Abstract
BackgroundThere are widespread concerns about abuse of care home residents. We report, in the largest care home survey, prevalence of staff anonymously-reported, perpetrated/witnessed abusive behaviours towards care home residents over 3 months. We also report positive care behaviours.Methods1544 staff in 92 English care home units completed the revised Modified Conflict Tactics Scale and Maslach Burnout Inventory.OutcomesMost staff reported positive care behaviours, but specific person-centred activities were sometimes infrequent. Many care home staff were never or almost never aware of a resident being taken out of the home for their enjoyment (34%, n = 520); or an activity planned around a resident’s interests (15%, n = 234). 763 (51%; 95% Confidence Interval (CI) 47% to 54%) of care home staff reported carrying out or observing potentially abusive or neglectful behaviours at least sometimes in the preceding 3 months; some abuse was reported as happening “at least sometimes” in 91/92 care homes. Neglect was most frequently reported: making a resident wait for care (n = 399, 26%), avoiding a resident with challenging behaviour (n = 391, 25%), giving residents insufficient time for food (n = 297, 19%), and taking insufficient care when moving residents (n = 169, 11%). 1.1% of staff reported physical and 5% verbal abuse. More staff reported abusive/neglectful behaviour in homes with higher staff burnout-depersonalisation scores (adjusted odds ratio 1.191, CI 1.052–1.349).InterpretationStaff anonymous reports of abusive behaviour and neglect could be used to monitor care quality, as cases currently reported are probably tip of the iceberg, and be an outcome in intervention studies.
Highlights
By 2021, an estimated million United Kingdom (UK) people will have dementia, despite a recent fall in incidence [1]
Of the 97 care home units participating in the MARQUE study baseline interview, 92 participated in this survey
Of the 1702 care home staff participating in MARQUE 1544 (91%) took part in the abuse study
Summary
By 2021, an estimated million United Kingdom (UK) people will have dementia, despite a recent fall in incidence [1]. One third of UK people with dementia live in care homes and at least two thirds of care home residents have dementia [2]. A number of inquiries regarding abuse and neglect of residents have influenced public perceptions of care homes [3]. The UK Department of Health defines abuse as “a violation of an individual’s human and civil rights by another person(s)" (2). Abuse is defined by the impact, rather than intention of actions or inactions on an individual. A carer may unintentionally be neglectful if they are unaware of a care recipient’s needs. There are widespread concerns about abuse of care home residents. In the largest care home survey, prevalence of staff anonymously-reported, perpetrated/witnessed abusive behaviours towards care home residents over 3 months.
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