In 1990 I was working as a social worker in a hospital social work
department and knew little about elder abuse. One woman, Edwina
(not her real name), had been diagnosed with a terminal illness,
and we planned her discharge from hospital into a nursing home.
When I visited two days after her admission to the home, Edwina
broke down and told me how the staff had teased, bullied and
physically assaulted her. She was readmitted to hospital, but died
three days later. There were no prosecutions or disciplinary action
taken against staff at the home. The only outcome was a requirement
for staff at the home to undertake further training in caring for
the terminally ill. This began my concern about the abuse of older
While the issues surrounding the abuse of older people were largely
ignored back in 1990, a lot has subsequently changed. The problems
we now face are not so much to do with accepting that abuse of
older people occurs and needs tackling. It is more about making
sure the issues are addressed in a unified fashion with all the
various health and social care agencies talking to each other. But
many agree that the National Service Framework for Older People
fails to relate to elder abuse. It does not cross-reference the No
Secrets guidance on developing multi-agency policies to protect
vulnerable adults from abuse, which was launched in 2000, a year
before the NSF. This is a missed opportunity given the impact that
the guidance is beginning to have.
In addition, each standard within the NSF has to be examined in
turn to see whether it encompasses abuse. Clearly, with the benefit
of hindsight, this was a mistake – in my opinion “rooting out elder
abuse” should have been a standard in its own right.
I am an optimist by nature and believe that the abuse of older
people will eventually be recognised widely in policy, practice and
legislation. The time for compromise and accepting that the needs
of older people are secondary to other groups within our society
has to end.
The NSF for older people talks about a “10-year programme of
action” that aims to “ensure fair, high quality, integrated health
and social care services for older people”. And we still have the
time to incorporate tackling abuse within this agenda. So let us
hope, for the thousands of other older people who are abused in the
UK daily, that this fine rhetoric is converted into action.
Steve James is adult protection co-ordinator for Walsall
Council and a trustee of charity Action on Elder Abuse.