Who is at risk of being abused?
Anybody can be abused. It is as simple as that unfortunately! It is important that we get away from the stereotypes that have been created through history - woman abused by men - this is not the case, not anymore at least.
Anybody can be abused and anybody could be an abuser.
IT’S A SCARY THOUGHT ISN’T IT!
There are some people that are more at risk than others though. This is children and vulnerable adults.
This article is not going to go into the detail of child abuse.
Who is a vulnerable adult?
‘A person aged 18 or over, who is in receipt of, or maybe in need of community care services by reason of mental or other disability, age or illness and who is, or may be unable to take care of him or herself or unable to protect him or herself against significant harm or exploitation’.
(No secrets - Department of Health 2000)
What is the definition of a vulnerable adult?
#An adult to whom accommodation and nursing or personal care are provided in a care home;
#An adult to whom personal care is provided in their home under arrangements made by a domiciliary care agency; or
#An adult to whom prescribed services are provided by an independent hospital, independent clinic, independent medical agency or national health service body.
#In relation to an adult who is not mentally impaired, means ill treatment or the impairment of health;
#In relation to an adult who is mentally impaired, or a child, means ill-treatment or the impairment of health or development.
What is the definition of abuse?
#The violation of individuals human and civil rights by any other person or person’s.
#It may consist of a single act or repeated acts.
#It may be physical, verbal or psychological, an act of neglect or omission to act, or it may occur when the vulnerable person is persuaded to enter a financial or sexual transaction to which he/she has not consented or cannot consent.
#It may occur through deliberate targeting or grooming or vulnerable people and may be carried out by individuals or groups of individuals.
#Abuse can occur in any relationship and may result in significant harm to, or exploitation of the person subjected to it.
What are the different types of abuse?
Physical abuse
Hitting, slapping, pushing, inappropriate restraint, kicking, forcing, squeezing, biting, suffocating, drowning and withholding or misuse of medication.
(Whilst the use of medication and restraint may be appropriate in some circumstances, the key issue is whether the use is beyond being reasonable or outside of any prescription or recommendation or is excessive and disproportionate to what is required in the circumstances)
Sexual abuse
Sexual remarks and suggestions, introduction to indecent material, indecent exposure, teasing, indecent assault, touching without consent, sexual intercourse and being forced to touch another person.
(This includes both contact and non-contact behaviour. To be deemed as abusive, this is done with no consent from the victim)
Psychological/Emotional abuse
Lack of privacy, lack of choice, denial of dignity, deprivation of social contact or the creation of deliberate isolation, making someone feel worthless, withholding love or affection, threatening, humiliation, blaming, controlling, pressuring, coercion and ignoring the person.
Financial or material abuse
Theft, embezzlement, fraud, the abuse of influence and power of friendship to persuade a person to make gifts or change their will.
Neglect or acts of omission
Not giving personal care, deliberate withholding of aids, withholding food, drink and light, not providing adequate or appropriate clothing, restricting access to medical services, denial of religious or cultural contacts, denial of contact with family or significant others and leaving alone and/or unsupervised.
Poor professional practice
Unsatisfactory standards - sloppy care. Pervasive ill treatment - gross misconduct.
This can include any of the methods of abuse.
Institutional abuse
Collective failure of an organisation to provide an appropriate and professional service to vulnerable adults.
This can take on various types of abuse including physical and emotional etc.
Stranger abuse
This can take on any kind of form of abuse and will warrant a different kind of response from that appropriate to abuse in an ongoing relationship or in a care location. Nevertheless, in some instances it may be appropriate to use the adult protection procedures to ensure that the vulnerable person receives the services and support that they need. Such procedures may also be used when there is the potential for harm to other vulnerable people. It may be appropriate to use local POVA (protection of vulnerable adults) procedures.
Harm
Should be taken to include not only ill treatment (including sexual abuse and forms of ill treatment which are not physical), but also the impairment of, or an avoidable deterioration in, physical or mental health; and the impairment of physical, intellectual, emotional, social and behavioural development.
Discriminatory abuse
Abuse where an individual or a group of individuals discriminate against a person or persons.
Spiritual abuse
This can include the misuse of:
#A position of power, leadership or influence to further the selfish interests of someone other than the individual who needs help.
#Authorisation: unconditional submission to leaders is expected.
#Averse to criticism: the person who dissents becomes the problem rather than the issue being raised
#Perfectionist: individual worth is determined by performance; there is no comparison for weakness or failure.
#Image conscious: protecting the reputation of the leaders or church is more important than truth or justice.
#Not allowing a person to express or practice their beliefs.
(This is often difficult to identify because its definition may be more of an issue of personal interpretation of practices. Others’ views and cultures should be respected.)
Domestic Violence
This can take on any form of abuse.
It is important to realise and remember that anyone can be the abuser and anyone can be a victim!
(Definitions courtesy of Cambridgeshire County Council)
When is abuse a criminal offence?
Examples of abuse as criminal offences (in Britain):
#Domestic violence
#Rape and other sexual offences
#Theft and fraud
#Some forms of discrimination
What are the indicators of Abuse?
#General changes in social and emotional behaviour
#Becoming withdrawn
#Agitation
#Anxiety
#Anxious to please
#Lack of eye contact
#Depression or confusion
#Isolation
#Exclusion from outside social contacts
#Lack of clothing
#Lack of access to financial resources
#Restriction of mobility due to the absence of aids
#Relatives may refuse to allow a person to have respite or personal care
#Difficulty in gaining access
So there are many general signs of abuse, but there are also more specific signs for each type of abuse. It is important to remember that some of these signs may be for other reasons and not at all mean that the person is being abused.
Physical Abuse:
#Multiple bruising that is not consistent with the explanation
#Multiple bruising of various stages of healing
#Abrasions, especially around the neck, wrists and/or ankles
#Unexplained burns, especially on the back of the hands
#Scalds, especially with a well defined edge
#Hair loss in one area, scalp sore to touch
#Unexplained fractures
#Deterioration of physical condition e.g. Malnutrition, ulcers and sores
#Cowering and flinching
#Frequent minor accidents without seeking medical advice
#Unusual lethargy or docility
#Frequent changing of GP (general practitioner) to another or from one care agency to another to avoid people spotting a pattern of physical indicators of abuse
Sexual abuse:
#Changes in behaviour e.g. Attention seeking, over sexualised behaviour or fixation on sexual matters
#Physical signs with no obvious medical explanation e.g. soreness in genital area/anal area, recurring thrush or cystitis, diagnosis or a sexually transmitted disease, bruising on the inner thighs or shoulders.
#Reluctance to receive personal care e.g. Objecting to being washed in genital areas; pushing carers away, getting distressed and refusing to undress or have a bath in front of somebody else.
Financial or material abuse:
#Sudden inability to pay bills
#Unable to explain withdrawals from accounts
#Unnecessarily poor living conditions (especially if they change suddenly)
#Personal possessions of worth going missing without a satisfactory explanation
#Someone has taken responsibility for all finances, but is clearly not doing so
#Unusual interest taken by friends or family especially if they have shown little concern in the past
#Family or other potential inheritors may put pressure on someone to refuse care services, including residential care.
#Unusual purchases unrelated to the known interests of the vulnerable adult.
Institutional abuse:
#Institutional abuse can result from poor morale, high staff turnover, sickness rates, excessive hours worked and frequent use of agency staff as well as poorly trained staff
#General lack of consideration for privacy e.g. staff enter patients rooms and just wash them and put them on the toilet - all the while their bedroom door is open and people can see in
#Residents seem unusually subdues
#Residents appear isolated
#Lack of care with personal clothing. This may include loss of clothes and people being dressed in other peoples clothes, spectacles and false teeth
#Poor hygiene e.g. an obvious smell of urine, residents have dirty clothing and staff change bed linen when the deem necessary
#Inappropriate use of equipment e.g. restraint devices such as chairs that are attached to tables and an overuse of bed rails.
#Medical and nursing practices - there may be a misuse of clinical practices such as over reliance on sedating medication, catheterisation and enemas
#Lack of communication between staff, staff and residents and staff and relatives.
Concerns, suspicions and allegations:
DON’T:
#Put it off
#Leave it to someone else to help the vulnerable person
#Be afraid to voice your concerns; the vulnerable person may need urgent protection and help!
OK, so, I just want to point out that a lot of this information has been sourced from training sessions that I have attended about Protection of Vulnerable Adults and information provided by my local council offices (here in Cambridgeshire, England).
A lot of it relates to a caring environment and may not apply to you or your loved ones, but the principle facts are all the same - the definitions, explanations and indicators are true in most settings.
This subject is very important to me!
It is important that we all raise awareness of the big issue that is abuse and try to deal with it that way.
If we know the signs then hopefully we can stop it before it gets out of hand!
Thanks for reading this article!
Sarah Louise Hudson
This is about abuse and vulnerable adults, how to spot the signs and how to stop the abuse.
I am just trying to raise awareness!
I did have this in the 'education' catergory, but when you hovered the mouse over the title it showed up as 'childrens' - strange
Thanks so much for reading this!
Adding your comment:
Blissful Princess 
Its sad to identify with all of this. Whats worse, to me is the fact that we need to be taught. I dont mind saying I honestly wish I had never been born in this existence. Maybe you will change a moment in each readers interaction with another human being, for the better.
Nope, I know what you are saying! These abusers are much lower than animals!! Thanks for taking the time to read it!! Sarah 
Covering their own backs. Next time you'll have to use some sort of anonymous whistle blowing system - hope fully there won't be a next time!! 
