UCL: No Secrets review must focus on abuse by family carers

Researchers today warned that a government safeguarding adults review will be “ineffective” if it does not take into account abuse of older people by family carers.

The Department of Health is currently consulting on changes to its No secrets guidance on the protection of vulnerable adults. But according to a team of researchers from the Department of Mental Health Sciences based at University College London, the consultation ignores the dangers posed by abusive family carers as it focuses on paid carers only.

The team conducted a survey of 220 family members who were caring at home for someone with dementia who had been recently referred to psychiatric services.

Half of dementia carers admit abuse

The results, published in the British Medical Journal today, revealed that 52% of carers admitted that they had conducted some form of abusive behaviour such as occasional “screaming or yelling”. A third reported more significant levels of abuse, such as more frequent insulting or swearing.

Three per cent said that they were sometimes afraid that they might hit or hurt the person they were caring for, but just 1.4% of respondents reported actual significant physical abuse.

Report co-author Professor Gill Livingston said that carers who were worried about their own behaviour were often not getting the support they needed. She added: “Our findings suggest that any strategy for safeguarding vulnerable adults must be directed towards families who provide the majority of care for older people, rather than exclusively at paid carers.”

Most serious abuse likely to be missed

Lead author Dr Claudia Cooper said that the study was the first representative survey to ask family carers about abuse, but admitted that those who showed the most serious abusive behaviour would be either reluctant to take part or unlikely to give truthful responses.

She added: “Many people think about elder abuse in terms of ‘lashing out’ and other similar acts, but abuse as defined by government guidelines can be as simple as shouting or swearing at the person being cared for.”

The Alzheimer’s Society, which recently signed up to a campaign coalition calling for legislation to safeguard vulnerable adults in the same way that children are protected under law, said that the results were “shocking”.

Enormous strain on carers

Chief executive Neil Hunt said: “We also need to ask why abuse is happening. Most carers do an excellent job in very difficult circumstances, but without help and support they are placed under enormous strain. Giving carers access to respite, psychological support and financial security could help end mistreatment.”

More information

Community Care conference: Dementia, Dignity and the Challenge of an Ageing Society

Anchor Homes dementia specialist on good practice

Safeguarding Adults Alliance launched to campaign for legislation

Action on Elder Abuse: ‘Adult protection needs legal backing’

Safeguarding: should councils have a duty of care to vulnerable adults?

Vulnerable adults need same protection as children