Strengthening elder neglect prevention through community-based nursing: stakeholder perspectives from Indonesia

Vollständiger Abstract

Worum geht es in dieser Arbeit?

Purpose Elder neglect is a complex and often hidden form of elder abuse influenced by family relationships, caregiver capacity and weaknesses in health and social service systems. Despite its growing public health significance, evidence on stakeholder perspectives to inform community-based prevention strategies remains limited, particularly in low- and middle-income countries. This study aims to explore stakeholder perspectives on the determinants, manifestations, prevention strategies and health system gaps related to elder neglect in Indonesia to inform the development of a community-based nursing model. Design/methodology/approach An inductive qualitative content analysis approach was conducted in (blinded) Regency of Indonesia. Ten purposively selected stakeholders representing primary health care and social service sectors participated in semi-structured, in-depth interviews. Data were analyzed following the Graneheim and Lundman approach, and the study was reported in accordance with the consolidated criteria for reporting qualitative research. Findings Following the qualitative data analysis, four interconnected themes emerged: (1) family relationship histories that shape vulnerability to elder neglect; (2) caregiving burden amid economic constraints and limited family capacity; (3) hidden manifestations of elder neglect in everyday life; and (4) a fragmented prevention system. Stakeholders described elder neglect as a multifactorial phenomenon arising from the interaction of strained intergenerational relationships, increasing caregiving demands, unmet physical and psychosocial needs and fragmented health and social care systems. They emphasized the importance of strengthening family support, enhancing caregiver capacity, improving early detection and fostering cross-sector collaboration to prevent elder neglect. Originality/value Preventing elder neglect requires an integrated community-based nursing approach that combines family empowerment, caregiver support, early detection and coordinated collaboration across health, social and community sectors. These findings provide an empirical foundation for developing a community-based nursing model to strengthen elder neglect prevention in Indonesia and similar settings.