Sunday, June 26, 2011

CARP online poll on elder abuse: lacks validity, reliability

I eschew online surveys and polls. They are inaccurate. They are wrong. It violates all of the scientific protocols for statistical reliability, validity, and we read media quoting them all the time.
In order for the study to be reliable, you need a true sample of the population. CARP surveying its members is not valid. These are people who have paid money to belong to this lobby group. And their opinions are just that - not data. NICE is conducting a better, reliable and valid survey, supervised by social scientists: Defining and measuring elder abuse.

Myths of Elder abuse abound. Personally, we need more people in more private homes to watch for such abuse. Those situated in long-term care, especially those with great staff, do monitor each other.

I would believe, from MY work in eldercare, that there are more caregivers, paid and unpaid, who are abused, than the opposite.
How to help aging, abusive parents
Is this valid? The question, have you EVER experienced abuse is misleading. Elder abuse occurs when you are elderly. Those answering can respond from any experience, at any age.

Elder Abuse Poll
Elder abuse can include physical abuse, such as beatings, sexual abuse, such as molesting, verbal abuse, such as cursing and swearing, financial abuse, including fraud and misappropriation of funds and neglect of the basic necessities of life.

Have you personally ever experienced ANY of these forms of elder abuse?
Yes80 Votes6.9 %
No1079 Votes93.1 %
Total1159 Votes

Which type of abuse did you suffer?
Physical abuse7 Votes0.6 %
Sexual abuse3 Votes0.3 %
Verbal/psychological abuse38 Votes3.3 %
Financial abuse16 Votes1.4 %
Neglect5 Votes0.4 %
OTHER ABUSE1 Vote0.1 %
NEVER BEEN ABUSED1069 Votes92.4 %
Total1157 Votes

Firstly, do you notice the above chart: 93.1% have not experienced abuse in Q. 1, yet in Q. 2, suddenly 92.4%, a difference in 10 votes, haven't been abused. Many more of my clients have engaged in self-neglect, rather than elder abuse.

Secondly, this doesn't have construct validity.  Can you say you've been verbally abused?
I can. I have been shoved by a large, angry parent while doing hall duty as a teacher. I've had parents yell at me. I've been yelled at by angry kids. But until the verbal abuse is persistent, it is not abuse. Angry clients with dementia have yelled at me, including my late father, but that isn't verbal/psychological abuse.

Thirdly, elder or child abuse is wrong. Neglect is wrong. But abuse is very different from understanding how seniors ought to be cared for, neglecting someone may mean they didn't have the education or knowledge to do so in the first place. With 70-year-olds caring for 90-somethings, they do the best they can.  Many more understand raising a child. Much fewer understand caring for failing seniors. They need footcare, and often dental care. Many die from aspiration pneumonia. There are those who do not visit a dentist. Is this abuse or neglect?

 Medscheck to ensure the medications are being taken correctly, and they aren't taking too many. Visit your pharmacist for Medscheck. In Ontario the government pays for a pharmacist to check in with you and your medications. Polypharmacy is a terrible issue with some seniors. 

Many seniors fail to use mobility devices, walkers, wheelchairs, and have a fall. This is predictable, and the statistics show how falls hurt many and result in unrecoverable hospital stays.
Does this mean we charge the caregiver with neglect - because they didn't force their spouse/aging parent to use said device?

Next question:

Who was the person who inflicted the abuse?
Professional caregiver in an institution6 Votes0.5 %
Professional caregiver in the home1 Vote0.1 %
Family caregiver - spouse18 Votes1.6 %
Family caregiver - child20 Votes1.7 %
Family caregiver - other9 Votes0.8 %
Trusted advisor (lawyer, accountant, etc)5 Votes0.4 %
Friend3 Votes0.3 %
Acquaintance13 Votes1.1 %
Stranger13 Votes1.1 %
NEVER BEEN ABUSED1069 Votes92.4 %
Total1157 Votes

Easy on a webpage to complain about family caregivers. I've yelled at my kids; they've yelled at me. That isn't abuse, either. In the above table, at this point, 47 people say they've been abused by a caregiver. It seems as if, if we can believe these stats, that we have to look to the home to ensure the safety of our seniors.

Also, rather than spending millions of dollars on more studies, let's provide more professional homecare, more people in the home, more respite for caregivers, would relieve the stress of caregiving. And it is stressful. As a stay-at-home mom in the 70s/80s, I found it difficult.
As a caregiver in my 50s, it was even worse with my father's brain tumour and resulting dementia. He didn't understand that he didn't understand numeracy principles anymore and couldn't DO his banking. He allowed the bank manager to take his paperwork back and forth from his house to the bank herself. He would have claimed I was financially abusive, as he didn't understand numbers anymore.

My mother, while fighting cancer, had radiation, chemo, and was not herself. She was verbally abusive to me; constantly undermining my authority, refusing to accept CCAC home care while I was living next door and working full time,. Who was abusing whom? She wasn't in her right mind. I knew that. She didn't know what she didn't understand any more.

Next...we have had awareness programs.

Experts on elder abuse have made a number of recommendations. Which ONE of the following do you think would do the most to prevent elder abuse?
Developing and implementing a National Strategy on Elder Abuse116 Votes10.0 %
Promoting and funding research on elder abuse12 Votes1.0 %
Coordination and dissemination of elder abuse resources35 Votes3.0 %
Development of a national public awareness program on detecting elder abuse294 Votes25.4 %
Ongoing support and coordination of groups working to prevent elder abuse114 Votes9.9 %
Developing a National Centre for Forensic Investigation of Elder Abuse14 Votes1.2 %
Working with the Justice Ministry, RCMP, Health Canada to coordinate response59 Votes5.1 %
Funding for a national volunteer agency to promote more awareness and research14 Votes1.2 %
DON’T KNOW143 Votes12.4 %
Total1157 Votes

These people answering the request for an opinion seem to disagree with themselves.

Generally, three kinds of abuse are recognized by society - child abuse, spousal abuse and elder abuse. Which of these do YOU think is the most abhorrent?
Child abuse270 Votes23.3 %
Spousal abuse22 Votes1.9 %
Elder abuse16 Votes1.4 %
DON’T KNOW23 Votes2.0 %
Total1157 Votes

Which of these do you think SOCIETY thinks is the most abhorrent?
Child abuse888 Votes76.8 %
Spousal abuse24 Votes2.1 %
Elder abuse8 Votes0.7 %
DON’T KNOW51 Votes4.4 %
Total1157 Votes

In fact, abuse is abuse, it should be the police who become involved. It is professional caregivers who can monitor.
Responding to Elder Abuse and Neglect:
The Challenge for Health Care and Social Service Workers

In many cases, 60/40, it is a male response on-line: how many men are caregivers, or in a position to understand abuse? 

What is your gender?
Male671 Votes58.0 %
Female486 Votes42.0 %
Total1157 Votes

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