Organisational aspects of elder mistreatment in long term care

Paula Hyde, Diane Burns, Anne Killett, Andrea Kenkmann, Fiona Poland, Richard Gray

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)
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This paper examines organisational aspects of elder mistreatment in light of the findings of the ResPECT Study of Organisational Dynamics of Elder Care commissioned by Comic Relief and Department of Health through the Prevention of Abuse and Neglect In the Care of Older Adults (PANICOA) programme. The study examined the organisational factors associated with abuse, neglect and/or loss of dignity of older people resident in care homes.
Approach: The study involved a knowledge synthesis of organisational aspects of elder mistreatment in residential care settings. The knowledge synthesis method was purposively adapted for examining the ill-defined and contested concept of elder mistreatment, as the available evidence is in varied forms and dispersed. Extensive searching of databases of academic journals was combined with careful searching for official investigation reports into mistreatment. The review and synthesis was followed by panel meetings with subject matter experts.
Findings: This paper identifies and elaborates five organisational factors associated with elder mistreatment; infrastructure, management and procedures, staffing, resident population characteristics and culture. It also indicates macro-structural factors affecting care quality. Investigation reports recognised common structural factors contributing to institutional abuse, however, as ‘problem’ organisations are closed down these circumstances recur elsewhere.
Research implications: Further work is needed to understand the interaction between and the influence of these organisational factors on mistreatment.
Practical implications: This may go some way towards explaining how care quality can collapse as a result of seemingly minor and unrelated organisational changes.
Social implications: Care home safety and quality is an ongoing concern, with popular analysis frequently stopping at the point of describing individual errant behaviour. Policy and practice struggles to take on lessons learned in inquiries. This synthesis deepens analysis of the inter-related factors.
Original languageEnglish
Pages (from-to)197-209
Number of pages13
JournalQuality in Ageing and Older Adults
Issue number4
Publication statusPublished - 8 Dec 2014


  • Elder Abuse
  • neglect
  • mistreatment
  • organisation
  • residential care
  • institutional abuse, older people, residential care, wicked problems
  • older people

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