Elder Sexual Abuse and Sexual Freedom in Faith-based Residential Care Facilities: Ethical Dilemmas, and Institutional Integrity

2021 ◽  
Vol 15 (2) ◽  
pp. 253-273
Author(s):  
Virginia Miller ◽  
Seumas Miller ◽  
Bruce Stevens

Abstract The issues of elder sexual abuse and sexual freedom in residential care facilities are complicated by the existence of many residents with cognitive impairments of a kind that compromise their ability to make decisions based on informed consent. The issues of elder sexual abuse and sexual freedom in faith-based residential care facilities, in particular, are further complicated by restrictive, theologically based, ethical principles pertaining to sexual activity – for instance, prohibitions on extra-marital sex and the use of prostitutes by residents. The tension that arises must necessarily deal with the integrity of faith-based aged-care facilities and current legislation that promotes the rights of age-care residents to sexual freedoms. In the midst of much public concern about the level and quality of institutional age care this particular aspect seldom attracts notice. It nevertheless exposes a quandary to do with how ought public theology and ethics respond.

2020 ◽  
Vol 36 (3) ◽  
pp. 24-36
Author(s):  
Caz Hales ◽  
◽  
Isaac Amankwaa ◽  
Lesley Gray ◽  
Helen Rook ◽  
...  

Little is known about the level of service demand and preparedness of Aotearoa New Zealand’s aged residential care facilities to care for older adults with extreme obesity. The aim of this study was to assess the current state of bariatric (extreme obesity) services within aged residential care. An environmental scan was conducted to identify bariatric resident needs and gaps in service provision to inform the development of policy and service provision. Observational and interview data from three facilities in Aotearoa New Zealand was collected along with a retrospective review of national resident admissions over a three-year period. Poor environmental design that included infrastructure deficiencies and financial barriers impacted on the ability to deliver safe and equitable care for this population. Specifically, equipment procurement and safe staffing ratios were of concern to the sector. There is an increasing need for bariatric level support within aged care, necessitating more equipment and staff, adaptation of physical care environments, and enhanced funding. Significant investment is required to address care concerns of older adults with extreme obesity at government and organisational levels.


2011 ◽  
Vol 17 (1) ◽  
pp. 95 ◽  
Author(s):  
Geoffrey Mitchell ◽  
Caroline Nicholson ◽  
Keith McDonald ◽  
Anne Bucetti

The delivery of palliative care in residential aged care communities is challenging, even more so in rural areas due to workforce ageing and shortages. The objectives of the present study were to: (i) assess the needs of, and quality of palliative care delivered to residents of 16 residential aged care facilities in rural southern Australia; and (ii) identify the needs of care staff to facilitate the delivery of quality palliative care. A cross-sectional survey of all residents, assessing the degree of functional limitation, stage of palliative care, and the presence of several quality indicators was conducted. Separate focus groups of care staff and relatives of residents sought information on the quality of care delivered, perceived strengths and weaknesses of the care delivered, and education and training needs. Quality palliative care in residential aged care facilities (RACFs) is hampered by workforce shortages, with low ratios of registered nurses, limited access to general practitioners after hours, and some communication difficulties. Some staff reported low confidence in technical and psychosocial aspects of care, especially for relatives. Relatives described mostly appropriate care, while acknowledging workload constraints. Most residents whose condition was unstable, deteriorating or terminal received advance care planning, though family expectations and unwillingness to discuss end-of-life care did tend to delay planning. Unstable residents with a reasonable prognosis were more likely to be transferred to hospital than terminally ill residents. Palliative care in participating RACFs appears to be adequate. Provision of targeted education for health care providers and implementation of protocols for advance care planning and end-of life care pathways will enhance this care.


2020 ◽  
Author(s):  
Anastasia Mallidou ◽  
Anne-Marie Boström ◽  
Daphne Kaitelidou ◽  
Jennifer Brett ◽  
Sara John Fowler ◽  
...  

Abstract Background Behavioral and psychological symptoms of dementia (BPSD) influence older persons’ quality of life. Non-pharmacological interventions such as individualized music (iM) are promising to reduce BPSD and sustain interpersonal connectedness that contributes to quality of life. The purpose of this study was to assess the practicalities (e.g., process, results) of iM activities application on older adults over 65 years of age diagnosed with dementia living in residential care facilities. Our objectives were to: a) evaluate the recruitment process; b) explore the process of iM activity implementation; c) assess the clinical significance of the outcomes. Methods A concurrent mixed methods feasibility study designed and was conducted in two residential care facilities in British Columbia, Canada to assess the practicalities (i.e., recruitment, acceptability of the intervention, adherence to it, and clinical significance) of iM activities implementation on older adults diagnosed with dementia living in residential care facilities. Data were collected from residents, their families and staff using administrative records, observations, surveys, and interviews. Our primary outcomes were affect and quality of life. Results The observed iM activities were feasible, acceptable and adhered to by residents with clinical significance. Specifically, about 47% of eligible residents, their families and staff agreed to participate in and completed the study (recruitment); approximately 86% of participants enthusiastically received and were satisfied with the iM activity (acceptability); more than 70% of participants completed at least seven of the nine iM sessions (adherence); about 55% of participants experienced an increase in positive affect scores and 29% had a decrease in negative affect scores after the intervention; more than 43% of participants had a reduction in BPSD (clinical significance). Finally, participants reported improvement of quality of life and positive effects of iM intervention and provided insights and suggestions to improve it. Conclusions Individualized music activities can be successfully implemented (i.e., feasible, acceptable, adherent) with significant clinical outcomes. Participants reported positive affect emotions, increase in quality of life and well-being. With this feasibility study, we developed a process to identify challenges and their solutions that may assist us in a following pilot study with similar iM intervention.


2011 ◽  
Vol 32 (1) ◽  
pp. 39-44 ◽  
Author(s):  
Kosuke Nakanishi ◽  
Tokiji Hanihara ◽  
Hitoshi Mutai ◽  
Shutaro Nakaaki

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