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That's not my Robert! Identity maintenance and other warrants in family members' claims about mistreatment in old-age care

Published online by Cambridge University Press:  14 December 2009

TOVE HARNETT*
Affiliation:
Institute of Gerontology, School of Health Sciences, Jönköping University, Jönköping, Sweden.
HÅKAN JÖNSON
Affiliation:
Department of Social Work, Lund University, Lund, Sweden.
*
Address for correspondence: Tove Harnett, Institute of Gerontology, School of Health Sciences, Jönköping University, Box 1026, S-551 11, Jönköping, Sweden E-mail: [email protected]

Abstract

This study has explored how family members of care recipients define and sustain claims of mistreatment in old-age care. Twenty-one informants were recruited from an association of relatives of care recipients in Sweden. Using argumentation analysis, four warrants about mistreatment were identified from the qualitative interview data: they referred to physical harm, psychological harm, social-care deficiencies and identity subversion. The first three categories are similar to those recognised in previous research on elder mistreatment, but the fourth, which is described in detail in the article, is less familiar: elder mistreatment as the violation of an older person's identity. The family members backed their claims about staff members' violation of a care recipient's persona or identity by using arguments that drew on their unique knowledge of the care recipient's appearance, daily routines and preferred activities. They also described their attempts to protect the dignity and identity of a care recipient, their fears of abuse, and actual cases of conflict and retribution by care staff. They consistently positioned themselves as guardians of identity through their claims of mistreatment. The study provides important knowledge about family members' moral view of elder mistreatment, which may enhance the understanding of conflicts between formal care providers and family members.

Type
Articles
Copyright
Copyright © Cambridge University Press 2009

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References

Adams, T. 2005. From person-centred to relationship-centred care. Generations Review, 15, 1, 47.Google Scholar
Åkerström, M. 1996. Triader och typifieringar – Anhöriga som sociala verktyg, kunskapskällor, medbehandlare och ‘extra-patienter’ i ett vårdkontext [Triads and characterisations: family members as social tools, sources of knowledge, co-therapists, and ‘extra patients’ in a care context]. Socialvetenskaplig Tidskrift, 3, 4, 287300.Google Scholar
Baker, M. and Heitkemper, M. 2005. The roles of nurses on interprofessional teams to combat elder mistreatment. Nursing Outlook, 53, 5, 253–9.CrossRefGoogle ScholarPubMed
Best, J. 1990. Threatened Children: Rhetoric and Concern About Child-victims. University of Chicago Press, Chicago.Google Scholar
Boise, L. and White, D. 2004. The family's role in person-centered care: practice considerations. Journal of Psychosocial Nursing and Mental Health Services, 42, 5, 1220.CrossRefGoogle ScholarPubMed
Bowen, M. 1978. Family Therapy and Clinical Practice. Jason Aronson, New York.Google Scholar
Bowers, B. 1988. Family perceptions of care in a nursing home. The Gerontologist, 28, 3, 361–8.CrossRefGoogle ScholarPubMed
Brogden, M. and Nijhar, P. 2000. Crime, Abuse and the Elderly. Willan, Cullompton, UK.Google Scholar
Cooper, C., Selwood, A. and Livingston, G. 2008. The prevalence of elder abuse and neglect: a systematic review. Age and Ageing, 37, 2, 151–60.CrossRefGoogle ScholarPubMed
Davies, S. and Nolan, M. 2003. ‘Making the best of things’: relatives' experiences of decisions about care-home entry. Ageing & Society, 23, 4, 429–50.CrossRefGoogle Scholar
Duncan, M. T. and Morgan, D. L. 1994. Sharing the caring: family caregivers' views of their relationships with nursing home staff. The Gerontologist, 34, 2, 235–44.CrossRefGoogle ScholarPubMed
Eliasson, R. 1995. Forskningsetik och perspektivval [Research Ethics and Choice of Perspective]. Studentlitteratur, Lund, Sweden.Google Scholar
Gearing, B. 1995. Elder Abuse in Perspective. Open University Press, Buckingham, UK.Google Scholar
Gladstone, J. and Wexler, E. 2002. Exploring the relationships between families and staff caring for residents in long-term care facilities: family members' perspectives. Canadian Journal on Aging, 21, 1, 3946.CrossRefGoogle Scholar
Glendenning, F. 1997. What is elder abuse and neglect? In Decalmer, P. and Glendenning, F. (eds), The Mistreatment of Elderly People. Sage, London, 1341.Google Scholar
Glendenning, F. 1999. Elder abuse and neglect in residential settings: the need for inclusiveness in elder abuse research. Journal of Elder Abuse and Neglect, 10, 1/2, 111.CrossRefGoogle Scholar
Goffman, E. 1959. The Presentation of Self in Everyday Life. Doubleday, New York.Google Scholar
Goffman, E. 1991. Asylums: Essays on the Social Situation of Mental Patients and Other Inmates. Penguin, Harmondsworth, UK.Google Scholar
Gubrium, J. 1975. Living and Dying at Murray Manor. St. Martin's Press, New York.Google Scholar
Gubrium, J. and Holstein, J. 1997. The New Language of Qualitative Methods. Oxford University Press, New York.Google Scholar
Hammarström, G. 2006. ‘Det är ständiga bekymmer man har med anhöriga’: Ambivalens gentemot äldres barn bland personal i kommunal äldreomsorg [‘There are constant problems with the relatives’: ambivalence towards older people's children among staff in old-age care]. Gerontologia, 20, 3, 130–7.Google Scholar
Harbison, J. and Morrow, M. 1998. Re-examining the social construction of ‘elder abuse and neglect’: a Canadian perspective. Ageing & Society, 18, 6, 691711.CrossRefGoogle Scholar
Hertzberg, A. and Ekman, S.-L. 2000. ‘We, not them and us?’ Views on the relationships and interactions between staff and relatives of older people permanently living in nursing homes. Journal of Advanced Nursing, 31, 3, 614–22.CrossRefGoogle Scholar
High, D. M. and Rowles, G. D. 1995. Nursing home residents, families and decision making: toward an understanding of progressive surrogacy. Journal of Aging Studies, 9, 2, 101–17.CrossRefGoogle Scholar
Hudson, M. F. 1991. Elder mistreatment: a taxonomy with definitions by Delphi. Journal of Elder Abuse and Neglect, 3, 2, 120.CrossRefGoogle Scholar
Hugman, R. 1995. The implications of the term ‘elder abuse’ for problem definition and response in health and social welfare. Journal of Social Policy, 24, 4, 493507.CrossRefGoogle Scholar
Hydle, I. and Johns, S. 1993. Övergrepp mot äldre – Stängda dörrar och knutna nävar: Om misshandel i hemmet [Elder Abuse. Closed Doors and Clenched Fists: Domestic Violence]. Studentlitteratur, Lund, Sweden.Google Scholar
Isola, A., Backman, K., Voutilainen, P. and Rautsiala, T. 2003. Family members' experiences of the quality of geriatric care. Scandinavian Journal of Caring Sciences, 17, 4, 399408.CrossRefGoogle ScholarPubMed
Jönson, H. 2006. Vårdskandaler i perspektiv: Debatter om vanvård, övergrepp och andra missförhållanden inom äldreomsorg [Nursing Home Scandals in Perspective: Debates About Abuse, Neglect and Other Bad Conditions in Formal Care]. Égalité, Malmö, Sweden.Google Scholar
Lachs, M. S. and Pillemer, K. 2004. Elder abuse. The Lancet, 364, 9441, 1263–72.CrossRefGoogle ScholarPubMed
McCormack, B. 2003. A conceptual framework for person-centred practice with older people. International Journal of Nursing Practice, 9, 3, 202–9.CrossRefGoogle ScholarPubMed
Nandlal, J. M. and Wood, L. A. 1997. Older people's understandings of verbal abuse. Journal of Elder Abuse and Neglect, 9, 1, 1731.CrossRefGoogle Scholar
National Care Homes Research and Development Forum 2007. My Home Life: Quality of Life in Care Homes. A Review of the Literature. Prepared for Help the Aged by The National Care Homes Research and Development Forum, London. Available online at http://www.myhomelife.org.uk [Accessed 10 February 2009].Google Scholar
Penhale, B. 2008. Elder abuse in the United Kingdom. Journal of Elder Abuse and Neglect, 20, 2, 151–68.CrossRefGoogle ScholarPubMed
Phillips, C. D., Kimbell, A.-M., Hawes, C., Wells, J., Badalamenti, J. and Koren, M. J. 2008. It's a family affair: consumer advocacy for nursing-home residents in the United States. Ageing & Society, 28, 1, 6784.CrossRefGoogle Scholar
Pillemer, K. and Moore, D. W. 1989. Abuse of patients in nursing homes: findings from a survey of staff. The Gerontologist, 29, 3, 314–20.CrossRefGoogle ScholarPubMed
Plitnick, K. R. 2008. Elder abuse. AORN Journal, 87, 2, 422–7.CrossRefGoogle ScholarPubMed
Pomerantz, A. 1986. Extreme case formulations: a way of legitimizing claims. Human Studies, 9, 2–3, 219–29.CrossRefGoogle Scholar
Robb, B. 1967. Sans Everything: A Case to Answer. Nelson, London.Google Scholar
Roe, B. 2002. Protecting older people from abuse. Nursing Older People, 14, 9, 1418.Google ScholarPubMed
Rolland, J. S. 1994. Families, Illness, and Disability: An Integrative Treatment Model. Basic, New York.Google Scholar
Saveman, B. I. 1994. Övergrepp mot äldre i hemmet ur distrikssköterskors perspektiv [Maltreatment of Home-dwelling Older People as Seen by Community Nurses]. AKA-Print, Århus, Sweden.Google Scholar
Saveman, B. I., Åström, S., Bucht, G. and Norberg, A. 1999. Elder abuse in residential settings in Sweden. Journal of Elder Abuse and Neglect, 10, 1, 4360.CrossRefGoogle Scholar
Savishinsky, J. S. 1991. The Ends of Time: Life and Work in a Nursing Home. Bergin and Garvey, New York.Google Scholar
Sellers, C., Folts, E. and Logan, K. 1992. Elder mistreatment: a multidimensional problem. Journal of Elder Abuse and Neglect, 4, 4, 5–20.CrossRefGoogle Scholar
Shore, P. and Santy, J. 2004. Orthopaedic nursing practice and elder abuse. Journal of Orthopaedic Nursing, 8, 2, 103–8.CrossRefGoogle Scholar
Teaster, P., Lawrence, S. and Cecil, K. 2007. Elder abuse and neglect. Aging Health, 3, 1, 115–28.CrossRefGoogle Scholar
Tomita, S. K. 1990. The denial of elder mistreatment by victims and abusers: the application of neutralization theory. Violence and Victims, 5, 3, 171–84.CrossRefGoogle ScholarPubMed
Toulmin, S. 2003. The Uses of Argument. Cambridge University Press, Cambridge.CrossRefGoogle Scholar
Townsend, P. 1962. The Last Refuge. Routledge, London.Google Scholar
Utley-Smith, Q., Colón-Emeric, C. S., Lekan-Rutledge, D, Ammarell, N., Bailey, D., Corazzini, K., Piven, M. L. and Anderson, R. A. 2009. Staff perceptions of staff: family interactions in nursing homes. Journal of Aging Studies, 23, 3, 168–77.CrossRefGoogle ScholarPubMed
Wellin, C. and Jaffe, D. J. 2004. In search of ‘personal care’: challenges to identity support in residential care for elders with cognitive illness. Journal of Aging Studies, 18, 3, 275–95.CrossRefGoogle Scholar
Whitaker, A. 2004. Livets sista boning: Anhörigskap, åldrande och död på sjukhem [The Last Home: Family Ties, Ageing and Death in a Nursing Home]. Institutionen för socialt arbete, Stockholm.Google Scholar
Whitaker, A. 2009. Family involvement in the institutional eldercare context: towards a new understanding. Journal of Aging Studies, 23, 3, 158–67.CrossRefGoogle Scholar