Physical abuse includes hitting, pinching, sapping, pushing, kicking, physical restraining someone in an inappropriate way.
• Unexplained or inappropriately explained injuries.
• Unexplained cuts or scratches to mouth, lips, gums, eyes or external genitalia. • Unexplained bruising to the face, torso, arms, back, buttocks, thighs in various stages of healing; collections of bruises that form regular patterns which correspond to the shape of an object or which appear on several areas of the body. • Unexplained burns on unlikely areas of the body, e.g. soles of the feet, palms of the hands and back, immersion burns, rope burns from an electrical appliance. • Sudden and unexplained urinary and/or faecal incontinence. • Person flinches at physical contact.
• Person appears frightened or subdued in the presence of particular people. • Person asks not to be hurt.
• Person wears clothes that cover all parts of their body or specific parts of their body.
Sexual abuse includes any sexual act to which the vulnerable adult has no consented and may not understand.
• Person has urinary tract infection, vaginal infections or sexually transmitted diseases that are not otherwise explained. • Person appears unusually subdued, withdrawn or has poor concentration. • Person exhibits significant changes in sexual behaviour or outlook. • Person experiences pain, itching or bleeding in the genital/anal area. • Person’s underclothing is torn, stained or bloody
• A woman who lacks the mental capacity to consent to sexual intercourse becomes pregnant.
Emotional/psychological abuse includes threats of harm or abandonment, deprivation of contact, humiliation, rejection, blaming, controlling, intimidation, coercion, indifference, harassment, verbal abuse including shouting or swearing, isolation or withdrawal from services or support networks. Signs:
• Untypical ambivalence, deference, passivity, resignation. • Person appears anxious or withdrawn, especially in the presence of the alleged abuser. • Person exhibits low self-esteem.
• Untypical changes in behaviour, e.g. continence problems, sleep disturbance. • Person is not allowed visitors/phone calls.
• Person is locked in a room/in their home.
• Person is denied access to aids or equipment, e.g. glasses, dentures, hearing aid, crutches etc. • Person’s access to personal hygiene and toilet is restricted. Financial abuse includes taking another’s money or possession, pressure with connection with wills, property, benefits or financial transactions.
• Lack of money, especially after benefit day.
• Inadequately explained withdrawals from accounts.
• Disparity between assets/income and living conditions. • Power of Attorney obtained when the person lacks the capacity to make this decision. • Recent changes of deeds/title of house.
• Recent acquaintances expressing sudden or disproportionate interest in the person and their money. • Service user not in control of their Direct Payment or Individualised Budget.
Institutional abuse often occurs in social or health care establishment when the routines, systems and norms of an institution compel individuals to sacrifice their own preferred lifestyle and cultural diversity to the needs of an institution.
• Low staffing levels over a long period of time.
• Lack of knowledge or confusion about Guidelines
• Breakdown of communication between managers and the centre. • Staff factions
• Staff working the hours to suit themselves.
• Staff may drink heavily or abusing drugs on or off duty. • Staff ordering service users around or shouting at them. • Lack of positive communication with service users.
• Lack of participatory arrangements e.g. residents...
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