Types of Abuse

As an Art Therapist I work with people who have experienced abuse in various forms

The list of the types of abuse are below. The following list may be indicators of different problems, not necessarily abuse.

Physical

Physical injuries can occur where there is no satisfactory explanation, definite knowledge, or a reasonable suspicion that injury was inflicted with intent, caused through lack of care by the person having custody, charge or care of that person.

Indicators of physical abuse

History of unexplained falls
Unexplained bruising - in well protected areas or soft parts of the body
Bruising in different stages of healing
Unexplained burns - unusual location / type
Unexplained fractures to any part of the body
Unexplained lacerations or abrasions
Slap, kick, punch or finger marks
Injury shape similar to an object
Untreated medical problems
Weight loss due to malnutrition or dehydration

Emotional

This can include intimidation, humiliation, shouting, swearing, emotional blackmail and denial of basic human rights. Using racist language, preventing someone from enjoying activities or meeting friends.

Psychological or emotional indicators

Ambivalence about carer
Fearfulness, avoiding eye contact, flinching on approach
Deference
Insomnia or need for excessive sleep
Change in appetite
Unusual weight loss / gain
Tearfulness
Unexplained paranoia
Low self esteem
Confusion, agitation
Coercion
Possible violation of human and civil rights
Distress caused by being locked in a home or car etc.
Isolation - no visitors or phone calls allowed
Inappropriate clothing
Sensory deprivation
Restricted access to hygiene facilities
Lack of personal respect
Lack of recognition of individuals rights
Carer does not offer personal hygiene, medical care, regular food/drinks
Use of furniture to restrict movement

Financial

Financial or material abuse can take the form of fraud, theft or using of the vulnerable adults property without their permission. This could involve large sums of money or just small amounts from a pension or allowance each week.

Material or financial

Sudden inability to pay bills
Sudden withdrawal of money from an account
Person lacks belongings that they can clearly afford
Lack of receptivity by the persons relatives to necessary expenditure
Power of attorney obtained when the person is unable to understand what they are signing
Extraordinary interest by family members in the vulnerable adults assets
Recent change of deeds o the house
Carers main interest is financial with little regard for the health and welfare of the vulnerable adult
The person managing the finances is evasive and uncooperative
Reluctance to accept care services
Purchase of items that the individual does not require or use
Personal items going missing
Unreasonable or inappropriate gifts

Sexual

Sexual abuse is the involvement of vulnerable adults in sexual activities, which they do not fully comprehend, to which they are unable to give consent, either verbally or by their behaviour, to which they object or which may cause them harm.

Sudden change in behaviour
Sudden onset of confusion
Incontinence
Withdrawal
Overt sexual behaviour / language by the vulnerable adult
Self inflicted injury
Disturbed sleep pattern / poor concentration
Difficulty in walking
Torn, stained underwear
Love bites
Pain or itching, bruising or bleeding in the genital area
Sexually transmitted disease / urinary tract / vaginal infection
Bruising to upper thighs and arms
Frequent infection
Severe upset or agitation when being bathed etc.
Pregnancy in a person unable to consent

Neglect

A person can suffer because their physical and/or psychological (emotional) needs are being neglected by a carer. This could include failure to keep someone warm, clean and well nourished or neglecting to give prescribed medication.

Poor environmental conditions
Inadequate heating and lighting
Poor physical condition of the vulnerable adult
Persons clothing is ill fitting, unclean and in poor condition
Malnutrition
Failure to give prescribed medication properly
Failure to provide appropriate privacy and dignity
Inconsistent or reluctant contact with health and social care agencies
Isolation - denying access to callers or visitors

Institutional

Institutional abuse is different from other categories because it is about who abuses and how that abuse comes to pass, rather than about types of harm. Abuse occurs in a relationship, family, service or institution and it can be perpetrated by an individual or more collectively, by a regime.

No flexibility in bed time routine and/or deliberate waking
People left on the commode or toilet for long periods of time
Inappropriate care of possessions, clothing and living area
Lack of personal clothes and belongings
Un-homely or stark living environments
Deprived environmental conditions and lack of stimulation
Inappropriate use of medical procedures e.g. enemas, catheterisation
'Batch care' - lack of individual care programmes
Illegal confinement or restrictions
Inappropriate use of power or control
People referred to, or spoken to with disrespect
Inflexible services based, on convenience of the provider rather than the person receiving services
Inappropriate physical intervention
Service user removed from the home or establishment, without discussion with other appropriate people or agencies, because staff are unable to manage the behaviours