Abuse - definitions and signs.
Abuse: ‘is a violation of an individual’s human and civil right by any other person or
Persons’. This is a deliberate act to harm other especially vulnerable adults and children. It may be something that is done to the person or something not done when it should have been. It does not necessarily have to be intentional; if the vulnerable person experiences it as abuse then it is considered to be abuse. Abuse can take the form of:
Physical Abuse: physical abuse consists of anything one person does to another that causes physical pain. This includes slapping, punching, pushing, throwing objects at another person ,assaulting someone with an object, biting, exposure to electric shock, strangling, whipping and excessive punch to the body. Any physical contact has the potential to be seen as a form of physical abuse. Physical abuse may be carried out by care workers and family members. Physical harm may also be caused when a nurse is rough handling a patient in the process of turning him over in bed or when giving the service users personal care.
Neglect – Neglect typically means the refusal or failure to provide an elderly 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 elder. Neglect is when carers failed to provide proper care and attention to service users. Like not providing them with regular meals, clean clothes and personal hygiene. Neglect can take place in care homes, hospital, day care centers for children and learning disability for adults and the service users home. Neglect could be physical whereby there is failure to provide necessary food and shelter. It can also be medical (failure to provide medical treatment), educational (failure to educate child or attend to special education needs and emotional which is failure to provide psychological care.
Sexual Abuse: Sexual abuse is any sort of non-consensual sexual contact. Sexual abuse can happen to men or women of any age. Sexual abuse by a partner can include derogatory name calling, refusal to use contraception, deliberately causing unwanted physical pain during sex, deliberately passing on sexual diseases or infections and using objects, toys, or other items without consent and to cause pain or humiliation. Sexual abuse may result from inappropriate touching to rape. Sexual abuse can take place in the care homes, hospitals, nurseries, day care centres for learning disabilities and individual homes
Psychological Abuse: Psychological abuse occurs when one’s feelings, thoughts, preferences, desires, needs, appearance or friendships are worthless or made to appear unimportant to the abusers. This can also be seen as threat of harm or humiliation, blaming them that they are incapable, criticising and withdrawing them from services that will benefit them. This type of abuse can take place in care homes or closed psychiatric ward. It could take place between two service users or groups of established tenants in sheltered accommodation picking on new tenants when using communal lounges and facilities.
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Financial abuse Financial abuse is the misuse of an older adult's money or belongings by a relative or a person in a position of trust. Financial abuse can happen to any older adults. It can happen when the abuser really wants or needs money and he/she thinks that she has a right to the older person’s money or belongings. The abuser may gain access to an older person’s money by manipulation, threats, promising to care for the older person or being friendly. These always happen when the service users receive home care and support.
Institutional abuse is the failure of an organisation to protect clients from abuse by:
Tolerating or encouraging unprofessional behaviour between staff and not providing proper staff training or supervision. not properly meeting an individual’s needs Institutional abuse can sometimes happen in residential homes, nursing homes or hospitals when people are mistreated because of poor or inadequate care, neglect and poor practice that affect the whole of that service. Examples of institutional abuse is when a nurse or a Carer putting all service users to bed before sleeping time in order to ease their work load.
Domestic Violence: Domestic violence is any type of abusive behaviour by one partner that attempts to gain and maintain control over the other. Domestic violence is when one partner consciously tries to, or does, manipulate and dominate the other. It is about power and control. Domestic violence can take many forms including physical violence, sexual assault, emotional abuse or social or financial control. Abuse does not have to be physical or sexual to be domestic violence.
It can happen in all types of: relationships: gay, lesbian or heterosexual; monogamous, open or three-way; dating, new relationships or long-term; live in or not. And it happens across all communities, social classes, ages, cultural backgrounds and geographical areas.
Discriminatory Abuse: Discriminatory abuse is when someone picks on you or treats you unfairly because something about you is different, for example it may be: Your clothes, weight, race or skin colour, language, gender, sexuality, age and disability. For example a service user’s health and care needs may not be met because of her cultural or religious beliefs.
Signs and symptoms of abuse
Signs of physical abuse can include injuries such as bruising and burning. Scalding of the lower body and feet can be an indicator if someone has been put into a scalding hot bath, or scalding to mouth if they have been forced to drink a very hot drink. Wearing clothing that covers the body so that people would not notice the scar. The abusee will be withdrawn, fearful or develop anxious behaviour when they are around their abuser. The victim may suddenly and without explanation express a desire not to visit or receive visits from family or friends. The caregiver's refusal to allow visitors to see an elder alone is an indicator that abuse is going on.
Neglect: Signs and symptoms of neglect are always difficult to recognise. Some of the signs and symptoms could be insufficient food and water, poor grooming (e.g., overgrown fingernails and toenails, unclean hair, unshaven facial hair), unsuitable clothing for the weather, smell of urine or faeces on the person. Behaviour signs could be fear of being touched, changes in sleep patterns, sudden fear of bathing or toileting and sudden fear of a person or place.
Sexual Abuse: signs of sexual abuse on the victim could be bruises around the breasts and genitals area. The victim will be complaining of pain while urinating or having a bowel movement, or exhibiting symptoms of genital infections such as offensive odours, or symptoms of a sexually transmitted disease. Having unexplained periods of panic, which may be flashbacks from the abuse and also showing a sudden reluctance to be alone with a certain person. The victim may also develop discomfort when walking or sitting and blood stains to underclothes. A sexually abuse person may displays insecurity, loss of appetite, poor concentration, change in sleeping habits, unpredictable behaviour, uses obscene language, bed wetting which could lead to depression and withdrawer from certain activities.
Psychological Abuse: The signs and symptoms of psychological abuse are feeling of depression, withdrawal from social interactions, isolation from friends and family. The victim will find it hard to trust others and he/she will always feel nervous. Another symptom of psychological abuse is depression. Because psychological abuse creates anger, this anger is often turned inward and develops into depression.
Financial Abuse: This could be sudden changes in bank account or banking practice, including an unexplained withdrawal of large sums of money by a person accompanying the elder/dependent adult. One of the sign of financial abuse is when the service users is not allowed to spend money without agreement of a caregiver Another sign of financial abuse is when the victim failed to meet his/her financial obligation like paying bills.
Institutional abuse: this could be lack of consideration of dietary requirements for example not providing service users their choice of food ( a Muslim service user may prefer Halal Meal), service users could also be called inappropriate names, they might lack adequate physical care and loss of dignity evidence of abuse in more than one person. Individuals may appear unkempt, dirty, unusually subdued, have lack of aids to support daily life, anxiety and fear in the presence of social care workers and drowsiness.
Domestic Abuse: Recognizing the signs and symptoms of domestic violence begins by observing the behaviour of both the abuser and the person being abused. The abuser may appear overly controlling or coercive, attempting to answer all questions for the victim or isolating him or her from others. Some of the obvious signs could be facial scrapes, bruises, cuts, or fractures, loose tooth or arm scrapes. The abuser may also seek to isolate the victim from other people who may provide assistance.
Discriminatory abuse: Harassment, including unwelcome comments and gestures, jokes of a derogatory nature, offensive language, and the presence of offensive materials and graffiti all constitute discriminatory abuse. Bullying, including verbal abuse and comments about the person’s condition which are felt as insults are included as discriminatory abuse. It also encompasses exclusion, shunning of particular people or other differential treatment, including lack of attention to dietary needs, failure to provide suitable food and failure provide for cultural needs.
Factors that may lead to abusive situations are:
Lack of unemployment and finances can make a Carer feel frustrated and undervalued because there is little money to pay for their expenses and as a result they might see service users as a burden. This type of situation often leads to abuse or neglect of service users because the Carer will be worried about his or her financial problems instead of focusing or paying attention to the clients.
Lack of training: Neglect and abuse may result due to lack of adequate training of staffs about how to provide care to service users. Lack of training may cause risks or injury to service users. For example a Carer should be trained on how to use appropriate measures or techniques when attending to service users in health and social care settings.
Stress and Anxiety: Stress is a commonly used term. Stress may build up when the carer feel that the continuous and demanding role of caring does not always fulfilled the needs of the clients. This often result to anger, resentment and negative behaviour towards their clients
Residential care also has the potential of abuse especially if the vulnerable person has recently increased dependency, and disturbs the carer at night, or has become aggressive, possibly hitting out at the carer this may be a trigger point for abuse.
Short term effects of sexual abuse:
Short term effects can also be the indicators of sexual abuse. There are those which are evident at the time of the abuse or in days, weeks or months following an abuse. A sexually abused person may show some or many of the following symptoms. Some are clearly medical while some are emotional and behavioural.
Medical symptoms include venereal disease or infection, teenage pregnancy, vaginal or rectal bleeding, vaginal or rectal itching or soreness and recurrent urinary tracts infections.
Emotional or behavioural symptoms include many signs of distress; the individual will start to show a lot of fear about men in general, or a particular man or place. The person may seem unhappy and sad for no reason. She will be quiet, insecure and disinclined to mix with other people. Her personality can change suddenly and noticeably. She may swing from being happy and open to being quiet, withdrawn and secretive. Night behaviour and sleep patterns may change in various ways, like not wanting to sleep alone, starting to bed wet and frequently having nightmare.
Short term effects of domestic violence:
Women subjected to domestic violence may experience effects relating to the violence. The direct physical effect of domestic violence can range from minor scratches or bruises to fractured bones or sexually transmitted diseases resulting from sexual activity and other practices. The victims are often left powerless due to the fear or intimidation brought on by their abuser. They also suffer from depression and other psychological distress, such as eating disorders and low self-worth. In homes of domestic violence, the children are at a higher risk of becoming abused themselves. Battering becomes frequent during pregnancy and pregnant women living in domestic violence are twice as likely to suffer from miscarriages. The victim will find it difficult to establish trust in relationships. Some victims turn to alcohol to lessen the physical and emotional pain of the abuse.
Long term effects of sexual Abuse.
Long term effects usually occur as a result of the person who has been abused never having spoken about it or not being believed or helped with it. Some long term effects can be serious, where the woman in an effort to keep the memories blocked becomes very self destructive. Depression is a big problem for many women who have been abused and is caused by a combination of the short term effects mentioned. For some it is an anger turned in against themselves and it causes them to feel that life is not worth living, and may impel them towards taking their own lives.
A woman who has been abused may attempt to destroy herself through alcohol and substance abuse in an effort to escape the feelings she has about herself and her life. She may constantly suffer from nerves or have a very frightening panic attacks for no reason. The victim can be afraid of something for no reason like going outside the house or being in confined spaces, some victims switch from one phobia to the other. They are likely to develop an eating disorder, these include Anorexia and bulimia. Anorexia is starving to death and still feeling fat or ugly while Bulimia means eating huge amounts of food at the same time, then vomiting it afterwards. A service user who has been sexually abused will find it difficult to trust other people, particularly men. They always feel guilty about the sexual abuse because they believed that it must have been their fault. The victim of sexual abuse may block their emotions and feelings.
Sometimes women who have been abused continue to abuse themselves in various ways (self harm). They may feel so bad, hopeless and become self destructive in the way they live their lives.
Long term effects of Domestic violence: Many abused women will continue to struggle with the effects of the abuse they sustained for years or for the rest of their lives. Most of the physical injuries sustained by women from their abuse partners seem to cause medical difficulties as women grow older. Arthritis, hypertension and heart disease have been identified by abused women as directly caused by domestic violence early in their adult lives. Victims may experience physical injury such as, bruises, broken bones, head injuries, internal bleeding, chronic pelvic pain, abdominal and gastrointestinal complaints, frequent vaginal and urinary tract infections, sexually transmitted diseases, and HIV. In addition, abused women are at a greater risk to commit suicide.
Many battered women spend so much money on divorce in order to avoid further abuse and this could lead them to poverty. They often lose their jobs because of absenteeism due to injury or illness as a result of the violence.