title: Caring for elder patients: Mutual vulnerabilities in professional ethics.
abstract: Neglect and abuse of elders in care institutions is a recurring issue in the media. Elders in care institutions are vulnerable due to their physical, cognitive, and verbal limitations. Such vulnerabilities may make them more susceptible to mistreatment by caregivers on whom they are heavily dependent.
  The goal was to understand caregivers' concerns about ensuring correct and proper treatment, as well as their experiences with neglect and abuse of older patients. This article examines resources and challenges of professional ethics within the care setting.
  A study was conducted to explore the quality of care provided to older patients in nursing homes, geriatrics institutions, and ambulant care in the northwest region of Switzerland.
  A total of 23 semi-structured interviews were conducted with nursing staff of varying experience levels.
  Ethical approval was granted by the competent regional ethics commission, Ethikkomission Nordwest-und Zentralschweiz EKNZ [Ethics Commission Northwest and Central Switzerland] (2014-015).
  Three themes emerged from our data analysis: professional identity, professional context, and professional relationships. Our findings indicate mutual vulnerabilities within these three themes, characterizing the interactions between nursing staff and older patients. Study participants believe that incidences of error, neglect, and abuse are consequences of their own vulnerability since they are not able to meet the demands of an overstraining work situation.
  Different aspects of this mutual vulnerability are described and critically discussed as challenges for professional ethics.
  Early education, continuous training as well as better management and response from the institution are necessary to maintain professionalism while handling mutual vulnerabilities.
authors.affiliation: University of Lucerne, Switzerland; University of Basel, Switzerland.
authors.forename: Karin
authors.initials: K
authors.lastname: Nordström
authors.affiliation: University of Basel, Switzerland.
authors.forename: Tenzin
authors.initials: T
authors.lastname: Wangmo
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D004552:Elder Abuse; D005260:Female; D005851:Geriatric Nursing / Q000941:ethics*; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations / Q000941:ethics*; D009735:Nursing Homes; D009740:Nursing Staff / Q000523:psychology* / Q000706:statistics & numerical data; D036301:Qualitative Research; D011787:Quality of Health Care; D013557:Switzerland; D035862:Vulnerable Populations; D055815:Young Adult
keywords: Abuse; care of elders; neglect; nursing staff; professional ethics; vulnerability