Abuse can occur anywhere, including at home and in care settings. People with dementia are especially vulnerable because the disease may prevent them from reporting the abuse or recognizing it. They also may fall prey to strangers who take advantage of their cognitive impairment.
Increased social isolation
We know that isolation – both with regard to care homes and people living in the community – can increase the risk of abuse happening and reduce the likelihood it will be reported and dealt with. Being detached from the outside world and from our family and friends, as well as being away from the places we usually visit, can be very unsettling. Even when restrictions ease, people may still feel the effects of the isolation experienced over the last year or may not yet feel ready to mix more.
Some support services, such as day services or lunch clubs, may still have to close at times to protect people from transmission of the virus. These service disruptions may cause the person to be confused due to changes in routine and to be more socially isolated with fewer daily contacts. The lack of structure and meaningful activity may cause confusion and distress.
Try to ensure that the person you are supporting is able to maintain social contacts as much as possible, in whatever way they feel comfortable with. This may include continuing to use technology or meeting outdoors, or through a window at times when isolation is again required.
Stress on carers and caring relationships
There may be additional pressures on carers or family members when supports such as day services, respite services and lunch clubs have to close. Carers and family members may find themselves having to spend longer periods providing support without adequate breaks and assistance. This can cause stress and tensions that put additional strain on the caring relationship.
It is important that carers take care of themselves. You can help by making sure that they are aware that support is available.
- They are entitled to a carer’s assessment under the Care Act 2014; see also Assessments: Your guide to getting help and support in England(Carers UK Factsheet).
- Carers in paid work have statutory rights to help balance paid work and caring responsibilities. See Your rights in work(Carers UK Factsheet).
- Carers UKand Carers Trust offer useful information, advice and services for carers.
If you notice someone is struggling you should make sure they know they can ask for help from the local authority. If you think that the carer is not coping and this may cause a risk of abuse or neglect, you should report it to your line manager in line with your safeguarding policy and procedures.
Overstretched and stressed care staff
The implications of COVID-19 on the care sector have been well publicised in the media. Staff continue to face significant pressures, particularly when colleagues need to isolate or become unwell, and it is important to ensure they remain supported by employers. Staff wellbeing is important in order to maintain good quality, safe services. Staff should receive:
- adequate and appropriate personal protective equipment based on risk assessment. See current guidance on PPE
- adequate supervision and support
- appropriate COVID-19 training
- support on end of life care, death and bereavement.
Some members of staff may be at increased risk of serious illness from COVID-19. Guidance has been issued to support employers to assess and reduce these risks.
An increase in criminal behaviour (scams etc)
The pandemic has been seen as an opportunity by some criminals to exploit people with dementia. Financial scams have increased and there has been a noted increase in scams relating to the pandemic, for example, masks ordered online that never arrive, or the offer of false cures. As a frontline worker you are the eyes and ears that may be the first person to pick up any signs of abuse. Here is a checklist of things you can do:
- Talk to your residents or clients about the increased risk of abuse at this time.
- Be aware that any changes in behaviour or demeanour could indicate abuse.
- Advise people not to answer the door to strangers – and be aware of fake ID.
- Try not to alarm people but ask them to be wary of offers to help, particularly from strangers.
- Advise people to check with family, friends or paid support that offers of support, advice and help are legitimate.
- Warn people against responding to any text, email or phone call from an unidentified source. Explain that fraudsters will imitate official bodies such as the Government or the NHS – and they do it very well!
- Advise people that they should never give their personal data, passwords or pin numbers to anyone. Official financial bodies and other organisations will never ask for them.
An increase in domestic abuse
The COVID-19 crisis has caused many people to spend a lot more time with those in their household. In some cases this has caused additional tensions that spill over into abuse and violence. Evidence from statutory and voluntary agencies across the UK highlights an increase in reports of domestic abuse, with Refuge reporting a 60 per cent increase in calls and online requests between April 2020 and February 2021. The increase is thought to be related to forced coexistence, economic stress, and fears about the virus. In the case of people with dementia being cared for by family at home it may be due to the carer not coping with limited services, increased caring responsibilities and fewer breaks.
Those who are living with an abusive partner or family member may be less likely to ask for help during the pandemic as they may not want to bother overstretched emergency services. Fewer visitors to the household may mean that evidence of physical abuse goes unnoticed.
Domestic abuse is not just about physical violence. It can include other types of abuse such as emotional or psychological, sexual, financial and neglect. Domestic abuse can be experienced by both men and women.
If someone is in immediate danger you should call the police. If you have any concerns that abuse is happening to a person with dementia you should report it in line with your organisation’s safeguarding policy.