The article “Physical abuse by staff and co-residents of older people and people with intellectual disabilities” by Inger Kjellberg and Karin Berg (2024) addresses the critical social problem of physical abuse in institutional care settings, highlighting its detrimental effects on residents. The authors emphasize that effective prevention of such abuse is highly dependent on staff reporting, particularly in contexts like Sweden, where designated officials are mandated to investigate reports of mistreatment.
Published in the Journal of Social Work, this study delves into the complexities of how these designated officials, often trained social workers, judge the seriousness of reported physical abuse incidents. The research specifically aimed to analyze what designated officials considered serious in reported incidents of physical abuse across two distinct care settings: care for older people and care for people with intellectual disabilities. The study examined similar cases of physical abuse to illustrate differences in judgments and to understand how the seriousness of abusive situations is framed.
Utilizing interpretative content analysis and analytic induction, Kjellberg and Berg (2024) analyzed reports of both staff-to-resident abuse and resident-to-resident abuse. The material for their analysis included 29 comparable reports from care for older people and care for people with intellectual disabilities.
Key findings from the study reveal several significant insights:
- Severity of the incident itself did not determine seriousness: The study found no consistent differences between incidents described as serious and those described as non-serious based solely on the physical acts involved. Similar situations were judged differently, suggesting that the actual severity of abuse was not the primary driver of investigators’ decisions.
- Prevalence and perception of resident-to-resident abuse: Resident-to-resident abuse was the most commonly reported incident type, especially in dementia care and care for people with intellectual disabilities. Despite often involving more severe acts of violence, these incidents were rarely considered serious by investigators.
- Normalization of violence, particularly in dementia care: Older people in dementia care were identified as the highest risk group for abuse by co-residents. The violence in these settings was frequently explained as a symptom of dementia, leading to a tendency to normalize violence and apply a narrow understanding of what constitutes violence.
- Organizational issues as a key factor: Instead of the details of the abusive incidents or the extent of harm to the victim, organizational issues predominantly guided investigators’ judgments of seriousness. Incidents were more likely to be deemed serious if the investigator highlighted organizational deficiencies such as lack of leadership, supervision, documentation, or competent staff.
- Staff as scapegoats: In cases of staff-to-resident abuse, staff members were often singled out as scapegoats for organizational shortcomings, even when allegations were not proven. Police reports were rarely filed by organizations, and the responsibility often fell to the victim or their next of kin.
The findings of this study raise concerns about the effectiveness of the current mandatory reporting system in Sweden for protecting vulnerable service users. The authors conclude that more training in assessing violence is necessary for social workers investigating these reports, along with methods that prioritize listening to service users and their advocates.
References: Kjellberg, I., & Berg, K. (2024). Physical abuse by staff and co-residents of older people and people with intellectual disabilities. Journal of Social Work, 25(2), 233–249. https://doi.org/10.1177/14680173241278257
