Introduction: In an ageing and a very developed society like ours, it is necessary to ensure that older adults receive ethical care both within the family and the health care settings. The well-being of vulnerable elders must be protected because with rising age, their ability to physically care for themselves might diminish to a lesser or greater extent. Additionally, age related onset of neurological conditions such as dementia and Alzheimer’s disease makes an older person more vulnerable to neglect and abuse. The issue of vulnerability of older adults is timely and important not only because of the general ageing of the population, but also due to the fact that older persons today can expect to live for a few decades post-retirement. Consequently, their longer lifespan is associated with increased needs of care, resulting from living with several comorbidities and higher morbidity rates. Greater probability of suffering from several physical and neurological conditions and of increased needs render older people more vulnerable. Data concerning the incidence and prevalence of elder neglect and abuse occurring within the family setting and health care settings is available from studies conducted in the Canada, United States, the United Kingdom, Israel, Germany, and other developed countries. Such data from Switzerland is lacking. These studies have used either available government data, reports of abuse and neglect witnessed and perpetrated by health care workers, or self-reports of neglect and abuse incidents experienced by older adults.
Study purpose: Since no study so far has captured the scope or nature of elder neglect and abuse in Switzerland, this pilot study aims to examine in an exploratory manner this phenomenon from the perspectives of nursing staffs working in geriatric units, emergency care, and nursing homes. This sub-group of health care workers are chosen because nursing staff members provide the most basic care to older patients. As the first exploratory study of its kind, it may not be feasible to include older adults or older patients when the basic contextual understanding of elder neglect and abuse is unknown for Switzerland.
Methods: Based on the exploratory nature of the study, qualitative methodology will be employed where open-ended interviews with nurses and nurse aids will be carried out. The aims of the interviews are to (a) examine whether this group of health care professionals perceives that there is a problem of elder neglect and/or abuse [given that we do not know what the situation is in CH]; (b) explore whether they have witnessed neglect and abuse (intentional or unintentional) of an older patient in their care setting in the last 12 months irrespective of who the perpetrator was; (c) their beliefs related to why older patients are neglected and/or abused; and (d) what in their opinion must be done to ensure ethical care of older patients. It is envisioned that approximately 25 nurses would be interviewed and they would be working in the Basel region. Purposive sampling will be used to obtain a participant pool that is diverse enough to provide maximum variability. Thus, nurses of different age (20 – 60 years), nationality (German or Swiss or other), different trainings (BSc Nursing or vocational nursing without college degree or nurse aids), working experience (more than one year), and working in different facilities (geriatric center, emergency unit, and nursing homes) will be recruited to participate in this study. Data will be interpreted using qualitative analysis where coding of concepts, themes, patterns, and categories occurs.
Conclusion: Elder neglect and abuse is a societal problem with many facets encountered worldwide. Because of the sensitive nature of the topic, lack of funding, and fear of negative results data on this subject is limited. The proposed research endeavours to study this highly sensitive issue in Switzerland in an exploratory manner. Study findings will be the first of this kind in Switzerland and will contribute towards improving understanding of elder neglect and abuse and thereby, providing a basis for taking steps to ensure well-being and ethical care of older patients and other elders in our society.