What is abuse?

What is abuse?
What is safeguarding?
Types of abuse
Recognising abuse

Abuse is a violation of an individual’s human and civil rights by anybody else. It may consist of a single act or repeated acts. It can be intentional or unintentional and can result from a lack of knowledge.

It includes:

  • physical abuse
  • sexual abuse
  • psychological abuse;
  • financial or material abuse;
  • neglect and acts of omission; 
  • discriminatory abuse
  • organisational abuse;
  • fabricated or Induced Illness

 A vulnerable adult is a person who:

  • Has needs for care and support (whether or not  the local authority is meeting any of those needs) 
  • is experiencing, or at risk of, abuse or neglect
  • as a result of those care and support needs is unable to protect themselves from either the risk of, or the experience of abuse or neglect

 An Individual who receives Sense services may be identified under the Care Act as a vulnerable adult.  Sense recognises the increased vulnerability of adults who are:

  • completely deaf and completely blind;
  • have extremely limited / no verbal communication;
  • have limited / no external representation;
  • have limited / no knowledge of keeping safe.
  • have limited mobility

Information on ‘What is Abuse?’

There are various versions produced by different organisations that are aimed at providing information to vulnerable individuals with information on what is abuse. These can be readily found on the internet.

The examples in the download below have been adapted from – ‘Safeguarding Adults with Learning Disabilities’ – Published by Department of Health/CSIP/Valuing People Support Team/University of Hull – October 2007, and have been adapted to reflect the reporting contacts at Sense.

What Is Abuse and Who Do I Tell - Easy Read (PDF, 126KB)
What Is Abuse and Who Do I Tell - Widget (PDF, 745KB)

What is Safeguarding?

Safeguarding means protecting an adult’s right to live in safety, free from abuse and neglect. It is about Sense, staff and external professionals and agencies working together to prevent and stop both the risks and experience of abuse and neglect. 

At the same time making sure that the adult’s wellbeing is promoted including, where appropriate, having regard to their views, wishes, feelings and beliefs in deciding on any action.  

Sense staff must recognise that adults sometimes have complex interpersonal relationships and may be ambivalent, unclear or unrealistic about their personal circumstances. 

Types of abuse

Physical abuse includes assault, hitting, slapping, pushing, kicking, and misuse of medication, restraint, or inappropriate physical sanctions.  

Domestic Abuse includes psychological, physical, sexual, financial, emotional abuse; so called ‘honour’ based violence. 

Sexual abuse includes rape, indecent exposure, sexual harassment, inappropriate looking or touching, sexual teasing or innuendo, sexual photography, subjection to pornography or witnessing sexual acts, indecent exposure and sexual assault or sexual acts to which the adult has not consented or was pressured into consenting.

Psychological abuse includes emotional abuse (e.g. saying something to deliberately make a service user feel upset), threats of harm or abandonment, deprivation of contact, humiliation, blaming, controlling, intimidation, coercion, harassment, verbal abuse, isolation or unreasonable and unjustified withdrawal of services or supportive networks. Also, acts deemed to be punitive (punishing) and not in line with agreed behaviour guidelines.  Withholding aids and equipment.

Financial or material abuse includes theft, fraud, internet scamming, coercion in relation to adults’ financial affairs or arrangements, including exploitation, pressure in connection with wills, property or inheritance or financial transactions, or the misuse or misappropriation of property, possessions or benefits.  This includes identify theft.

Neglect and acts of omission includes ignoring medical, emotional or physical care needs, failure to provide access to appropriate health, social care support or educational services, the withholding of the necessities of life, such as medication, adequate nutrition and heating and withholding aids and equipment.

Discriminatory abuse includes forms of harassment, slurs or similar treatment; because of race, gender and gender identity, age, disability, sexual orientation or religion. 

Further types of abuse include:

Organisational abuse can include any of the above types of abuse.  Institutional abuse occurs where the procedures and practices of an organisation lead to abuse.  For example, systematic and repeated failures that are culturally inherent to the organisation - for example, a collective failure within an organisation to take action on safeguarding incidents.

Self – neglect covers a wide range of behaviour neglecting to care for one’s personal hygiene, health or surroundings and includes behaviour such as hoarding. 

Fabricated or induced illness (FII).  This is when a carer fabricates signs or symptoms of illness and can include falsification of past medical history.  It also refers to when a carer induces an illness (by a variety of means).  These cases can be extremely complex.

Additional Areas of Abuse

Cyber-Bullying: Cyber bullying takes place online, on social networking websites or through mobile phones.  Adults are threatened, teased, upset or humiliated. It can happen on its own or with other forms of bullying. The signs of cyber bullying are not always obvious. It can happen 24 hours a day, seven days a week and can continue even when an adult is alone, causing them to feel trapped and unable to escape. 

Cyber bullying is a growing problem and includes: 

  • Sending threatening or disturbing text messages 
  • Homophobia, racism or sexism 
  • Making silent, hoax or abusive calls 
  • Creating and sharing embarrassing images or videos 
  • Trolling: the sending of menacing or upsetting messages on social networks, chat rooms or online games 
  • Excluding adults from online games, activities or friendship groups
  • Setting up hate sites or groups about a particular adult
  • Encouraging adults to self harm
  • Voting for someone in an abusive poll 
  • Hijacking or stealing online identities to embarrass an adult or cause trouble using their name 
  • Sending texts to pressure an adult into sending images or other activity 

Note: Adults may be bullied by someone they know or someone using a fake account to remain anonymous. 

Hate Crime: Involves any criminal offence which is perceived, by the victim or any other person, to be motivated by hostility or prejudice based on a personal characteristic. Hate crime can be motivated by disability, gender identity, race, religion or faith and sexual orientation. 

Forced Marriage: A forced marriage is a marriage without the full consent of both parties and where pressure or threats are a factor. This is very different to an arranged marriage, which both people will have agreed to. Emotional pressure from their family might stop them from saying anything to anyone else. The lack of control over their own decisions can lead them to depression and self – harm. 

A forced marriage is where one or both people do not (or in cases of people with learning disabilities, cannot) consent to the marriage and pressure or abuse is used. It is an appalling and indefensible practice and is recognised in the UK as a form of violence against women and men, domestic/child abuse and a serious abuse of human rights. 

The pressure put on people to marry against their will can be physical (including threats, actual physical violence and sexual violence) or emotional and psychological (for example, when someone is made to feel like they’re bringing shame on their family). Financial abuse (taking your wages or not giving you any money) can also be a factor. 

If there are concerns that a child, male or female, is in danger of a forced marriage, you should discuss this with you manager in the first instance. Local agencies and professional workers should contact the Forced Marriage Unit or call 020 7008 0230 where experienced case workers will be able to offer support and guidance. If they are closed, contact the Foreign Office Response Centre or call 020 7008 1500. If someone is in immediate danger than call police on 999. 

Female genital mutilation (FGM): FGM is recognized internationally as a violation of the human rights of girls and women.

Female genital mutilation (FGM) comprises all procedures that involve partial or total removal of the external female genitalia, or other injury to the female genital organs for non-medical reasons. 

Further details.  

Recognising Abuse

Recognising indicators of potential abuse is complex and there is no simple checklist to allow for easy recognition.

There is a need to balance requirements for vigilance and awareness of the issues with the need to offer people a variety of developmental and ordinary life experiences.

Personal knowledge of the deafblind person is the most important factor in recognising changes to usual behaviour(s). There are potential warning signs that can act as alerts but they should be observed and assessed with care.

People react to abuse in different ways:

  • some people can deny that anything is wrong 
  • some people may accept what is happening - sometimes people accept incidents as being part of being old or vulnerable, or they may feel ashamed and believe that what has happened is their fault

Danger signs

The indicators given here are possible signs of abuse. It is important to remember that no single sign should be regarded as proof and the list is intended to assist rather than alarm.

Cause for Concern?

It is important to remember that not all situations that are causes for concern are abusive.

  • Some causes for concern are clearly abusive and need immediate action
  • Some causes for concern need further investigation in order to make a judgement about whether or not it is abusive
  • Some causes for concern need intervention in the form of support or education for those concerned

Always a cause for concern:

  • A deafblind child or adult becomes unusually distressed or agitated in a particular person’s presence
  • A member of staff, a volunteer or a parent asks you to lie about a situation involving a vulnerable adult or child - particularly if that individual appears distressed
  • A member of staff, a volunteer or a parent asks a deafblind person to lie about anything (especially if it is about meeting that individual)
  • Private unauthorised meetings between the deafblind child or adult and a member of staff or volunteer outside of work

Finding out about abuse

There are many ways in which you may become aware that abuse may be occurring.  If someone tells you about it this is known as disclosure:

  • you may be told by the person themselves
  • the person may make a chance/ throw away remark, rather than tell you directly
  • the person who is abusing or neglecting the vulnerable adult or child may tell you
  • another person may tell you about it

You may also see signs and symptoms of abuse - or indicators. These are only indicators - individually they do not mean that abuse is definitely occurring. Some signs may indicate that more than one type of abuse is occurring.

There are three main types of indicator:

1. Physical Indicators

(Also referred to as medical/forensic indicators)
You may observe physical indicators of abuse such as:

  • bruises - especially bruises with a specific shape (such as a hand or belt buckle) in areas that do not normally get bruised easily or finger bruising on upper arms
  • injuries
  • urinary infections
  • vaginal infections or sexually transmitted diseases
  • anal dilation
  • nausea and vomiting

You may also see other indicators linked to emotional distress such as:

  • bed wetting
  • urinary incontinence
  • changes in appetite
  • self harm

2. Behavioural Indicators

The people who use our service may find it difficult to express how they feel. You may see sudden / repeated / unexplained changes in behaviour and inappropriate attachments.

The person may:

  • withdraw from activities, communication and participation
  • seem frightened or confused
  • seem angry and they may have physical/verbal outbursts
  • seek attention and/ or protection, often from numerous or unlikely sources such as strangers
  • have nightmares
  • become distressed around a particular member of staff
  • exhibit inappropriate sexual activity

3. Circumstantial Indicators

There may be circumstantial indicators of abuse, for example:

  • an individual having no or little money available
  • torn or bloody clothing
  • talking or boasting about sex
  • loss of independent living skills

Other indicators may include:

  • not getting enough help with feeding leading to malnourishment
  • poor toileting arrangements
  • lack of stimulation
  • unjustified and / or excessive use of restraint
  • rough handling, extreme behaviour modification e.g. deprivation of liquid, medication, food or clothing
  • unwillingness to try to learn the person’s means of communication
  • ill-fitting equipment

 

First published: Tuesday 7 April 2015
Updated: Wednesday 13 January 2016