Safeguarding adults at end of life: audit and case analysis in a palliative care setting.

This paper reports an audit of safeguarding adults' cases arising over two years from the introduction of an adult protection policy in a UK palliative care service serving a diverse area with 48 beds, over 600 home care and 100 day care patients. Twenty cases were identified, involving institutional, physical, verbal, and financial abuse and neglect. Most patients wanted protective work, but some did not want to disturb personal care and relationships in spite of abuse. Protection from abuse increased support for patients and carers. An analysis of cases where neglect was associated with physical abuse identified a large proportion of cases where difficulties in existing family relationships, sometimes associated with alcohol and drug misuse and histories of mental illness, exacerbated the stresses of caring at end of life, leading to abuse allegations or concerns. Assessment of family relationships and interventions to clarify and organize family caring responsibilities, and deliver services that can support carers and monitor potential abuse are useful social work contributions.