Global Approaches to Older Abuse Research in Institutional Care Settings: A Systematic Review

Abstract

AbstractObjectiveOver the last two decades, authors have argued the rate of abuse among older adults in institutional settings has been underestimated due to challenges in defining and responding to the issue. The purpose of this systematic review is to provide an in-depth analysis of empirical studies examining methodologies measuring abuse of older people residing in a long-term institutional care facility (nursing homes, independent living and assisted living facilities), specifically staff-to-resident abuse.MethodsGuided by PRISMA guidelines, 10 databases were searched from 2005 till July 2023. This review inclusion criteria were any type of abuse, as defined by the World Health Organization reported by staff and residents, family and relatives, and public anonymous registries. This article also includes a methodological critical assessment of studies which has not been conducted before. To direct the review, we use four guiding questions: a) what are the study characteristics? b) what are the methods and measurement tools that have been used? c) what has been the impact of methodology on the results? and d) what is the quality of these studies?ResultsIn the last 18 years, 22 studies from eight counties undertook cross-sectional examinations of staff-to-resident abuse. The review identified a heterogeneity of definitions of abuse and variations with who reported abuse, measurement tools and recall periods. We found the quality of studies varied significantly, with no consistency.DiscussionThese variations in study methodologies impacted the ability to synthesise the findings making it difficult to estimate a global prevalence rate of aged care abuse. From the analysis, we develop an Aged Care Abuse Research Checklist (ACARC) as a first step towards achieving a global standardized, evidence-based methodology for this field. Doing so will normalize processes within organizations and the community, allowing early interventions to change practices, reduce the risk of recurrence and improve resident quality of care and workplace cultures.Systematic Review Registration NumberPROSPERO registry number: CRD42018055484,https://www.crd.york.ac.uk/PROSPERO.