Hostname: page-component-77c89778f8-swr86 Total loading time: 0 Render date: 2024-07-23T07:26:11.606Z Has data issue: false hasContentIssue false

Abusive Interactions: Research in Locked Wards for People with Dementia

Published online by Cambridge University Press:  01 March 2010

Fiona Kelly*
Dementia Services Development Centre, University of Stirling E-mail:


This paper reports on a study in which unique access to three locked psycho-geriatric wards of a hospital allowed ethnographic exploration into everyday social worlds of fourteen people with dementia. Findings indicate abusive practice in the wards and show that participants in receipt of such practice responded with self-defence and resistance, but ultimately were defeated. In a development of Sabat's (2001) Selfs 1–3 framework, I identify how abusive practice arose due to staffs' inability to recognise different aspects of patients' self. Recommendations for practice include integrating a developed Selfs 1–3 framework into staff training and evaluating its impact on practice.

Themed Section on ‘Harm’, ‘Abuse’, Agency and Resilience Across the Lifespan
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


Action on Elder Abuse (2004), Hidden Voices: Older people's Experiences of Abuse, London: Help the Aged.Google Scholar
All-Party Parliamentary Group on Dementia (2008), ‘Always a last resort: inquiry into the prescription of antipsychotic drugs to people with dementia living in care homes’, House of Commons, London, available at [accessed 16 April 2009].Google Scholar
Alzheimer Scotland (2008), ‘Antipsychotic drugs and dementia briefing paper’, available at [accessed 14 April 2009].Google Scholar
Ballard, C., Margallo-Lana, M., Juszczak, E., et al. (2005), ‘Quetiapine and rivastigmine and cognitive decline in Alzheimer's disease: randomised double blind placebo controlled trial’, British Medical Journal, 330, 874–8.CrossRefGoogle ScholarPubMed
Bennett, G., Kingston, P. and Penhale, B. (1997), The Dimensions of Elder Abuse: Perspectives for Practitioners, London: Macmillan Press.CrossRefGoogle Scholar
Bradford Dementia Group (1997), Dementia Care Mapping Manual, 7th edn, University of Bradford.Google Scholar
Brimelow, S. and Lyons, D. (2009), Remember, I'm Still Me, Edinburgh: Care Commission/Mental Welfare Commission.Google Scholar
Bryden, C. (2005), Dancing with Dementia, London: Jessica Kingsley Publishers.Google Scholar
Cohen-Mansfield, J., Golander, H. and Arnheim, G. (2000), ‘Self-identity in older persons suffering from dementia: preliminary results’, Social Science and Medicine, 51, 3, 381–94.CrossRefGoogle ScholarPubMed
Davis, D. (2004), ‘Dementia: sociological and philosophical constructions’, Social Science and Medicine, 58, 2, 369–78.CrossRefGoogle ScholarPubMed
Descartes, R. (1640), ‘Meditations on the first philosophy in which the existence of God and the distinction between mind and body are demonstrated’, in R. Wilkinson (2002), Minds and Bodies, Milton Keynes: The Open University.Google Scholar
Dewing, J. (2002), ‘From ritual to relationship: a person-centred approach to consent in qualitative research with older people who have a dementia’, Dementia, 1, 2, 157–71.CrossRefGoogle Scholar
Fruzzetti, A., Shenk, C. and Hoffman, P. (2005), ‘Family interaction and the development of borderline personality disorder: a transactional model’, Development and Psychopathology, 17, 1007–30.CrossRefGoogle ScholarPubMed
Garner, J. and Evans, S. (2000), Institutional Abuse of Older Adults, London: Royal College of Psychiatrists.Google Scholar
Gill, S., Bronskill, S., Normand, S. et al. (2007), ‘Antipsychotic drug use and mortality in older adults with dementia’, Annals of Internal Medicine, 146, 11, 775–86.CrossRefGoogle ScholarPubMed
Glendinning, F. (1999), ‘The abuse of older people in institutional settings: an overview’, in Manthorpe, J., Penhale, B. and Stanley, N. (eds.), Institutional Abuse: Perspectives Across the Lifecourse, London: Routledge.Google Scholar
Innes, A. (2009), Dementia Studies: A Social Science Perspective, London: Sage.CrossRefGoogle Scholar
Innes, A. and Kelly, F. (2007), ‘Evaluating long stay settings: reflections on the process with particular reference to dementia care mapping’, in Innes, A. and McCabe, L. (eds.), Evaluation in Dementia Care, London: Jessica Kingsley Publishers.Google Scholar
Kelly, F. (2009), ‘Recognising and supporting self in dementia: a new way to facilitate a person-centred approach to dementia care’, Ageing and Society, 29 (in press).Google Scholar
Kitwood, T. (1997), Dementia Reconsidered, Buckingham: Open University Press.Google Scholar
Lee-Treweek, G. (2000), ‘The insight of emotional danger: research experiences in a home for older people’, in Lee-Treweek, G. and Linkogle, S. (eds.), Danger in the Field: Risk and Ethics in Social Research, London and New York: Routledge.CrossRefGoogle Scholar
Sabat, S. (2001), The Experience of Alzheimer's Disease: Life through a Tangled Veil, Oxford: Blackwell Publishers.Google Scholar
Sabat, S. (2008), ‘A bio-psycho-social approach to dementia’, in Downs, M. and Bowers, B. (eds.), Excellence in Dementia Care, Berkshire: Open University Press.Google Scholar
Sameroff, A. and MacKenzie, M. (2003), ‘Research strategies for capturing transactional models of development: the limits of the possible’, Development and Psychopathology, 15, 613–40.CrossRefGoogle ScholarPubMed
Snyder, L. (2006), ‘Personhood and interpersonal communication in dementia’, in Hughes, J., Louw, S. and Sabat, S. (eds.), Dementia: Mind, Meaning and the Person, Oxford: Oxford University Press, pp. 259–76.Google Scholar
Taylor, C. (1994), ‘The politics of recognition’, in Gutmann, A. (ed.), Multiculturalism: Examining the Politics of Recognition, Princeton, NJ: Princeton University Press.CrossRefGoogle Scholar
Wardhaugh, J. and Wilding, P. (1993), ‘Towards an explanation of the corruption of care’, Critical Social Policy, 13, 431.CrossRefGoogle Scholar