Les mères borderlines ont fréquemment une relation particulière à leur bébé, des premiers jours aux premiers mois, qui évolue mais qui garde une tonalité particulière, celle de ne pas tenir réellement compte des besoins de l’enfant. Les premiers temps sont marqués par la fusion avec comblement oral continu. Cet état laisse rapidement la place à une discontinuité où l’oralité a une place centrale dans cette dynamique, de la fusion au lâchage, bébé nourri, bébé gavé, bébé qui attend, bébé bâillonné par la tétine mais rarement dans le regard et dans la sécurité. Ces interactions sont celles qui caractérisent la négligence et sont entourées de multiples et subtils dysfonctionnements. Nous exposerons ces caractéristiques particulières à ces familles et les effets sur le développement de ces enfants.

Often older people, while maintaining a level of independence, rely on family members to provide care and assistance. Caregivers who are also registered nurses (RNs) may provide a different perspective around the experience when their older relative is admitted to acute care. The aim of our research was to investigate and develop theory regarding nursing care provision as described by RNs, who were family caregivers to older adults, when that older adult was admitted to acute care. Over a six-month period in 2011, RNs meeting this criterion (n = 12) were interviewed individually. We identified two central categories: “Culture of Neglect” and “Vigil by the Bedside”. The core category “Normalization of Neglect” was identified as the theory, grounded in the data the participants provided which described a culture of neglect that had normalized poor nursing care. These findings highlight the issue of neglect and abuse, and further investigation is warranted.

A systematic review of the literature was conducted to identify effective approaches to preventing and addressing abuse and neglect of older adults within health care settings in Canada. The review was conducted using databases searched from January 2000–April-May 2013. Additionally, expert panel members submitted article citations from personal archives. Two research associates (NRA) screened each title and abstract for inclusion. After inter-rater reliability was determined between the NRAs (Kappa score of 0.76), the records were divided, appraised, and data extracted independently. The review resulted in 62 studies that focused on identifying, assessing, and responding to abuse and neglect of older adults; education, prevention, and health promotion strategies; and organizational and system-level supports to prevent and respond to abuse and neglect. Abuse and neglect of older adults remains under-explored in terms of evidence-based studies; consequently, further research in all of the areas described in the results is needed.

This article reviews developments in the field of elder abuse and neglect since the publication of Elder Abuse and Neglect in Canada (1991). The arguments made here are twofold: first, we have no idea of the size and nature of the problem of abuse and neglect in the community or in institutions; second, we do not know how to solve these problems or their attendant issues that have been masked by rhetoric and the recycling of information for the past 20 years. It is time to move forward from the “awareness phase”. What we must tackle in the future is as obvious now as 20 years ago. Our knowledge is incomplete (i.e., our glass remains half full) because we lack the type of investigations we most urgently need: prevalence studies in the community and institutions, serious theory development, and random clinical trials to test our interventions both socially and legally.

This research presents risk factors for abuse and neglect among older adults who accessed health and social service organizations in London, Ontario, 1991. The paper reviews four theoretical perspectives on elder abuse and neglect: the situational model, social exchange theory, symbolic interactionism and a feminist model. Risk factors for physical abuse, chronic verbal abuse, material abuse and neglect were identified for each theoretical model. Each set of risk factors was regressed on each type of abuse in order to determine the efficacy of the theoretical models. The data suggest that the risk factors associated with the situational and feminist model(s) provide the best fit in terms of physical abuse; the symbolic interaction model explains the most variance in chronic verbal abuse; both the symbolic interaction and feminist models explain about the same amount of variance in neglect; and none of the theoretical models adequately explains the variance in material abuse.