ABUSE Abuse is maltreatment as a single or repeated act, or neglect; it may be intentional or owing to ignorance or thoughtlessness, by a person or persons in a position of power.

Categories of Abuse Physical Sexual Financial Emotional (psychological) Neglect Self neglect Institutional

Physical Abuse Physical abuse is defined as the use of physical force that may result in bodily injury, physical pain, or impairment. Physical abuse may include but is not limited to such acts of violence as striking (with or without an object), hitting, beating, pushing, shoving, shaking, slapping, kicking, pinching, and burning. In addition, inappropriate use of drugs and physical restraints, force-feeding, and physical punishment of any kind also are examples of physical abuse.

Sexual Abuse Sexual abuse is defined as non-consensual sexual contact of any kind with a person. Sexual contact with any person incapable of giving consent is also considered sexual abuse. It includes, but is not limited to, unwanted touching, all types of sexual assault or battery, such as rape, coerced nudity, and sexually explicit photographing.

Emotional or Psychological Abuse Emotional or psychological abuse is defined as the infliction of anguish, pain, or distress through verbal or nonverbal acts. Emotional/psychological abuse includes but is not limited to verbal assaults, insults, threats, intimidation, humiliation, and harassment. In addition, treating an older person like an infant; isolating an individual from his/her family, friends, or regular activities; giving an individual the "silent treatment;" and enforced social isolation are examples of emotional/psychological abuse.

Financial Abuse Financial or material exploitation is defined as the illegal or improper use of an individuals funds, property, or assets. Examples include, but are not limited to, cashing an individuals cheque without authorisation or permission; forging an individuals signature; misusing or stealing an individuals money or possessions; coercing or deceiving an individual into signing any document (e.g., contracts or will); and the improper use of guardianship or power of attorney.

Neglect Neglect is defined as the refusal or failure to fulfil any part of a person's obligations or duties to an individual. Neglect may also include failure of a person who has responsibilities to provide care for an individual (e.g. pay for necessary home care services) or the failure on the part of a care service provider to provide necessary care. Neglect typically means the refusal or failure to provide a person with such life necessities as food, water, clothing, shelter, personal hygiene, medicine, comfort, personal safety, and other essentials included in an implied or agreed-upon responsibility to an individual.

Self Neglect Self-neglect is characterised as the behaviour of an individual that threatens his/her own health or safety. Self-neglect generally manifests itself in an individual as a refusal or failure to provide himself/herself with adequate food, water, clothing, shelter, personal hygiene, medication (when indicated), and safety precautions.

Institutional Abuse Residents are separated from social interaction with the outside world, daily life is carried out by timetable, there is a basic distinction between managers and the managed, and the aims of the institution are more important than the aims of the individuals within it.

Abuse Triggers Abusers past Prejudice Resentment Power happy Mental illness Stress Insufficient staffing levels Munchausen’s by proxy

Reasons why individuals are unable or reluctant to report abuse Fear of recrimination Left alone with the abuser Unaware of support available Guilt Protecting the abuser Knows no different Unable to report or describe due to life stage vocabulary or intellectual ability e.g. a child, individual with a learning disability Mental impairment e.g. Dementia Communication barrier

Duty of Care Be vigilant Report any changes in the individuals behaviour/physical appearance Follow organisational procedure for reporting suspected or disclosed abuse. Reassure service user, discuss the support network available to them and explain your responsibilities according to organisational policies. (Confidentiality limits)

What not to do in the event of suspected or disclosed abuse Do not contaminate evidence Do not apply misleading questions Do not challenge the abuser if the service user will be left alone with them on your departure NEVER ignore what you may have witnessed, been advised of or suspect