“Cultural Iatrogenesis” in Health and Social Care Decision-Making in Cases of Elder Abuse

Older people experiencing abuse in the home are often transformed by welfareist and justice
interventions into “cases” processed through bureaucratic systems that can lead to outcomes in
which their safety, choice and well-being are compromised in the best interests of maintaining
family life. This presentation draws on findings from two empirical studies: the first is a
collaborative pilot project that critically examines the feasibility of employing restorative justice
techniques to address elder abuse, and the second is an evaluation of the “Access to Justice”
initiative for older people in Wales. The presentation will use case studies to explore how
cultural norms and practices across different professional domains may inadvertently lead to a
form of iatrogenesis in which older people’s views are not always sought and their best wishes
are overlooked. In light of these findings, the research team at Aberystwyth University is
working collaboratively with policy-makers, practitioners and lay people to critically assess how
Restorative Justice approaches could be used in this context. In particular, attention will be given
to how victims might play a more active role in safety planning and decisions taken to promote
their health and well-being.