APPEAL (A Path to Prevention of Elder Abuse in Long term care) is a research program funded by FORTE, the Swedish Research Council for Health Working Life and Welfare, for the years 2023-2029. It is a collaboration between researchers at Linköping University, Region Östergötland, the city of Gothenburg and Karolinska Institutet. We also collaborate with researchers at Norwegian University of Science and Technology (NTNU) in Trondheim, Norway. The aim of the research programme is to explore perceptions and experiences of elder abuse in home care and nursing homes and the long-term goal is to co-create an intervention for elder abuse in nursing homes. The research programme includes several parts with the aim of integrating perspectives from all involved parties, i.e., older adults and their relatives as well as staff in long term care.
A Path to Prevention of Elder Abuse in Long-term care, APPEAL
The past year prevalence of elder abuse among community dwelling older adults have been reported to be about 10-15% in both Swedish and international studies. Older adults are subjected to abuse both by family members, e.g., intimate partners and adult children, but also by staff in different care contexts. The prevalence is estimated to be considerably higher among care dependant older adults, but this is much less investigated.
About the research
Older adults and their relatives
In this part of the project, we will investigate the prevalence of elder abuse among care recipients in home care and nursing homes. Furthermore, we will explore perceptions and experiences of elder abuse among both care recipients themselves and their relatives. One important part will also be to explore participants’ perceptions about potential preventive efforts and what kind of help they would like to receive from health and social care.
Staff in long-term care
International studies have revealed that 60-65% of staff in nursing homes admit having perpetrated some form of abusive act towards a care recipient during the past year. In many cases the intent is not to harm, but rather the result of not being able to manage a difficult situation, sometimes due to organizational limitations. Regardless of intent, the consequence of the abusive act is often negative for the older adults. In addition the abuse may also have negative implication for staff, that feel guilty or frustrated about organizational limitations.
Staff may also become witness of elder abuse by relatives, which may be a situation that is difficult to handle. In the part of APPEAL that focus on staff, we will investigate the prevalence of perpetrating or witnessing elder abuse among staff working in long term care. In addition, we will conduct group-interviews and individual interviews to explore perceptions and experiences of abuse among staff and managers within home care and nursing homes.
Intervention
The results of the two first parts of the program, involving older adults and their relatives as well as staff, will guide the development of an intervention to prevent elder abuse in nursing homes. To assure relevance and feasibility, the intervention will be co-constructed with key stakeholders, i.e., staff, care recipients, and relatives. The intervention will be tested in a pilot-study at nursing homes.
