Transforming Nursing Practice

The problem of psychological or emotional abuse is increasing in public health care. The emotional distress among the aged population needs attention. Emotional abuse is defined as an act of using aggression, verbal arguments, isolation, or humiliation with aged individuals resulting in their decreased sense of respect, care, and dignity (Ilie et al., 2017). Such abuse can happen in homes or nursing care homes. For example, preventing the elderly to access the services or treating an elderly like a child. According to the Australian law reform commission (2020), psychological or emotional abuse is the most common type of abuse faced in the aged care sector. The Australian government is continuously making efforts to reduce the cases of psychological or emotional abuse in the aged care sector in Australia. The following sections will discuss more the problem and the present established ways or strategies to deal with it.

According to Schofield& Mishra (2014), the evidence of emotional or psychological abuse include changes in sleeping or eating orders, restricting to participate in social gatherings, having cute mood swings, self-injurious behavior development, or the elderly might look distressed or in depression. Such abuses have resulted in much other harm for aged individuals like low self-esteem, avoiding eye contact, poor health care services, or isolation of such aged people. Therefore, to prevent the development of such behavior or attitude among aged people, it is important to deal with it as they also have the right to live life happily with full respect and dignity. They also have equal rights to access the services as well. Although no such rates in Australia regarding such abuses as in other countries like Canada. According to the Australian Institute of Health and Welfare (2019), it was found that nearly 2.9% of the aged populations are the victims of emotional or psychological abuse either at their homes because of families or in caring homes. It was also found that family abuse constituted 92% of the abuse while adult children contributed to approximately 67% of the psychological abuse.

Much of the aged care abuse also goes neglected or undetected. The Australian Institute of Health and Welfare (AIHW) found that specifically the indigenous aged are more prone to abuse as they restricted from access to various health or public services and are also not treated with respect. According to Kaspiew et al. (2018), abusing in the aged care sector can lead to the risk of enhanced fragility, chronic pathological deterioration, malnutrition, dementia, suicide, or increased risks of depression or stress. It may also lead to increased chances of depression, anxiety, or stress development in aged individuals if emotional or psychological abuse is reported in the aged care sector. Moreover, in addition to these mentioned damage caused by emotional abuse other harms include increased anxiety or poor health services leading to effective health care, treatment, and poor quality care, ultimately resulting in a poor quality of life.

According to AIHW (2020), the government is trying at its best to deal with abuse cases. A National Plan to Respond to the Abuse of Older Australians (Elder Abuse) was launched by the Australian government in 2019. This plan aimed at delivering dedicated services to aged people who are the victims of emotional or other abuses. These people are also supported across the country as well with the help of his plan. The government also funded a big amount of about 15 million dollars for the implementation of Our Plan to Protect the Rights of Older Australians. This funding helps in 2 major areas –the development of Elder Abuse Knowledge Hub is supported and the National Plan on Elder Abuse implementation is also supported. The Elder Abuse Knowledge Hub ensures the following points: evidence-based research and practice, respect for inclusion and differences, and rights and social justice of elders.

Many other services have also been started by the Australian government to deal with abuse like Australia’s Elder Relationship Services, Elder Abuse Helpline, Elder Abuse Prevention Unit, According to AIHW (2020), the national plan identifies the following goals: build the evidence base, achieve national consistency and promoting the agency or autonomy of elderly people. It also takes into account that there is no discrimination based on sex, disability, age, or cultural grounds. The plan also takes into account the needs and experiences of older people living in remote and rural areas and older indigenous populations. The government also implemented The ACT Disability Aged and Carer Advocacy Services. The government has also released a fund of 13.8 million dollars to implement the services to prevent the abuse in the aged care sector. According to Lu et al. (2017), many caregiver interventions play a key role in dealing with abuse cases in the aged care sector. These interventions include abuse-prevention strategies – helplines, legal or counseling support, support groups, education and awareness, respite care, meal preparation, or housekeeping services.

These helplines assistances are provided by the trained and professional members and some money management services are also availed for the aged people who suffer from abuse in the aged care sector. Many other services are also helping in fighting with the issue of elderly abuse like spreading information regarding aged care abuse in the health care sector, referrals to mediation or counseling, referrals to legal advice support, and safety plan development along with face-to-face support with a dedicated case manager. With the use of these services available the chances of abuse in the aged care sector are reduced to a great extent. Moreover, the individual should be encouraged to protect his/her own by staying socially connected, control their finances, know his/her rights, and access the services designed for the seniors.

The recommendation for the Commission includes planning for future decision-making, strengthening service responses, improving access to information or community awareness, or enhancing the understanding. If these areas are put in focus then it will result in positive outcomes with making it easy for the aged people to access the services or information, as many families live in remote areas resulting in a struggle to navigate systems so better co-ordination across jurisdictions is needed. The multidisciplinary approaches provide great help in reducing the risks of emotional or psychological abuse in the aged care sector. These approaches include effective management, care, or appropriate medical interventions. For those who are facing the abuse they should be made available to services like advocacy services; family-inclusive services – with counseling and services for aged people; collaborative practice models – with the help of families, lawyers, and other social workers; legal assistance and helplines. Moreover, the social worker, health professionals, aged people along with their families should be involved in awareness programs to spread the necessity to identify the underlying risks and combat the problems (Pillemer et al., 2016).

The aged people should also be made aware of the rights and services they should follow to manage with such incidences. The health care professionals or families who are found guilty should be taken under strict actions. The people should be encouraged to develop a positive attitude in the aged care sector to deal with aged patients or individuals. Aged care programs, counseling sessions, help from friends, or families should be encouraged and reporting of the abuser by using the help services should be done. According to Ravenswood et al. (2017), the coordination among the multidisciplinary teams can provide great help in dealing with this issue. The responses are decision making, long-term care, financial services, adult protective services, mental health care, criminal justice, and many others. The establishment of emergency shelters can also play a major role in contributing to deal with this issue. The community and health care services should support personal care, shopping, or cleaning. The aged people should also be helped to reach them to their health professionals to get counseling or treatment sessions (Lu et al., 2017). Moreover, the families/health professionals should understand that everyone has a right to quality care and everyone should be treated with respect and dignity either old or young.

The problem of psychological or emotional abuse is increasing in public health care. The emotional distress among the aged population needs attention. Such abuses have resulted in much other harm for aged individuals like low self-esteem, avoiding eye contact, poor health care services, or isolation of such aged people. The abusing in the aged care sector can lead to the risk of enhanced fragility, chronic pathological deterioration, malnutrition, dementia, suicide, or increased risks of depression or stress. A National Plan to Respond to the Abuse of Older Australians (Elder Abuse) was launched by the Australian government in 2019. The recommendation for the Commission includes planning for future decision-making, strengthening service responses, or improving access to information. The aged people should also be made aware of the rights and services they should follow to manage with such incidences. The coordination among the multidisciplinary teams can provide great help in dealing with this issue.

References for Transforming Nursing Practice

Australian Institute of health and welfare. (2020). Elder abuse: Context, concepts and challenges. Retrieved from: https://www.aihw.gov.au/getmedia/affc65d3-22fd-41a9-9564-6d42e948e195/Australias-Welfare-Chapter-7-summary-18Sept2019.pdf.aspx

Ilie, A. C., Pîslaru, A. I., Alexa, I. D., Pancu, A., Gavrilovici, O., & Dronic, A. (2017). The psychological abuse of the elderly - A silent factor of cardiac decompensation. Maedica12(2), 119–122.

Kaspiew, R., Carson, R., & Rhoades, H. (2018).Elder abuse. Commonwealth Government of Australia. Retrieved from: https://aifs. gov.au/publications/elder-abuse/export

Lu, N., Liu, J., Wang, F., & Lou, V. W. (2017).Caring for disabled older adults with musculoskeletal conditions: A transactional model of caregiver burden, coping strategies, and depressive symptoms. Archives of Gerontology and Geriatrics69, 1-7. https://doi.org/10.1016/j.archger.2016.11.001

Pillemer, K., Burnes, D., Riffin, C., & Lachs, M. S. (2016). Elder abuse: Global situation, risk factors, and prevention strategies. The Gerontologist56(Suppl_2), S194-S205.https://doi.org/10.1093/geront/gnw004

Ravenswood, K., Douglas, J., & Haar, J. (2017). Physical and verbal abuse, work demands, training and job satisfaction amongst aged-care employees in the home and community sector. Labour& Industry: A journal of the social and economic relations of work27(4), 302-318.

Schofield, M. J., & Mishra, G. D. (2014). Three year health outcomes among older women at risk of elder abuse: Women’s health Australia. Quality of Life Research, 13(6), 1043–1052. DOI:10.1023/b:qure.0000031343.15372.a5 

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