Institutional abuse
Institutional abuse occurs where an institution, such as a nursing or residential home or hospital, does not provide an appropriate or professional service to the vulnerable person. This includes a failure to ensure the necessary safeguards are in place to protect the vulnerable adult and ensure they are provided with an appropriate level of care. The abuse described in the previous sections could all become institutional abuse when it occurs in an institutional setting.
Institutions that care for vulnerable adults have a responsibility to ensure suitable staff training, record keeping and also liaison with other care providers in the interest of the vulnerable person. Failure to do this could constitute institutional abuse. This form of abuse can often be detected by the attitudes or behaviour of care staff that amount to discrimination because they indicate prejudice, ignorance, thoughtlessness and stereotyping.
Institutional abuse could include:
- Inappropriate application of rules
- Lack of environmental stimulation
- Inappropriate use of medication such as sedatives or enemas
- Preventing residents from following their religious beliefs, for example being allowed to pray or follow dietary restrictions
- Dirty clothing or bed linen
- Name calling
- Inadequate or poorly trained staff
- Vegetarians being given or forced to eat meat
Signs of institutional abuse could include:
- Residents not being allowed visits or visits being delayed
- Care staff not leaving during resident visits
- Deterioration in a resident’s behaviour
- Residents appearing disorientated or confused
- Unintentional loss of weight
- Signs of restraint such as marks on the wrist
- Fear, hesitance or agitation
- A resident becoming unwilling to communicate
Pharmacy staff are in an ideal position to detect abuse of vulnerable adults from observations within the pharmacy, whilst visiting customers in their own home or during visits to residential or nursing homes.
Please note, the signs of abuse detailed in this module are not exhaustive and if you have any concerns you should discuss them with your pharmacist.