I learnt from my Twitter stream (thanks to Lindsay_Pike) that as well as being Carers’ Week, this week is also ‘Safeguarding Adults Awareness Week’. I had never come across this as a ‘week’ before so used my carefully honed research skills to type ‘Safeguarding Adults Awareness Week’ into Google to see what it might be about.
While the very scientific poll undertaken in Rotherham on the site of the councillor who was promoting it says that
76 % of the people surveyed were aware of safeguarding. A similar survey two weeks ago showed 54% recognition. The campaign of posters on the back of buses had been particularly successful.
I wonder if this ‘week’ though is truly ‘national’ and how important awareness is to identification and work to fight against abuse of adults who might be at risk of abuse.
There is a vast chasm between awareness of abuse towards adults and children – for me the division is arbitrary at best. Abuse of a person with knowledge/power/influence towards someone who lacks the ability – cognitive/physical or emotional to guard against it should be tackled regardless of the age of the so-called ‘victim’.
Why should society deal differently with the perpetrator according to the age of the person who is abused if the power differential is equivalent?
This is why I find the divisions and differences between the way that safeguarding is managed in childrens and adults services so different.
There are a lot of assumptions made though in the world of safeguarding. One is that anyone ‘old’ or anyone ‘disabled’ is automatically a s0-called ‘vulnerable’ adult. That isn’t necessarily the case.
But when someone who is at risk of being abused is – the responses from all parties can be patchy.
Perhaps that is why there is a differential in the way that safeguarding is investigated – the determination of being at risk is more straightforward with children because there are clear age boundaries to guide when an action is abuse and when it isn’t.
With adults, it is a value judgement about capacity and power relationships and that loaded word that I can’t quite find a perfect replacement for – vulnerability.
What makes one adult more vulnerable to abuse than another and is there a continuum of vulnerability that can cloud the way investigations are dealt with? In some situations it is brutally clear – Winterbourne View, for example, but when an historically abusive relationship between a husband who is physically violent towards his wife progresses as she develops dementia – at what point does it become an issue for social services to step in?
Between two ‘capacitious’ adults where there are no children involved, this would not be a situation for social services. With a progressive dementia or other vulnerability, it does.
For me, this is a very live issue as I work with a few people who have historically been in abusive relationships and when we intervene and when we are able to intervene becomes a very key judgement in a safeguarding investigation.
The key issues of human autonomy and human rights come into play in so many of the judgements we make regarding decisions of when and how to investigate safeguarding issues and what is and is not a safeguarding issue.
For me, I find I relate much more to the philosophical tenets of rights, responsibilities and ethics as I try and fit together the marginal decisions and the importance that an assessment of capacity can have on the life of another. The ability to reflect on the day to day decisions that might otherwise be taken speedily become more evident and more clear.
I can’t escape of the heavy moral responsibility that I feel in my day to day work. Every decision I make about prioritising, about capacity and in much clearer terms about hospital admissions weigh increasingly with the thought of implication, choice, rights and outcomes.
A thoughtless and unexamined practitioner is a dangerous practitioner.
Sometimes we can choose to overcomplicate and overanalyse but without consideration we can forget the power that we have.
So this week of Safeguarding has more or less passed me by but it is something that I’ll ponder on for much more than a week. I hope that next years’ week, if it exists, has some more thought and coherence behind it (and that it doesn’t coincide with Carers’ Week!).