Defining the 'perpetrator': Abuse, neglect and dignity in care

Purpose - The purpose of this paper is to set out and discuss findings from a developmental study, commissioned by the English Department of Health and the charity, Comic Relief, which was commissioned to clarify definitional issues and recommend ways of operationalising key concepts for a prospective survey of abuse, neglect and loss of dignity in the care of older people in residential care in the United Kingdom (UK). Design/methodology/approach - As well as drawing upon their experience and expertise, the authors conducted a review of the literature, held consultation events with a range of stakeholders and undertook in-depth interviews with international academics and care home residents. Findings - Existing definitions and descriptions vary widely in form and content, are commonly subjective and imprecise and frequently make reference to abstract concepts which themselves need defining. Many of the concepts are also inherently evaluative, unspecific and open to interpretation. The study considered how, in this context, practical research definitions that are clear, unambiguous and widely acceptable to a range of stakeholders could be developed. Research limitations/implications - The study took a UK focus and the review of literature was confined to the English language. Further research might usefully extend discussion about definitions cross-culturally. The interview samples were small and should not be considered to be representative. Originality/value - The paper identifies key issues in defining the perpetrator. It focuses on the concepts of trust and intentionality, the responsibilities of the care home and multiple perpetrators and makes practical proposals for operationalising the 'perpetrator' in research. Recommendations from the study were positively received and have directly informed the Government-funded research programme in England.