Spitex and violence: Spitex in dealing with violence

How widespread is the link between Spitex and violence?

It is very difficult to quantify the exact extent of violence against older people at home (including by Spitex professionals). Most cases are trivialized or not reported. The vulnerability of older people due to health impairments and dwindling autonomy is often swept under the carpet. Yet it is precisely these facts that make them particularly vulnerable to abuse.

But violence towards senior citizens is by no means always deliberate and malicious. In most cases, the reasons are quite different. They may be one of the following:

• overburdening of relatives or care staff
• Emotional overload
• lack of training and experience in dealing patiently with older people
  

What role can Spitex play when it comes to violence?

This refers not only to the use of violence by Spitex professionals against senior citizens, but also the other way round. It is quite common for senior citizens themselves to be overwhelmed by the situation.

They feel patronized and do not want to give up their independence. Sometimes they are unable to express how they feel about their new circumstances. Seniors then sometimes have no other option than to use force.

Spitex often also acts as a whistleblower for domestic violence. It is by no means only the elderly who are overwhelmed by the situation. If relatives find it difficult to deal with the situation and lack patience and empathy, the fuse is short.

But only very few senior citizens have the courage to confide in someone. However, attentive Spitex staff are quick to recognize when violence is being used against their clients. They can then take important steps to help.

How can Spitex and violence be separated?

Both preventative and interventional measures must be taken in order to successfully and sustainably combat violence in the Spitex sector. They should be aimed at the victims and their relatives as well as the professional nursing staff and the public.

At a legal level, various measures have already been taken to separate violence from Spitex. It goes without saying that violence against older people is a violation of human rights. In addition, the matter is covered by the Council of Europe Convention on preventing and combating domestic violence.

The cantons are considered to be primarily responsible for solving the problem of violence. However, aid and counselling organizations, educational institutions and Spitex organizations also play an important role. There needs to be a more intensive exchange between them, as the various cantons and language regions are currently pursuing different approaches.

Insights into the Federal Council's work on Spitex and violence

In 2015, the Federal Council was asked to record the extent of violence against senior citizens. The results were to serve as the basis for measures to be taken. This involved not only physical violence, but also psychological and material violence as well as discrimination and neglect.

As a result, the Federal Social Insurance Office (FSIO) launched a study in 2018. Its aim was to precisely define violence in old age, investigate its prevalence throughout Switzerland and examine prevention, detection and intervention measures.

Attempts at a definition

The lack of a uniform definition of violence against older people has been criticized for more than 30 years. But nothing has changed so far. Nevertheless, the words of the World Health Organization are repeatedly referred to. It describes the situation as acts or omissions of appropriate actions within a trusting relationship that cause harm to older people.

The lack of a uniform definition results in difficulties with regard to the discussion of suitable measures for prevention, early detection and intervention. In addition, older people often have a different understanding of what violence and neglect mean.

The nationwide prevalence of violence against senior citizens

With regard to the number of older people affected by violence, the FSIO also came up with the figure of 300,000 people mentioned at the beginning. Due to the high number of unreported cases, the FSIO even considers a figure of 500,000 people per year to be realistic. This figure does not include cases of age discrimination.

On the FSIO's prevention, early detection and intervention measures

Quality management measures within the care sector and corresponding training were discussed. Emergency numbers, hotlines and publicity campaigns were also discussed. Screening and assessment tools for the early detection and clarification of suspicious cases also already exist. However, there is still a lack of meaningful studies on their suitability. As a result, there is currently no measure for prevention or early detection that is clearly recommended.

What strategies are there at a political level?

Even if there is currently still a lack of targeted measures, victims and their families are not alone. Governmental and non-governmental actors are providing information material, training courses and victim advice centers for victims of violence, relatives and perpetrators of violence.

What is still lacking, however, are family-oriented measures that reach out to those affected. There is also a lack of suitable services for perpetrators of violence. It should also be mentioned that the current services do not cover all cantons and are not explicitly geared towards violence in old age.

Some services therefore already exist. However, it is still unclear to what extent they are actually suitable for preventing violence in old age. In addition, they are not yet widely known and are therefore hardly used. This may be due to the taboo surrounding the topic.

If you notice violence against an older person, don't look away. Due to their age and associated limitations, it is not easy for senior citizens to defend themselves in an emergency. What's more, they are often afraid to report violent incidents. The shame is too great.

This makes it all the more important for attentive people like you to take the initiative and not let violence happen blindly. There are various contact points such as the National Competence Center Age without Violence, which also offers anonymous support on request. The advisors are not only experts in the field of violence, but also in dealing with senior citizens.

Find a safe Spitex with OPAN

At OPAN, we act as an interface between clients, attending physicians and various Spitex organizations. If you are looking for a suitable Spitex organization for your relative, then you have come to the right place.

All we need first is your relative's zip code. Once you have entered this, we will show you all the facilities in the area.

Now you have the choice. Take your time to look at the search results and discuss with your relative which organization would be suitable. Once you have given your general personal details, a member of staff from the chosen Spitex will contact you shortly. Together you will discuss the next steps.

At this point, we have already brought the client and the Spitex organization together. But how do the medical professionals involved get involved? We enable the specialists to send a wide range of documents such as findings and similar to the chosen Spitex organization online. This means that staff are always up to date.

Among other things, they know the following facts exactly at all times:

• Which medication must be administered when and in what dose?
• Does blood pressure need to be measured?
• Does the blood sugar level need to be monitored?
• Are there any wounds that need to be treated?
• What physical limitations are currently present?
• What changes should I pay particular attention to?

Thanks to OPAN, doctors also have the option of registering their patients with a suitable Spitex service themselves.

We would be happy to explain to you in more detail how our platform works. Simply get in touch with us. Together we will find a Spitex that meets the requirements of your relative and guarantees conscientious and non-violent work.