Respect to Prevent- A whole system approach to the prevention of elder abuse within care settings

The population in Europe is growing older. It is estimated that by 2060, one in eight people will be aged 80 or more[1].With the increase in the more vulnerable older old, elder abuse will become more prevalent in society[2]. Theoretical understandings of elder abuse inform responses to elder abuse. In the main approaches focus on interpersonal relationships[3]. Biggs and Lowenstein posit the concept of generational intelligence as a way of understanding elder abuse[4]. Generational intelligence is the ability to reflect and act, drawing on an understanding of one’s own and others’ life positions.  Without this awareness, older people are seen as different, without the same rights as the rest of society. Shifting from conflict to solidarity between generations requires compromise and the equal recognition of priorities. Description of Respect to Prevent programme : Drawing on this theory, Respect to Prevent, an innovative educational and training programme, is aimed at preventing elder abuse within care settings through: raising awareness amongst older people of their human rights and empowering them to exercise their rights. increasing generational intelligence, the capacity ‘to walk in the older person’s shoes’, challenging ageist attitudes amongst staff The programme consists of four sessions: an information session for managers of care settings, experiential workshops using socio-drama to engage older people and care staff, a reformative session which provides feedback to management on changes to organizational policies and practices to enhance the dignity of older clients.  The target population : The programme is aimed at older people, health and social care professionals and care providers.   The programme is being developed under the Erasmus + project, Socio-drama, Tackling Ageism, Preventing Abuse (S.T.Age) and involves  organizations working in the field of elder abuse prevention and  community education theatre from Finland, Ireland, Italy and Romania.  Timeline : The programme is being piloted in residential/ day care centres in Ireland, Romania, Finland and Italy. The evaluation will be concluded in April 2017. Impact and outcomes : Tools used to evaluate impact include Fraboni Scale of Ageism to be completed by care staff pre and post workshop, participant observations, one-to-one questionnaires for all participants.  Preliminary results indicate that the programme is accessible and meaningful to participants, including people with dementia. Older participants have an opportunity to voice what they see as their human rights, and what these rights should look like in the context of their daily life. Opening up this conversation allows them to look at ways of supporting each other to be safe. Experiencing life in the older person’s home, and not a place of work, gives care staff a different perspective, as one care staff observed “just putting yourself in that person’s shoes, their priorities are not the same as ours”. The outcome is the implementation of changes to organizational structures and practices to enhance dignity within long-term care residential settings. Sustainability :  Once finalized, the programme will be delivered by the organisations in the different countries.  References : 1- Eurostat,  Population Projections 2010-2060 [internet]. Luxembourg; 2011 June 8 [cited 2016 December 16]. Available from: http://ec.europa.eu/eurostat/documents/2995521/5039334/3-08062011-BP-EN.PDF/fad284a6-74eb-4eb6-9e6c-f29331b875f0 2- Soares J.J.F, Barros H, Torres-Gonzales F, Ioannidi-Kapolou E, Lamura J, Lindert J, et al. Abuse and Health Among Elderly in Europe. Lithuanian University of Health Sciences. Kaunas; 2010. Available from: http://www.ncpop.ie/userfiles/file/International%20Reports/ABUEL.pdf 3- O’Brien M, O’Brien- Olinger S, Boccaletti3 L, Milianata3  S., Caciula I, Laurola H, et al. Elder Abuse Context and Theory – Finland, Ireland, Italy and Romania [Internet]. Dublin; 2016 [cited 2016 December 16]. Available from http://www.combatingelderabuse.eu/wp-content/uploads/2016/04/Booklet_stage.pdf 4- Biggs S. & Lowenstein A. Generational Intelligence – A Critical Approach to Age Relations, New York: Routledge; 2011