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Purpose: The purpose of this paper is to assess frailty, geriatric conditions and multimorbidity in people experiencing homelessness (PEH) using holistic evaluations based on comprehensive geriatric assessment (CGA) and draw comparisons with general population survey data. Design/methodology/approach: Cross-sectional observational study conducted in a London-based hostel for single PEH over 30 years old in March–April 2019. The participants and key workers completed health-related questionnaires, and geriatric conditions were identified using standardised assessments. Frailty was defined according to five criteria in Fried's phenotype model and multimorbidity as the presence of two or more long-term conditions (LTCs). Comparisons with the general population were made using data from the English Longitudinal Study of Ageing and the Health Survey for England. Findings: A total of 33 people participated with a mean age of 55.7 years (range 38–74). Frailty was identified in 55% and pre-frailty in 39%. Participants met an average of 2.6/5 frailty criteria, comparable to 89-year-olds in the general population. The most common geriatric conditions were: falls (in 61%), visual impairment (61%), low grip strength (61%), mobility impairment (52%) and cognitive impairment (45%). All participants had multimorbidity. The average of 7.2 LTCs (range 2–14) per study participant far exceeds the average for even the oldest people in the general population. Originality/value: To the best of authors' knowledge, this is the first UK-based study measuring frailty and geriatric conditions in PEH and the first anywhere to do so within a CGA-type evaluation. It also demonstrates the feasibility of conducting holistic evaluations in this setting, which may be used clinically to improve the health outcomes for PEH. [ABSTRACT FROM AUTHOR]

Purpose A previous publication in this journal reported the findings of a 2013 survey into people’s experiences of membership of a Christian church in the UK (author citation removed for the purposes of review). A major finding of this survey was that many people said they had been “harmed” by their experience with some labelling it as “Spiritual Abuse” (SA). Respondents in the 2013 study also stressed the importance of developing safeguarding policy and practice in this area. The purpose of this paper is to explore the findings of a more extensive survey conducted in 2017 which aims to identify people’s understanding of SA some four years after the initial work and within a context of some discussion and uncertainty around the term itself. The study also aims to assess the current status of safeguarding policy and practice in SA perpetrated against individuals in the Christian church in the UK. A secondary aim of the study is to ascertain how far understandings, policy and practice have developed since the initial survey was conducted. It is emphasised that the authors do not assert that SA is perpetrated solely in the Christian church. However, as this is their personal religious background it is the focus of this work.Design/methodology/approach A mixed methods online survey of Christians, Church attendees and members of Christian organisations was conducted in 2017. Data were analysed using descriptive statistics, inductive thematic and content analysis.Findings A clear definition of SA is required. There is an ongoing need to develop policy and practice in the area of SA in order to respond effectively to those who have these harmful experiences.Research limitations/implications This work has been conducted within the Christian faith community and thus, represents only this faith context. Accordingly, it is research with a specific group. The work would usefully be expanded to other faith contexts.Practical implications People are still being harmed by experiences in the Christian church. Safeguarding policy and practice in the area of spiritual abuse needs to be developed in the immediate future.Social implications Those working in statutory agencies, faith and community contexts need to develop an understanding of SA.Originality/value This is the largest survey conducted on the topic of SA in the Christian faith to date in the UK. [ABSTRACT FROM AUTHOR]

Purpose – There have been increased concerns about disciplinary procedures in relation to adult safeguarding. The purpose of this paper is to argue that the personal "boundary attitude" of workers is a strong component of their response to issues that have a safeguarding dimension. Design/methodology/approach – This study reports an analysis of questionnaire responses and data generated from interactive training events. Findings – The data suggest most workers adopt a personal stance or "boundary attitude" that drives their response to many of the diverse circumstances they face at the interface of their professional and personal life. Research limitations/implications – The particular profession, stage in career development or work environment may affect staff responses and this needs further exploration. Practical implications – There are implications for how services identify the most effective workers and their least effective colleagues, as well as for staff selection and training. Improving our understanding of boundary attitude will help to protect vulnerable people from abuse whilst supporting them to have a full life. Social implications – A better understanding of whether staff who maintain rigid boundaries deliver better outcomes than their colleagues who exercise substantial flexibility will help in recruitment, supervision and safeguarding activities. Originality/value – The paper explores an under-recognised issue in adult safeguarding, the personal "boundary attitudes" of staff, and their impact on judgements that affect a range of professional decisions they take. [ABSTRACT FROM AUTHOR]

Purpose – Financial abuse of people with dementia is of rising concern to family carers, the voluntary sector and professionals. Little is known about preventative and early response practice among community services staff. The purpose of this paper is to investigate voluntary sector staff's views of the risks of managing money when a person has a dementia and explore ways that individuals may be protected from the risks of financial abuse. Design/methodology/approach – An online survey of staff of local Alzheimer's Society groups across England was conducted in 2011 and was completed by 86 respondents. Open-ended responses supplemented survey questions. Statistical analysis and content analysis identified emergent findings. Findings – Most respondents said their people with dementia experienced problems with money management, with almost half the respondents reporting encountering cases of financial abuse over the past year. Most were alert to warning signs and vulnerabilities and offered suggestions relevant to practice and policy about prevention and risk minimization. Research limitations/implications – Adult safeguarding practitioners are likely to encounter money management uncertainties and concerns about exploitation of people with dementia. They may be contacted by community-based support staff from the voluntary sector about individual queries but could ensure that such practitioners are engaged in local training and networking activities to promote their skills and confidence. Practical implications – As with other forms of elder abuse, professionals need to be aware of risks of financial abuse and be able to suggest effective yet acceptable preventive measures and ways to reduce risks of harm and loss. Further publicity about adult safeguarding services may be needed among local community support services. Originality/value – There have been few studies investigating the views of people working with people with dementia in the community about adult safeguarding. [ABSTRACT FROM AUTHOR]