Dental professionals need more training to identify abuse

Dental Tribune International

Mon. 19. August 2024

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JÖNKÖPING, Sweden: Elder abuse is a significant issue worldwide, and 2017 research reported a global prevalence of 15.7%. Researchers in Sweden recently undertook a study to evaluate how health and social care staff identify and understand elder abuse within the context of dementia care. The research explores the challenges faced by staff in recognising and responding to abuse, particularly when it is perpetrated by family members. The researchers found that elder abuse is multifaceted and that detection could be improved with better screening tools, training and customised support systems.

In Sweden, national regulations mandate that social care staff, as well as healthcare and dental care staff, be equipped to detect and respond to abuse. However, previous research indicates that elder abuse often goes undetected, partly because of the challenges staff face in distinguishing the symptoms of abuse from normal ageing or cognitive impairment symptoms, particularly in individuals with dementia.

The study was carried out in 2021, and the 39 participants were drawn from both healthcare, including dental care, and social care settings in Sweden, where regions and municipalities share joint responsibility for dementia care. Staff were asked to evaluate whether certain strategies by caregivers aimed at managing the behaviour of the adult in their care depicted in fictional scenarios were abusive. These vignettes were followed by group interviews where participants discussed their experiences and perceptions of elder abuse.

The study revealed significant inconsistencies in how staff members identified and classified abusive acts. None of the participants were able to correctly identify all the abusive behaviour management strategies presented to them, highlighting the complexity of recognising abuse in real-world scenarios. The most commonly identified abusive act was the caregiver (wife) asking their son to hold the adult patient (husband) down while she showered him, recognised by 78.4% of participants. In contrast, other strategies were less consistently identified as abusive, reflecting the difficulties in interpreting these situations.

Through the group interviews, participants shared their experiences of witnessing various forms of elder abuse, particularly emotional/psychological abuse and neglect, which were the most frequently observed. Emotional abuse often involved verbal attacks, social isolation and violations of the person’s right to self-determination. Neglect was also commonly reported, when family members failed to provide adequate care because of either lack of knowledge or intentional actions that were sometimes motivated by financial concerns.

The results indicated that staff often struggle with uncertainty in identifying abusive acts, and this can lead to under-reporting and feelings of inadequacy among staff. The lack of consistent guidelines and resources further exacerbates these challenges, leaving staff to rely heavily on their own judgement.

The study concluded that health and social care staff are capable of recognising elder abuse; however, inconsistencies in defining abusive acts limits their identification. Training and the development of standardised screening tools could improve staff’s ability to detect and respond to elder abuse more effectively. However, the complexity of elder abuse, especially in cases involving dementia, indicates that a one-size-fits-all approach may not be sufficient. Instead, tailored interventions and comprehensive support systems are necessary to address the multifaceted nature of abuse in this vulnerable population.

The study, titled “Health and social care staff’s recognition of elder abuse perpetrated by family members of persons with dementia: A mixed-method study”, was published online on 9 August 2024 in the Scandinavian Journal of Public Health, ahead of inclusion in an issue.

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Abuse Advocacy Education Elderly oral care

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