Definition
“Any act or omission, if it affects the life, physical integrity or mental or freedom … or seriously jeopardizes the development of his personality and / or damaging its financial security.” Council of Europe , November 1987.
Any action or lack of action that are an affront to Life and Human Rights.
The abuse is just as active and passive and reveals the concept of negligence.
Neglect is defined as a defect, error of care, implementation, lack of attention …

Mistreatment
This exercise to someone, either actively or by omission of violence that undermine his person, his integrity corporelleet / or psychological, financial security or freedom.

(Hallo Abuse)

Since 1995 he has been creating ALMA is a network of detection and action on elder abuse.
It is an association of retired volunteers and professional sectors: social, medical, legal, whose role is to: prevent, understand and listen, advise and guide.

Form of abuse
Violence of abuse:

# Physical abuse: slapping, smacking, beating, rape, …
# Psychological abuse: coarse language, mental cruelty, threats, …
# Drug abuse: abuse of neuroleptics, deprived of medicine, …
# Violence Citizenship: violation of civil rights, …
# Violence active: Investment authoritarian confinement, bondage …
# Violence passive neglect, abandonment, …

The predisposing factors in institutions
# Lack of staff
# Exhaustion,
# Aggression, violence in the elderly,
# Regulations abusive or absent,
# Alcohol, drugs,
# No team discussions of problems encountered.

Restraints
ANAES publishes a guide to assessment practice in October 2000 which means “to both improve the security of the person without this practice and to minimize the action.” The contention is made on medical prescription. It is substantiated in the patient record.

Repository practice for restraint
The prescription is made after assessing the risk / benefit for the elderly by the multidisciplinary team.
Monitoring is programmed is transcribed in the patient record.
The elderly and the relatives of the elderly are aware of the reasons and goals of contention.

Profile of Persons Abused by ALMA

Mostly female (77%), widow, 75 years or older, isolated, dependent, “owning” property.

Profile of abuser
# Family member,
# Person directly responsible for care to the person,
# Care professionals, home support,
# Person with a history of domestic violence,
# Consumers of alcohol, drugs,
# Person living on a daily, ongoing.

Why so few complaints
Fears:
# Reprisals,
# To be discontinued,
# To be placed in an institution or lose their place,
# Cause a scandal
# Cause a conflict in the family
# Losing relationships.
Perceptions:
# Do not realize the seriousness of their situation,
# Excuse or justify abusive behavior,
# Ignore the possibilities of assistance and redress,
# Feel guilty about their state of dependence,
# Feel powerless
# Believe “have what they deserve.”
The attitudes of those around
# Denies the problem,
# Minimizes the incident giving rise to the complaint,
# Keep the conflict and retaliation,
# Under pressure to conformity,
# Guilty of existence of resource support,
# Feels obliged to confidentiality.

Act and abuse
New Penal Code (1995): Article 226-13 and Article 226-14.

Rules of professional IDE
Article R4312-2 and Article R4312-25.

The charter of the frail elderly
Article XIII & Anyone experiencing dependence should protect not only property but also his person.

Attitudes Caregivers
Reach out to the patient’s needs & reward.
As if we did not understand what the patient wants punishment.
The caregiver who sits reward.
The caregiver who stands punished.

How?
Always wonder about its care practices: these practices, the routine may ultimately deny the older person and turn it into an object of care.

Care practices
To mitigate the risk of abuse establishment of:
# Care Project,
# vocational training
# thinking as a team.

Care Project
These objectives are:

# Give the teams the means to reflect on the care actions underway
# Introduce new measures, tailored to the demand of the elderly.

Thinking and learning
Word of FDI:
# introduction of group of words
# Each caregiver must be able to speak freely.
Training:
# The caregiver will inform and shape new care practices,
# It takes the distance with respect to its business practices,
# The training is a beneficial break.