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The purpose of this paper is to update the core data set of self-neglect safeguarding adult reviews (SARs) and accompanying thematic analysis. The initial data set was published in this journal in 2015 and has since been updated annually. The complete data set is available from the author. The second purpose is to reflect on the narratives about adult safeguarding and self-neglect by focusing on the stories that are told and untold in the reviews.

Further published reviews are added to the core data set, drawn from the national SAR library and the websites of Safeguarding Adults Boards (SABs). Thematic analysis is updated using the domains used previously, direct work, the team around the person, organisational support and governance. SAR findings and recommendations are also critiqued using three further domains: knowledge production, explanation and aesthetics.

Familiar findings emerge from the thematic analysis and reinforce the evidence-base of good practice with individuals who self-neglect and for policies and procedures with which to support those practitioners working with such cases. SAR findings emphasise the knowledge domain, namely, what is actually found, rather than the explanatory domain that seeks to answer the question “why?” Findings and recommendations appear to assume that learning can be implemented within the existing architecture of services rather than challenging taken-for-granted assumptions about the context within which adult safeguarding is situated.

A national database of reviews completed by SABs has been established (www.nationalnetwork.org.uk), but this data set remains incomplete. Drawing together the findings from the reviews nonetheless reinforces what is known about the components of effective practice, and effective policy and organisational arrangements for practice. Although individual reviews might comment on good practice alongside shortfalls, there is little analysis that seeks to explain rather than just report findings.

Answering the question “why?” remains a significant challenge for SARs, where concerns about how agencies worked together prompted review but also where positive outcomes have been achieved. The findings confirm the relevance of the evidence-base for effective practice, but SARs are limited in their analysis of what enables and what obstructs the components of best practice. The challenge for SAR authors and for partners within SABs is to reflect on the stories that are told and those that remain untold or untellable. This is an exercise of power and of ethical and political decision-making.

The paper extends the thematic analysis of available reviews that focus on work with adults who self-neglect, further reinforcing the evidence base for practice. The paper analyses the degree to which SARs answer the question “why?” as opposed simply to answering the question “what?” It also explores the degree to which SARs appear to accept or challenge the context for adult safeguarding. The paper suggests that SABs and SAR authors should focus explicitly on what enables and what obstructs the realisation of best practice, and on the choices they make about the stories that are told.

This chapter explores occupational stress in research managers and administrators (RMAs). Data gathered from RMAs in the USA, Great Britain, Europe, Australasia, and Canada through the Research Administrator Stress Perception Survey (RASPerS) are used to examine factors that are known stressors or outcomes from occupational stress. The purpose of RASPerS is to measure and raise awareness about occupational stress and its impact on health behaviour in RMAs. Using descriptive statistics, factors associated with occupational stress including increasing demands, hours worked, anxiety due to competing demands between work and home, and reported self-neglect due to occupational stress are examined. We also explore what RMAs report as being the top motivating factors for remaining in the profession despite high levels of stress.

Awareness of the impact of occupational stress can aid RMAs in maintaining a healthier lifestyle and assist RMA leaders in building work environments that foster employee retention.

Our understanding of what intervention strategies are effective in improving the well-being of older adults experiencing elder abuse and self-neglect (EASN) is severely limited. The purpose of this study was to examine the use of a method called “teaming,” a wraparound approach to provide enhanced social support to older adults experiencing EASN. A teaming intervention was administered by advocates in Maine, USA, as a component of a larger community-based EASN intervention, Repair harm, Inspire change, Support connection, Empower choice (RISE), implemented to complement adult protective services.

Qualitative interviews and a focus group were conducted with RISE advocates (n = 4). A descriptive phenomenological approach involving two independent assessors was used to code transcripts into themes and subthemes.

Three domains were identified: (1) team and support forming process, which describes the development of a supportive network based on each client’s needs; (2) techniques, which refers to the specific strategies advocates use to promote collectivity and shared responsibility around the client; and (3) implementation challenges, which discusses the difficulties advocates encounter when using teaming with people experiencing EASN.

This study represents the first in-depth exploration of teaming in the context of EASN intervention. Preliminary findings on the experiences of advocates suggest that teaming is a beneficial approach to support the individualized needs of each client, and to promote improved and sustainable case outcomes for clients.

The purpose of this paper is to consider the role of the Mental Health Act (MHA) 1983 in safeguarding adults at risk of abuse and neglect. The author has undertaken a thematic review of Safeguarding Adults Reviews (SARs) commissioned in England and Adult Practice Reviews (APRs) commissioned in Wales where the MHA 1983 was a central aspect to the review.

Reviews were included based on specific determinants, following analysis of SARs, APRs and executive summaries. This should not affect the credibility of the research, as themes were identified in conjunction with analysis of literature regarding use of the MHA in the context of adult safeguarding. Consequently, this review has been underpinned by evidence-based research in the area of study.

The interaction between statutes, such as the MHA 1983 and Care Act 2014, signify challenges to professionals, with variable application of mental health legislation in practice.

Lack of a complete national repository for review reports means that it is likely that the data set analysis is incomplete. It was noted that limitations to this research include the fact that Safeguarding Adults Boards in England may not publish SAR reports or may choose to publish an executive summary or practice brief instead of the full SAR report, therefore limiting the scope of disseminating learning from SARs, as this is difficult to achieve where the full report has not been published. The author aimed to mitigate this by undertaking comprehensive searches of Local Authority and SAB websites, in addition to submitting Information requests to ensure that this research encompassed as many relevant review reports as possible.

This is an important and timely topic for debate, given that the UK Government is proposing reform of the MHA 1983. In addition, existing thematic reviews of SARS tend to be generalised, rather than specifically focused on the MHA.

Schizophrenia, a chronic mental disorder, poses enormous threat to the individual, family and society. The advent of deinstitutionalization of the mentally ill transferred the burden of care to families especially close relatives. Few studies have described the families' subjective views in this context. Hence, this study aimed to explore impacts of caregiving and coping strategies for family caregivers of patients with schizophrenia in Enugu, South East Nigeria.

A descriptive qualitative design was employed, and 14 family caregivers of individuals with schizophrenia attending federal neuropsychiatric hospital Enugu were purposively selected. A semi-structured interview guide was used to generate information, and the transcribed data were content analyzed using a thematic approach.

Three major themes and 16 subthemes were derived to reflect the perceived impact of caregiving and coping strategies of family caregivers, which include burden of care (physical-self neglect, ill health, sleep deprivation; psychological-gross irritability, ruminations; social-stigmatization, social restrictions, diminished connections, reduced productivity); positive aspects (heightened understanding; empathetic attitude, strengthened ties) and adaptive resources (acceptance, optimism, social support, spiritual devotion).

Family caregivers of individuals with schizophrenia experience bio-psychosocial burden as a result of caregiving. Coping with challenges of caregiving can prevent distress and burnout. Hence, there is need for mental health professionals to recognize caregivers as person in need of emotional and practical support and care for the mentally ill in the context of a family-centered approach.

The purpose of this paper is to interrogate and develop the conceptualisation of discriminatory abuse in safeguarding adults policy and practice beyond the current interpersonal definition. The paper draws on Safeguarding Adults Reviews (SARs) that refer to discriminatory abuse or safeguarding practice with adults who have care and support needs and protected characteristics.

A search of the national network repository of SARs identified 27 published reviews for inclusion. The contents were thematically analysed to understand how discrimination was experienced in these cases. Fricker’s “Epistemic Injustice” theory was adopted as a conceptual framework, informing the analysis of findings.

Evidence from SARs provides a challenge to the interpersonal emphasis on language and behaviour in national policy. Although the reviews acknowledge that interpersonal abuse occurs, a close reading spotlights practitioner and institutional bias, and inattention to social, structural and contextual factors. The silence on these matters in policy provides a narrow frame for interpreting such abuse. This suggests significant potential for epistemic injustice and signals a need to acknowledge these social, structural and contextual factors in safeguarding practice.

Discriminatory abuse is an under-researched and under-utilised category of abuse in safeguarding adults practice. The paper adopts Fricker’s theory of “Epistemic Injustice” to highlight the silencing potential of current policy approaches to discriminatory abuse to suggest a more inclusive and structural framing for safeguarding practice with those targeted due to their protected characteristics.

The Adult Support and Protection (Scotland) Act 2007 (ASP Act) mandates public bodies to investigate situations of harm and to support and protect adults at risk. One of the fundamental principles of the legislation is to involve the person in the adult protection process. Older people are highly represented among those defined as adults at risk and have the right to participate in decisions about their lives. However, contextual factors can impact participatory parity, and participation can be tokenistic. Drawing on the author’s practice experience, this paper aims to explore the supports and barriers to meaningful participation in adult protection.

Based on practice during the first decade of the ASP Act, this paper uses amalgamated scenarios involving older adults at risk to illustrate some of the key themes emanating from literature.

Despite Human Rights Conventions and law promoting participatory principles, research evidence and practice experience suggests that ethical principles do not always translate to practice. Within adult protection case conferences (APCCs), participation is nuanced and multifaceted, involving individual and structural facilitators and impediments. APCCs can be inhospitable environments for the adult at risk. But they also have the potential to be collaborative and supportive spaces, promoting the person’s self esteem and agency. The author plans to conduct research with service users and practitioners exploring the extent to which APCCs can facilitate meaningful participation.

This paper contributes to the wider debate about the participatory rights of service users and the value of experiential knowledge.

This paper aims to explore the links between being lonely and isolated, and increased risks of abuse for adults with care and support needs.

Thematic analysis was used to explore features of loneliness and social isolation present in South Yorkshire Safeguarding Adults Reviews (SARs) published since 2014.

Ten out of fifteen SARs indicated there had been issues of loneliness and/or social isolation for the person who was the subject of the SAR.

The limitations of this paper are that it only included SARs from the South Yorkshire area. Future research should explore national and international perspectives on these issues.

Safeguarding Boards should include actions to address loneliness and social isolation as part of prevention strategies and services to develop approaches that can minimise or prevent abuse before it occurs. Practitioners should routinely explore whether the people they work with feel lonely and/or isolated and support people to take appropriate action to mitigate these risks.

This paper uses the existing body of literature about loneliness and social isolation to explore the risks of abuse and neglect for adults with care and support needs.

The purpose of this paper is to critically review the context of adult protection in Ireland with a focus on older people. The paper traces advances and current limitations in policy, regulation, practice and legislation.

A review of historical and current contexts in adult safeguarding in Ireland is presented with consideration of key public reviews and commentaries related to care provision, governance and the legislative status of adults at risk.

While Ireland’s journey to provide adult safeguarding responses for older people has progressed since 2002, there remain many gaps. Further work needs to be addressed urgently to enable a comprehensive alignment of fit-for-purpose, responsive legislation, practice and policy to meet the complex and diverse needs of an increasing ageing population who may require safeguarding support. This includes fostering robust inter-sectorial collaboration, safeguarding legislation and cultural change related to human rights approaches.

The paper is a discussion on the context of adults safeguarding in relation to practice, policy and legislation.

Identifies the need for significant reform in the Irish system of health service. Argues for an overarching, inter-sectorial approach to addressing adult safeguarding, which focuses on prevention as well as early intervention.

The paper offers a review of the current diverse elements comprising current adult safeguarding and older people in Ireland and integrates legislative, regulatory, policy and practice realities. Challenges are illustrated within the context of reactive rather than proactive safeguarding agendas which are linked to public scandals and debates. The paper argues for a more integrated and robust inter-sectorial approach to safeguarding underpinned by adult safeguarding legislation and an overarching governance structure.