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:
- Intentional: The conscious and deliberate attempt to inflict physical, emotional or financial harm
- 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
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- Too hot/too cold bath
- Forced feeding
- Forced movements
- Mistreatment during care
- Improper use of restraints
- Chemical Restraint
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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?
- Use of oral, written or gestured language that includes derogatory terms to the person involved
- 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
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- Verbal Intimidation
- Unreasonable Confinement
- Denial of food, privileges/rights
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Signs of emotional/psychological abuse:
- Change in
behavior/mood
- Fear, anxiety, stress
- New/unexplained depression
- Withdrawal
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- Anger/agitation
- Unprovoked crying
- Changes in sleep patterns
- Changes in eating patterns
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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?
- The improper course of conduct with or without consent, that results in monetary, personal or other benefits, gain or profit for the abuser
- 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