Thousands of elderly people face abuse, says Commons report
http://www.100md.com
《英国医生杂志》
London
Tighter controls need to be put in place to ensure the safety of elderly people, says a Commons report. It estimates that as many as 500 000 elderly people in England are currently being abused by relatives, carers, or strangers.
Although the public is more aware than ever of child abuse and the measures that have been introduced to try to protect children, abuse of elderly people remains overlooked, says the House of Commons Health Committee.
"Our inquiry found that much abuse of older people is not reported because many older people are unable, frightened or embarrassed to report its presence," says the Committee's report.
"Often carers take no action because they lack training in identifying abuse or are ignorant of the reporting procedure. The lack of reporting results in difficulties in determining the true scale of the problem and this is compounded by lack of research."
Abuse takes many forms, including verbal, psychological, sexual, and financial abuse, as well as neglect, humiliation, and oversedation. Abuse occurs mainly in their own home but also in residential care homes, nursing homes, and hospitals, according to the report, which comes after an inquiry into the abuse of elderly people and makes a series of recommendations.
The report says that the figure of at leat half a million older people experiencing abuse is the only estimate available. "We are disappointed that the Department has not commissioned research to establish a more precise figure," it says.
The committee calls for better monitoring of NHS establishments that provide care of elderly people and greater involvement of lay people in the inspection process.
It also recommends that institutions are monitored to make sure they comply with the national service framework target that all people over 75 years old should have their medicines reviewed at least once a year and that people taking four or more drugs should have their treatment reviewed every six months. Standards for protecting adults, which have been omitted from the framework, should be added, says the report.
The committee is also concerned that GPs are being paid a retainer fee by care homes to look after their patients, despite the fact that all patients are entitled to the service of a GP free of charge, and recommends that the practice of additional payments should be abolished.
In response to the report the Healthcare Commission (previously the Commission for Healthcare Improvement) has pledged to do all it can to banish abuse of elderly people from the health service.
It says it is working with the Audit Commission and the new Commission for Social Care Inspection on a series of reviews of services for elderly people in England, measuring services' progress against the national service framework, and will publish its findings in 2005.
As part of each review thousands of cards are being sent out to the community through different venues, including voluntary organisations, bingo halls, and pharmacies, inviting elderly people to comment on their local services.
Report "breaks the taboo of not talking about elder abuse"
Credit: ALIX/PHANIE (PHN)/REX
Professor Ian Kennedy, chairman of the Healthcare Commission, said: "We take the abuse of older people very seriously. Older people can be some of our most vulnerable citizens and far too often can find it hard to speak out.
"This is the ideal opportunity for us to see if we can develop inspection tools that can pick up prescribing practices that concern us. That includes the high prescribing of sedatives and morphine."
Professor Ian Philp, national director for older people's services, has welcomed the report and believes it will help to "break the taboo of not talking about elder abuse" among the medical profession and the public.
The government will be formulating an official response to the report in the next two months, but steps are already being taken to address age discrimination in the NHS and dignity on the ward, issues that are related to abuse of elderly people, he said.
Training of staff in domiciliary care is also under way to help identify cases of abuse, said Professor Philp.
"But perhaps one of the most important things we are introducing is the single assessment process so that when older people come into the service they get the level of assessment appropriate for them, which should include a detailed and holistic review of their needs, including frank, head-on questions about whether they have experienced abuse or feel threatened," he added.(Zosia Kmietowicz)
Tighter controls need to be put in place to ensure the safety of elderly people, says a Commons report. It estimates that as many as 500 000 elderly people in England are currently being abused by relatives, carers, or strangers.
Although the public is more aware than ever of child abuse and the measures that have been introduced to try to protect children, abuse of elderly people remains overlooked, says the House of Commons Health Committee.
"Our inquiry found that much abuse of older people is not reported because many older people are unable, frightened or embarrassed to report its presence," says the Committee's report.
"Often carers take no action because they lack training in identifying abuse or are ignorant of the reporting procedure. The lack of reporting results in difficulties in determining the true scale of the problem and this is compounded by lack of research."
Abuse takes many forms, including verbal, psychological, sexual, and financial abuse, as well as neglect, humiliation, and oversedation. Abuse occurs mainly in their own home but also in residential care homes, nursing homes, and hospitals, according to the report, which comes after an inquiry into the abuse of elderly people and makes a series of recommendations.
The report says that the figure of at leat half a million older people experiencing abuse is the only estimate available. "We are disappointed that the Department has not commissioned research to establish a more precise figure," it says.
The committee calls for better monitoring of NHS establishments that provide care of elderly people and greater involvement of lay people in the inspection process.
It also recommends that institutions are monitored to make sure they comply with the national service framework target that all people over 75 years old should have their medicines reviewed at least once a year and that people taking four or more drugs should have their treatment reviewed every six months. Standards for protecting adults, which have been omitted from the framework, should be added, says the report.
The committee is also concerned that GPs are being paid a retainer fee by care homes to look after their patients, despite the fact that all patients are entitled to the service of a GP free of charge, and recommends that the practice of additional payments should be abolished.
In response to the report the Healthcare Commission (previously the Commission for Healthcare Improvement) has pledged to do all it can to banish abuse of elderly people from the health service.
It says it is working with the Audit Commission and the new Commission for Social Care Inspection on a series of reviews of services for elderly people in England, measuring services' progress against the national service framework, and will publish its findings in 2005.
As part of each review thousands of cards are being sent out to the community through different venues, including voluntary organisations, bingo halls, and pharmacies, inviting elderly people to comment on their local services.
Report "breaks the taboo of not talking about elder abuse"
Credit: ALIX/PHANIE (PHN)/REX
Professor Ian Kennedy, chairman of the Healthcare Commission, said: "We take the abuse of older people very seriously. Older people can be some of our most vulnerable citizens and far too often can find it hard to speak out.
"This is the ideal opportunity for us to see if we can develop inspection tools that can pick up prescribing practices that concern us. That includes the high prescribing of sedatives and morphine."
Professor Ian Philp, national director for older people's services, has welcomed the report and believes it will help to "break the taboo of not talking about elder abuse" among the medical profession and the public.
The government will be formulating an official response to the report in the next two months, but steps are already being taken to address age discrimination in the NHS and dignity on the ward, issues that are related to abuse of elderly people, he said.
Training of staff in domiciliary care is also under way to help identify cases of abuse, said Professor Philp.
"But perhaps one of the most important things we are introducing is the single assessment process so that when older people come into the service they get the level of assessment appropriate for them, which should include a detailed and holistic review of their needs, including frank, head-on questions about whether they have experienced abuse or feel threatened," he added.(Zosia Kmietowicz)