Different Signs and Symptoms of Abuse: Raising Your Awareness
Abuse is the mistreatment of a service user by one or more people which violates the service user’s human rights. Abuse can take many forms, and the impact on the service user and their family can be disturbing. In this essay I will demonstrate how to provide information to others on signs and symptoms of abuse so they will know how and when they are facing with different kinds of abuse. Recognising the signs and symptoms of abuse or neglect and acting appropriately is the responsibility of all care workers. You must report your concerns to your manager. Never act outside the policies and procedures. You should not let emotions about the situation cloud your judgement. Your role is to support the service user and to remain professional. To support your service users properly when working in care, you will need to be resilient and set aside your thoughts and feelings about a particular situation. Be aware that sometimes you may see incidents of abuse or neglect that will distress you. Always ensure that you also get the support that you need to deal with the feelings or emotions that you may experience.
Physical abuse includes many aggressive acts such as hitting, punching, pushing or burning. Using medication in a way that it is not prescribed to pacify the service user is also abuse. Physical abuse also includes force-feeding, slapping or breaking bones by inappropriate movement, for example causing a fracture by forcing a service user’s arm into a sleeve awkwardly. You may see other carers pinching or poking or slapping a patient. Nothing is acceptable if it causes harm or distress to a service user who may not feel authorised to complain. You have a responsibility (duty of care) to report your concerns so that they are appropriately investigated. Always read a service user’s care plan before you start caring for them, so that you can confidently and professionally manage any unusual behaviour, such as a service user displaying aggression. Inappropriate reaction to this type of behaviour could leave you vulnerable to accusations of abuse.
Psychological abuse is caused by someone behaving in such a way as to cause psychological trauma. As a carer, you may notice a change in your service user. For example, they may become very anxious or depressed. They may be self-harming or deliberately placing themselves in high-risk situations such as running into busy traffic, expressing their emotional pain, or developing anorexia. An individual may be exposed to psychological abuse for a long time. Although it can be just as devastating as physical abuse, it may not be noticed for a long time without any apparent physical signs. Psychological abuse is the act of imposing emotional abuse, verbal abuse or humiliation. It includes name-calling and undermining someone’s confidence. Emotional abuse may include: threatening to withdraw affection if the person does not behave in a certain way or perform a particular action, acting inconsistently, sometimes being affectionate and sometimes not, to manipulate someone and leave them unsure of how to behave to get the affection back threat of punishment, saying hurtful things to gain control by reducing a person’s self-confidence or sense of self-worth. Verbal abuse may include: deliberately using language that a service user will find disrespectful, shouting or threatening a service user, criticising a service user in a way that makes them feel insecure, unsafe or lowers their self-esteem. Humiliation may include: belittling a service user in the presence of family, friends, other caregivers or even strangers, deliberately undermining a service user, intentionally embarrassing a service user by disclosing private information.
Sexual abuse is forcing a person to take part in sexual behaviour for which they have no desire. It does not have to include touching genitalia (private parts). Examples of non-touching sexual abuse include forcing a person to watch pornography, photographing them in sexual poses, forcing them to watch or listen to sexual acts or exposing genitalia to a person when they do not want to see them. Sexual harassment may be passed off as a joke by the perpetrator but may rapidly escalate into behaviour that is not only unprofessional but can also lead to emotional harm. Care workers often have to deliver personal care when the service user is naked. Service users may try to abuse carers by using suggestive language or by inappropriate touching. You must maintain your professionalism, remind the service user of what is and is not appropriate, and report such incidents to your line manager. You will need to use empathy to understand why people react in a certain way to their care needs. Find out how you can make them feel more secure and what you need to do to support them in their care needs not to get upset and potentially make accusations against you for sexual abuse. You must be aware of your behaviour at all times. You should not do or say things which may be misinterpreted. It is not acceptable for care workers to joke about or direct a sexual remark at a service user or another staff member in the presence of a service user. You must report any such activity to your manager for the matter to be dealt with. In severe cases, sexual harassment can lead to prosecution under the Equality Act as it is a form of discrimination. You need to be aware of the signs of sexual activity without consent for service users with complex needs as they may be unaware that abuse has occurred. A service user cannot consent to sexual activity if they are unconscious or cannot give informed consent.
Financial abuse is a type of theft. It is another name for stealing money or valuables from a service user or defrauding them of their money or property. Often the people who cheat vulnerable service users of their property or inheritance are considered ‘friends’ by the service user. They can be very close to or get very close to the service user; they may have the power of a lawyer or steal a service user’s bank details or property. You may notice that small objects of high value, such as jewellery, are missing. If there is a cause for concern, then you must report this to your manager. Financial abuse is a crime and should always be investigated. However, some service users are reluctant to press charges when they are financially abused by a relative or their primary carer. It is often a complicated issue to address because the service user may assume that they have made a mistake or may be perceived as unreliable witnesses because of their vulnerability. As a care worker, you should try to ensure that vulnerable people do not fall victim to scams and ‘Get rich quick’ schemes and that someone is not trying to defraud them of their property or inheritance. Many elderly or vulnerable people are victims of cybercrime or literature received through the post asking for upfront payments, such as retrieving a jackpot prize or requesting bank details. It would be best if you alerted your service users to the dangers of these scams. As a care worker, you are also vulnerable to accusations of financial abuse. If a service user asks you to take money out of their purse or wallet to ‘Buy yourself something nice for being so kind’, always refuse politely. Remember that you are just doing your job. If they forget that they told you to take the money, or they later deny it, you will have no defence.
Domestic abuse can be defined as an incident or several incidents. A person is subjected to behaviours that control, scare, threaten, or persuade them to do something against their will. The government definition for domestic abuse “It occurs between people who are over 16 and are, or have been, intimate or are, or have been, a family”. It can also happen between people who live at the same address. Domestic abuse may take the form of physical, sexual, financial or emotional abuse. Controlling behaviours are now recognised as abusive within domestic relationships, such as in a relationship where someone tries to dominate another person by only allowing them to go to certain places or see certain people. They may also try to manipulate the other person by threatening violence. For example, a service user may feel forced into handing over money because they are threatened with violence, although they have never actually been hit. You will need to be aware, as a care worker, that some service users may feel too intimidated to seek help. There are some practical steps that you can take: do not be critical, the service user needs to be supported not judged, report your concerns to your line manager, make sure your concerns are recorded and sign the documentation appropriate to your workplace, never promise the service user that you will keep it a secret
Signs of abuse and neglect: As a care worker, you are in an excellent position to note changes in a service user’s physical appearance. There are many vital physical indicators of neglect: messy appearance, unexplained weight loss, ulcers, especially to the legs.
Signs of physical abuse: You may think that you have identified signs of physical neglect such as bruises, but are concerned that there may be an innocent explanation and that you are making a fuss. Older adults tend to bruise very easily. Poor manual handling techniques are a form of neglect. If you see ‘finger mark bruises’ or marks to parts of the body that are not usually touched when supporting a service user in their daily living activities, for example on the face, neck or feet, this could be a sign of abuse. You should document any bruises that you notice and report this to your manager immediately.
Signs of psychological abuse: Psychological abuse can change a service user’s behaviour in a way that you might notice. For example, they may become anxious or withdrawn, perhaps they are chatty and then stop abruptly in the presence of their abuser, or they may cry a lot. There is not necessarily one definitive sign that will show you that your service user is being abused; you are looking for a change in behaviour, particularly an unexplained change. It can be difficult to see, and some service users will try hard to cover up what is happening to them.
Signs of sexual abuse: As a carer, you must be aware of the signs of sexual abuse such as bruising or bleeding around the anal or genital areas, or the symptoms of sexually transmitted infections or pregnancy. If you observe any of these signs or symptoms, you must report them to your line manager. Preserve any evidence, such as blood or semen-stained underwear. Remember to be compassionate and respect the dignity of your service user.
Signs of financial abuse: Anyone can perpetrate financial abuse that the service user trusts with their financial information. Vulnerable adults are statistically more likely to be subject to financial abuse than other members of society. They are often targeted by people who want to take advantage of their intellectual or emotional vulnerability. The individual targeted is then manipulated into thinking that they are not being exploited. As a carer, you may see that valuable items are missing from the service user’s home or that the service user is short of money. Even a small loss can have a significant impact on the service user’s welfare. They may be left unable to pay for the services they need or cannot pay their rent or household bills. The service user may also suffer the range of emotions usually associated with being the robbery victim.
Signs of discriminatory practice: Discrimination is treating someone less favourably because of a perceived difference. It can lead others to behave in a similarly discriminatory manner leaving the subject of this kind of abuse feeling targeted, helpless or vulnerable. Anyone can be the object of discrimination. It may take the form of sexual harassment, bullying or racism and lead to the person discriminated against being subjected to denial of choice about their care, or even what care is offered to them, denial of privacy and dignity, and maybe of personal belongings, punishments, such as being denied food and drink, refusal of access to services, denial of disabled access or even being excluded from care settings inappropriately. Being discriminated against can lead to a range of feelings ranging from anger and frustration to being withdrawn, anxious or having low self-esteem. It would be best if you advocated for your service users who are subjected to discriminatory practices.
In conclusion, as a care worker, it is essential that you are aware of the different types of discrimination and can recognise them when you see them. People can be discriminated against on many other grounds, including age, gender, race, culture, religion, ability and sexual orientation.
