Judith Knam Project report STS390, “Media, war and peace” Spring session, 2008

1. Judith Knam Project report STS390, “Media, war and peace” Spring session, 2008 Science, Technology & Society University of Wollongong The report has two parts. 1. A response pack for an actual organisation. Judith Knam’s response pack starts on the next slide. 2. A dialogue between two students discussing the project. This dialogue is fictional. Pseudonyms were used so that the marker, Brian Martin, would not know the identity of student authors. Judith Knam’s dialogue is in a separate file. Judith has rewritten both parts of her report to disguise the identity of the organisation.

2. Response pack for the religious Healthcare centre Violence in Healthcare

3. The Religious Healthcare Centre Overview This response pack is designed to assist The religious healthcare centre in handling any queries about honesty in conduct and responsible care for their patients

4. Overview Overview Older people in our Society The Concept of Violence Sun Healthcare Case Study ‘How we differ’ Recommendations

5. Older people in our Society Overview Australians now have the world’s second longest life expectancy at 81.4 yrs by 2050, most Australians can expect to reach the mid-to-late 80s Within the Australian society it becomes increasingly the norm to refer aging family members to nursing homes, as the western lifestyle focuses on the individual over the collective

6. Older people in our Society Overview Neglect, exploitation and sexual, physical and psychological abuse are commonplace in Australian nursing homes until today Aged care centres are accused of indifference towards the elderly and Nursing home abuse

7. Overview

8. Wolfensberger on Deathmaking Older people are subjected to conditions and abuses, which make healthy, elderly people sick and feeble, and sick and feeble elderly people dead Wolfensburger, 1990, p.198 Overview “The medical profession is abandoning its radical commitment to life, and is massively participating in death-making” Older people are severely victimized in a number of ways (having their income and property taken away, being neglected and verbally abused or being physically assaulted). There are many well-meaning, competent, and dedicated health workers, but the bankruptcy of the overall system just defeats their efforts, and often blinds them to overarching truths

9. Ageism by Robert Butler Ageism is stereotyping and prejudice against individuals or groups because of their age Butler, 1975, p.29 Overview Older people have repeatedly expressed their wish to be addressed in respectful terms (older or senior) and have rejected the term "elderly”. Why? Because the use of "elderly" as a descriptor is that it may be seen to confuse the concepts of frailty (which is potentially reversible) and aging (which is not). The use of language influences unconscious worldviews that lead to a dramatic change in societal values, to social devaluation and to ‘logical’ conclusions

10. Violence is the exertion of force so as to injure or abuse Overview JohanGaltung on Structural Violence denotes a form of violence which corresponds with the systematic ways in which a given social structure or institution kills people slowly by preventing them from meeting their basic needs Structural violence and direct violence are highly interdependent Life spans are reduced when people are socially dominated, politically oppressed, or economically exploited Structural violence is visited upon all those whose social status denies them access to the fruits of scientific and social progress Senior’s sickness is a result of structural violence

11. Violence Abuse and Neglect - types of violence occurring in nursing homes Overview Psychological abuse = infliction of mental anguish. It includes verbal intimidation and humiliation, scolding, treating older persons as children, and withholding affection Physical abuse = is the nonaccidental use of physical force or coercion to inflict bodily harm. It includes assault, restricting freedom of movement, and sexual abuse Neglect =consists of the deprivation by a carer of basic necessities, such as food, liquids, or medication, or services, especially services that are necessary for maintaining physical or mental health.

12. Causes of violence Overview Violence is often a response to a highly stressed working situation  staff who are 'burned-out‘ and who experience aggression from patients are at risk of engaging in abusive behaviour Nursing homes have become a business concerned with profits – hence a concern with cutting costs outweighs a focus on human rights and common welfare of older people

13. Case study SunHealthcare Overview • In the 90s Sun Healthcare was a conglomerate owning an excess of 400 facilities worldwide, which created US$ 1.32 billion annually in revenues. • Sun was the holding company for several subsidiaries including • Sunrise (nursing homes), • Sundance (rehabilitation), • Sun International (international long term care), • Sunchoice (medical supplies) • and Sun Alliance (nursing home services such as laboratories, radiology, podiatry, dental and hospice). • It operated under ruthless profit-driven CEO Turner, whose strategy was “growth and expansion“

14. Case study SunHealthcare Overview Senate hearings in the US revealed widespread fraud and the misuse of Medicare and Medicaid funding; moreover sun compared poorly with competitors in terms of residents health and well being  20% of Sun's homes were among the "worst homes" By 1999 Sun declared bankruptcy because of the consequences of Sun's staffing policies in its homes were been exposed: For years Sun had been deliberately understaffing in nursing homes, which lead to vast numbers of frail seniors to suffer and thousands to die prematurely as a result

15. The religious healthcare centre How we differ Overview The religious healthcare centre is a non-for-profit organization, hence cost are not a driving factor in our operations Staff are dedicated to providing quality care in an atmosphere of homeliness and dignity, with personal regard for each individual, as the religious healthcare centre accommodates 55 patients at the mostStaff strive to enhance the quality of life for the sick and the aged, alleviate suffering and provide care in an environment which is distinctly Christian. religious healthcare centre respects and empowers the elderly and is opposed to euthanasia and ‘death-making’

16. How should the religious healthcare centre approach this topic with the public? Overview Despite being a non-for-profit organization, It is still important to publicly show awareness of the issue and to have processes in place that internally monitor and maintain the highest standards for patients!  Employees and staff need to be aware of what constitutes violence and their ethical and moral responsibilities towards their patients.

17. Recommendations for the religious healthcare centre’s staff Overview Actively promote the Australian Government’s “Aged Complaints investigation scheme”, of which free brochures are available at reception

18. Recommendations for the religious healthcare centre’s staff Overview The following checklist is from the Arkansas Adult Protective services, and serves as a checklist for staff in the Aged care industry to assess themselves. The purpose is for staff to be proactive and conscious of their level of stress; hence preventing violent encounters with patients

19. The religious healthcare centre on Aged Care Overview Hopefully, this response pack provided coherent information on Healthcare patrons and violence and will assist the religious healthcare centre’s staff in handling queries on precautions to preventing violence within the organization so that the religious healthcare centre can continue to be a responsible, ethical and socially sustainable Aged Care home.

20. References Overview Butler, R. N. (1975) Why Survive? Being Old in America, Harper & Row, Seattle Galtung, J. (1969) "Violence, Peace, and Peace Research," Journal of Peace Research, Vol. 6, No. 3, pp. 167-191 Gartrell, A. (2006) “Recent events highlight shameful neglect of Australia's elderly”, Australian Associated Press Pty Limited, Feb 24, 2006 Sydney Goode, D. (1994) ‘Quality of life for persons with disabilities: international perspectives and issues’, Brookline Books, Cambridge, 285 – 321 McCallum, J., Matiasz, S. & Graycar A. (1990) “Abuse of the Elderly at Home: The Range of the Problem”, National Centre for Epidemiology andPopulation Health, Canberra, p.10 Mclean, M. (2007) “Assisted-living option often explored at families' urging”, Journal of business, Vol. 22, Iss. 21

21. References continued Overview Books Pinkerton James, M. (1992) “The Elderly as Victims of Crime, Abuse and Neglect”, Australian Institute of Criminology, No. 27, Iss.1, p.1 -7 Quinlan, N. (2008) “OLDER" OR "ELDERLY"—ARE MEDICAL JOURNALS SENSITIVE TO THE WISHES OF OLDER PEOPLE?”, Journal of the American Geriatrics Society, Vol.56, Iss. 10 Whytehead, L, Chidwick, P.F. (1977) Considerations concerning the transit from Life to Death, Winnipeg, Canada Wolfensberger, W., Race, D. (2003) Leadership and Change in Human Services: Selected Readings from Wolf Wolfensberger, Routledge, New York

22. References continued Overview Online http://www.corporatenarc.com/nursing-home-scandal.php http://www.aradultprotection.com/Dementia_files/ElderAbuse.gif www.aradultprotection.com/Dementia_files/ElderAbuse.gif nursing-home-abuse-lawyers.us/images/ http://www.sunrisehcc.com http://www.catholichealthcare.com.au/Stella_Maris_Aged_Care.htm http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr08-je-je190.htm https://www.cia.gov/library/publications/the-world-factbook/geos/as.html www.catholichealthcare.com.au http://www.health.gov.au/internet/ministers/publishing.nsf/Content/mr-yr08-je-je190.htm https://www.cia.gov/library/publications/the-world-factbook/geos/as.html