Maltreatment within caring relationships: research -based - comments/notes

1. Doc. PhDr. Beáta Balogová, PhD. Maltreatment within caring relationships: research-based- comments/notes

2. Case study Helena 81-years-old client has been accepted to the geriatric department in a very neglected state with numerous bedsores. She lives in a common household with alcoholic abuse son who hasn't care about her.  Neighbours who provided medical care came into the house only with the help of police. Immobile older lady was found under the bed, dirty by fecal, wet, in a serious medical conditions. During the hospitalization at the geriatric hospital department, there was nobody who expressed an interest about her. There was a prosecutions brought to the client's son, noticed for failure care for dependent family member. Social nurse of geriatric department provided placement of client in the organization called “House of peaceful old age”.

3. Case study Mária 98 – years old client was frequently hospitalized in geriatric department because of many staple wounds and fractures. She transposed the house into her grandchild and after half year she was evicted by him. Currently, she lives in the garden house with her 70 – years old alcohol abuse son, who frequently sexually abused, tortured and beat her. She tries to keep the aggressiveness of son under control by giving him a daily dose of alcohol. If he drinks more, he's not able to control his activity. The son's attacks on the mother have been subject to dispute by the police, but client everytime withdrawed the accusation against her son. She can't move to the daughter's house, because she looks after her grandchildren who were left by their mother because of drug addiction.

4. Frequent cases of maltreatment tethering and locking immobile senior, untreated bedsores of immobile senior, financial exploitation in the form of taking his/her pension and selling his//her flat, ejection senior from household and let him/her sleep in the neighborhood, social isolation and ignoring of senior, threats of senior, humiliation and underestimation ...

5. Research results These are only partial results of retest research at Presov hospital geriatric department. The research was conducted first time in 2006, repeated research was made in October and November 2009. Every year there is an average 5 cases of maltreatment mobile seniors by family members of the total of 50 beds in the hospital. The research results leads to a public dialogue on the issues of seniors abuseand the presence of this phenomenon in society.

6. Individual reasons for maltreatment On the side of victim On the side of aggressor The existence of dependence between caregiver and cared person as a result of irrational beliefs in both sides.

7. The societal causes of maltreatment social factors - urbanization, deprivation and social stress, poverty, unemployment, environmental range that is accompanied by the development of diseases associated with the development of dementia and social tolerance of violence in the media, addictions - drugs, alcohol, medicines, other risk factors - conflicts and stress in the family, lack of financial and social resources for assistance by qualified caregivers, existential problems of the family, lack of support for informal caregivers, inadequate distribution and lack of staff, loss of work motivation - burnout syndrome (Tuma, 1998).

8. Visibile or latent maltreatment The results of previous research confirm: The syndrom of senior abuse and neglect.

9. Forms of maltreatment Tošnierová (2000) physical abuse, material and financial abuse, neglect by the second person, self neglecting, emotional abuse.

10. Methodology for maltreatment research Most of cases remain undetected, hidden even from the side of mayors or social departments. If it's monitored then we could reveal weaknesses in: absence of case studies, variability of methods, inconsistent registration, therapy and prevention, which is at the beginning, monitoring only the massive physical damage, mentally damage is pursued only rarely, lack of cooperation between helping professionals.

11. The current status of knowledge The absence of theoretical and empirical study in professional journals such as: Social work / Social work in last nine years,Employment and social policy within last five years,The absence of research, professional events focused on maltreatment at the university level.

12. Research particularity The victims are willing to cooperate only in a safe environment. Usually, in the risk of life situations, and mostly in the hospitals. But after their health is stabilized, they changed their arguments and withdraw notifying the police…, the proof of abuse for the police and the courts is difficult. It took into account only the physical consequences, mentally are considered rare and the social and economic consequences the courts never ever assessed.

13. Social protection and reporting maltreatment Social protection of seniors is not primary solving in the Slovak legislation, only in the acts as: Constitution of the Slovak Republic Criminal Law Civil Code or other international regulations regarding on human rights. But in practice there is no reports on maltreatment.

14. Senior social protection as a state obligation Social protection system should be more addressed and should respond on the wider social trends such as: a complex of demographic, economic, social factors that have been initiating and will initiate structural changes in society, as well as in the European context. This context exposed the schemes under the pressure of adaptation and modernization.

15. What we attained The most frequent aggressors are home carers, and their reasons lead us to do the conclusions: there exist a deficit in the training of informal carers. We are thinking of their work professionalism related with requirements of the health care knowledge and skills, psychosocial support in coping with senior negative emotions, but also with improving interpersonal relationships.

16. Solution in EU Slovak Joint Report on Social Protection and Social Inclusion 2007 prepared for the European Union shows that it is necessary to develop systems for long-term care, also for formal and informal care.

17. Solution in SR INTERLINKS The health care system and long-term care for seniors in Europe - modeling of conjunction and the connection between prevention, rehabilitation, quality of services and informal care.

18. Research Question Clearly define the maltreatment Characterize the aspects Identify causes Describe the forms Standardize the research methodology Propose legislative reforms Create multidisciplinary teams Conduct ongoing controversial public discussion...

19. Presentation of phenomenon should be public hearing associated with the onset of a new rational socialization of man whose primary way is the way of responsibility and humanity, go through ethic of responsibility, that the result of socialization of 21st century society will be not dehumanized individual.

20. Thank you for your attention.