Abuse and Neglect

What is abuse?

    Abuse comes in many forms:

• Physical:  Intentional use of physical force resulting in pain or bodily harm
• Sexual:  Sexual contact or exposure without consent
• Psychological/Emotional:  Infliction of mental anguish, threat, humiliation, intimidation, isolation or abusive conduct
• Financial/Material:  Unauthorized use of money, property or other resources

What is neglect? 

There are two types of neglect:

1. Intentional: The conscious and deliberate attempt to inflict physical, emotional or financial harm
2. Unintentional: An inadvertent action that results in physical, emotional, or financial harm.  This is usually due to ignorance, inexperience, inability, or lack of desire to provide care.

Let’s look a little more closely at each form of abuse and neglect – what they are and how you recognize them.

Physical Abuse – what is it?

Slapping Kicking Grabbing Pinching Scratching Hair pulling Rough Handling

Too hot/too cold bath Forced feeding Forced movements         Mistreatment during care Improper use of restraints Chemical Restraint

Signs of physical abuse

• Bruises:  different stages of healing, handprint bruises
• Skin tears, welts, swelling
• Withdrawal, sudden change in behavior/mood, the story doesn’t match injury

Verbal Abuse – what is it?

1. Use of oral, written or gestured language that includes derogatory terms to the person involved
2. Describing a person’s characteristics or habits within hearing distance regardless of age or ability to understand

  Signs of verbal abuse:

• Easily startled
• Isolation
• Increase in argumentative behavior, name-calling
• Withdrawal from a particular person when present

Emotional/Psychological Abuse – what is it?

Threat of injury Humiliation Punishment

Verbal Intimidation Unreasonable Confinement Denial of food, privileges/rights

  Signs of emotional/psychological abuse:

Change in behavior/mood Fear, anxiety, stress New/unexplained depression Withdrawal

Anger/agitation Unprovoked crying Changes in sleep patterns Changes in eating patterns

Sexual Abuse – what is it?

• Sexual contact that results from threats, force or the inability of the person to give consent.
• Could include (but not limited to):
  • Rape
  • Harassment through improper language or jokes
  • Fondling
  • Inappropriate touching or exposure

  Signs of sexual abuse

• Pain when walking or sitting
• Bruising or pinch marks
• Infections
• Fear of receiving care by staff/specific sex staff
• Isolation

Financial Exploitation – what is it?

1. The improper course of conduct with or without consent, that results in monetary, personal or other benefits, gain or profit for the abuser
2. Temporary or permanent use of patient’s belongings or supplies with or without their consent

  Signs of financial exploitation:

• Missing money, possessions, etc.
• Patient report that things were borrowed by staff
• Food missing from the tray
• Tipping or gifts to staff

Neglect – what is it?

• Purposeful withholding of food/fluids/medication/treatment
• Ignoring call lights and call buttons not within reach
• Making patient wait for staff convenience
• Failure to follow infection control measures
• Failure to provide a safe environment
• Absence of supervision when needed
• Not sending children to school

Signs of Neglect

• Dehydration
• Pressure ulcers
• Loss of weight/malnutrition
• Malodorous or lice
• Symptoms over/under-medication
• Withdrawal/Change in behavior

If you see signs of abuse or neglect or have witnessed abuse or neglect, what should you do?

• You must report all incidences or suspicions of abuse/neglect to your manager or supervisor
• A full investigation will follow
• Mandatory reporting for all licensed staff in the state of Pennsylvania for suspected child abuse and elder abuse
• Report suspected cases of abuse/neglect related to pre-hospitalization to the care manager on the unit
• Call the Comply Line at 866-458-4864