range of obligations aimed at the protection of the elderly is the requirement for the mandatory reporting of sexual and serious assault in the aged care sector. This column considers some of the issues relevant to addressing the abuse of older Australians.

Nursing Home Statutes: Mistreatment Definitions

INTRODUCTION

Forty-nine states and the District of Columbia have adult protective services (APS) related statutes that define adult/elder mistreatment found in domestic settings. Institutional adult/elder mistreatment laws are administered by the nursing home licensing agencies and may contain different or duplicate APS-related mistreatment definitions. The purposes of this paper are to describe and summarize the mistreatment definitions in the nursing home licensure statutes and compare those definitions with the definitions found in the APS-related statutes.

METHODS

Westlaw and Lexis-Nexis law database systems were used to retrieve all adult protective services statutes and institutional licensure statutes. Each statute's text was reviewed and coded by two researchers.

RESULTS

Institutional mistreatment definitions are addressed in 14 of the states and District of Columbia's nursing home statutes. No one state has a list of the 27 different definitions of mistreatment identified in the literature search. The common types of mistreatment described were physical and emotional abuse, neglect, financial and property exploitation, and sexual abuse.

CONCLUSION

Standardized definitions of resident-to-resident and institutional specific types of mistreatment need to be included in nursing home statutes.

Recommendations for the Elder Abuse, Health, and Justice Fields About Medical Forensic Issues Related to Elder Abuse and Neglect

Increased interest in pursuing criminal and civil actions against alleged perpetrators of elder abuse and neglect has revealed that efforts to assist victims and hold perpetrators accountable are often hampered by the lack of knowledge about the detection and diagnosis of elder abuse and neglect and by the lack of resources for development of research and assistance in these matters. This report sets forth recommendations for the elder abuse, health, and justice fields about medical forensic issues related to elder abuse and neglect. The recommendations were developed by a "working group" of experts representing an array of disciplines that address the problem of elder abuse and neglect pursuant to a grant project funded by the National Institute of Justice (NIJ), the research, development, and evaluation agency of the U.S. Department of Justice (DOJ). The project was conducted by the American Bar Association Commission on Law and Aging, with the assistance of the University of California, Irvine School of Medicine. This was the final project report submitted to NIJ; it has been updated to include information about the availability of reports and products from other grant projects that are discussed in the report.

The impact of juror characteristics and victim health status on the perception of elder physical abuse

An experiment investigated mock juror perceptions of elder abuse using a community sample from Lexington, Kentucky. Two-hundred six men and women ranging in age from 18 to 88 read a fictional criminal trial summary of a case of elder physical abuse (EPA) in which the accuser was described as healthy, frail, or confused. In addition, the influence of participant age, participant gender, and attitude toward the elderly on juror perceptions of EPA was also investigated. Results showed that women had higher conviction rates than did men. Accuser health status, participant age, participant gender, and attitude toward the elderly affected other rating variables including accuser believability, accuser inaccuracy, defendant believability, and verdict confidence. Results suggest implications for how EPA cases are perceived in court.

Mandatory reporting

Policy responses of both state and federal governments to the abuse of more vulnerable members of society has placed an added obligation on nurses who become aware of, or suspect on reasonable grounds, the occurrence of such abuse. In the areas of aged care and child protection nurses need to be aware of these obligations. In aged care for example, nurses often find themselves the subject of complaints. They find their employment threatened as a consequence and are also contacted by police as part of the investigation into the allegations. This article sets out some of the key components of reporting regimes for aged care and child protection. It is not meant to be legal advice and members should contact the QNU should they seek more detailed advice on their individual situation.