Wicked problems or wicked people? Reconceptualising institutional abuse.
Institutional abuse is a global issue, sometimes ascribed to the behaviour of a few wicked people. It persists despite regulatory measures, interventions from enforcement and protection agencies, organisational policies and procedures. Therefore, the accurate recognition and early detection of abuse and taking corresponding steps to deal with perpetrators are critical elements in protecting vulnerable people who live in institutions. However, research is less clear about why and how abuse (re)occurs. Using the tame and wicked problem analysis of Rittell and Webber (1973) as a lens, we examine the ways institutional abuse is formulated in care settings. Drawing on case study data from eight care homes for older people, we show how solutions seeking to reduce institutional abuse and improve care quality can cause additional problems. The article reconceptualises institutional abuse through the lens of wicked problem analysis to illustrate the multifaceted and recurring, wicked problem characteristics of residential care provision.
Faculty of Medicine and Health Sciences, University of East Anglia, Norwich. diane.burns@uea.ac.uk
Diane
D
Burns
Paula
P
Hyde
Anne
A
Killett
D000368:Aged; D000884:Anthropology, Cultural; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D004552:Elder Abuse / Q000517:prevention & control / Q000523:psychology / Q000706:statistics & numerical data*; D004739:England / Q000453:epidemiology; D004995:Ethics, Professional; D006801:Humans; D007326:Institutionalization; D007407:Interviews as Topic; D019982:Organizational Case Studies; D015279:Organizational Culture; D016134:Organizational Policy; D011340:Problem Solving; D011369:Professional-Patient Relations / Q000941:ethics*; D036301:Qualitative Research; D011785:Quality Assurance, Health Care; D012112:Residential Facilities / Q000592:standards; D000078329:Workforce