Investigators must improve their response to crimes against older people if they are to provide greater justice for the vulnerable says Lynne Phair leading expert. Carol Jenkins reports.
Older people are some of the most vulnerable in our society yet investigations into the abuse of the elderly are often fraught with challenges and problems that could result in failed prosecutions.
Lynne Phair is one of the leading voices in the UK around the care and investigation of older people. An expert witness with a nursing background, she has advised hundreds of organisations including police forces, at the highest level. She is a magistrate with a decade of experience on the bench.
She also works with Panorama to uncover neglect and featured on their programme ‘Behind Closed Doors: Elderly Care Exposed.
A passionate advocate for older people, she believes more work needs to be done by investigators to improve their response to such crimes. This can only be done if we as a society engage in a frank debate about the key issues that can often get polarised or skewed due the fact that this a very emotive subject.
“There is the misconception that because it is difficult to care for older people then somehow the
abuse is justified,” explained Mrs Phair
“If a care worker is stressed and slaps a person with dementia in the face then somehow it is seen
by society as acceptable. We cannot justify any behaviour that would not be acceptable elsewhere
else in society.”
Whilst, she acknowledges there could be mitigating circumstances when it comes to the sentencing
of the care worker, that there can be no justification for treatment.
She uses the example of the investigation of domestic violence. This is now a crime that will not be
tolerated by society; police and other criminal justice organisations now take a robust approach
“We need to approach the investigation of crimes against older people in the same way as we do domestic
violence and ensure prosecutions are conducted in the same robust manner.”
The fact that elderly people do routinely suffer with medical complains, bruise easily and lose weight can often make it difficult to determine whether their symptoms are due to old age or neglect.
“If an older person has pressure sores then it can be very difficult to determine whether this is due to neglect,” said Mrs Phair.
“The majority of pressure sores are preventable but some of them can’t be prevented. The way to determine neglect is to look at whether the health care professional did what was reasonably expected to prevent the pressure sores.”
Mrs Phair urges investigators to enhance their understanding of this challenging area by developing better relationships with health care professionals in order to get their expert input. She has developed good practice guidelines for investigating neglect that has been approved by the Department of Health.
Another myth that needs to be challenged is around our deeply entrenched views as a society that health care professionals always act in the best interests of those they are caring for.
It is unpalatable to think that a nurse or a care worker is capable of being negligent. We must not continue to believe that nurses are ‘angels of mercy’ and that they can do no wrong. I don’t see any difference between a lorry driver who ignores his tachograph limit and then goes on to kill a mother and her children on the motorway and a nurse who fails to treat a pressure sore and does not execute national reasonable practice.”
She argues that both the lorry driver and the nurse probably didn’t set out to cause harm but they were both negligent in their duty and should be dealt with in same robust fashion.
This false myth also extends to the NHS and that there is often the misconception that all care in the NHS is good and care in care homes is bad.
“You are more likely to get referrals about care homes than the NHS. We need to see beyond this limited view that one is intrinsically ‘bad’ and the other good as this is only adding to the problem.”
There are also misconceptions about the reliability witnesses and victims. Mrs Phair points out that we are not listening to the voice of whistleblowers, victims and their families.
“The fact that someone has dementia does not necessarily make them a reliable witness.”
She urges investigators to develop more of an understanding about the nature of abuse – pointing out that verbal abuse is just as much a crime as physical abuse.
She believes that the issues will only get worse due to the fact that our population is getting older and more people are being cared for in homes by unsupervised workers.
Looking to the future, Mrs Phair recommends investigators develop specialist teams and employ care investigators to help provide expert input.
She also wants to see us as a society challenge ‘ageism’ and the deeply entrenched view that older people don’t have rights due to the fact they are nearing the end of their lives.
“The starting point must be that whatever age someone is, they are a citizen of this country and they have the same rights as everybody else. We must do all we can to protect those rights.”
The Investigator is teaming up with Lynne Phair to host a one day workshop looking at the Investigation of crimes against older people on February 22.
The workshop will include:
A look at the term ‘neglect’ and how to assess this within an investigative context
Everyday crimes,(such as common assault) and how they may apply in health and care services
Working with health & social care professionals to gather evidence
Section 44 Mental Capacity Act and Criminal Justice and Courts Act 2015 - ill treatment and wilful neglect. What does this look like?
What is reckless practice in health and social care?
Issues around the safeguarding of adults at risk and their vulnerability