ABUSE Child, Domestic Violence, and Elder Mistreatment

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ABUSEChild, Domestic Violence, and Elder
Mistreatment

• Updated 10/06
• All Clinical Staff

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ObjectivesAt the completion of this SLP, the
learner will be able to

• Recognize the national and Maryland statistics on
  Child, Elder, and Spousal abuse.
• Define what constitutes child, elder, and spousal
  abuse.
• Identify signs and symptoms indicating potential
  abuse.
• List staff responsibilities in managing suspected
  cases of abuse, with reference to hospital policy
  and procedure.
• Identify community resources that could be of
  assistance to potential abuse victims.
• Identify State requirements for reporting abuse.

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Child Abuse and neglect
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Incidence of Child Abuse

• There are an estimated 3 million cases of
  suspected child abuse or neglect each year.
• 2,000 or more children die yearly as a result of
  abuse or neglect.
• Only 50-60 of the children identified as harmed
  by abuse or neglect in 2004 were investigated by
  Child Protective Services.
• Child abuse occurs in all ethnic groups and
  transcends all socioeconomic levels and religious
  affiliations.

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Contributing Factors of Child Abuse and Neglect

• Family Factors
• marital conflict
• extended family contact
• domestic violence
• financial stress
• crisis in the abusers life

• Environmental Factors
• cultural attitudes
• economic pressures
• isolation from the community

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Contributing Factors of Child Abuse and Neglect

• Parent Factors
• Parents abused as children
• low self esteem
• child rearing skills
• unrealistic expectations
• immaturity and dependency
• lack of trust and empathy
• substance abuse

• Child Factors
• Age
• Behavior
• level of isolation

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CHILD ABUSE Physical Indicators

• multiple injuries in various stages of healing
• unexplained injuries, especially located in parts
  of the body not usually affected by normal
  childhood activity (eyes, mouth, neck, cheeks,
  lower back, genital area, buttocks, abdomen)
• repeated injuries, especially those where the
  shape of an object has left a visible mark
  (electrical cord, belt buckle, circular
  burns-such as a cigarette burn)

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Domestic Violence
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What Is Domestic Violence?

• Domestic violence is control by one partner over
  another in a dating, marital or live-in
  relationship. The means of control include
  physical, sexual, emotional and economic abuse,
  threats and isolation.

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Who Is Affected by Domestic Violence?

• Domestic violence occurs in every culture,
  country and age group. It affects people from all
  socioeconomic, educational and religious
  backgrounds and takes place in same sex as well
  as heterosexual relationships

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Early Signs of Abuse

• Quick whirlwind romance
• Jealousy at any perceived attention to or from
  others
• Hypersensitivity to perceived slights
• Pressures you into doing things you arent
  comfortable with If you really love me, youll
  do this for me

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How common is domestic abuse?

• According to a National Violence Against Women
  Survey, 22 of women are physically assaulted by
  a partner or date during their lifetime.
• Nearly 25 of women have been raped and/or
  physically assaulted by an intimate partner
  during their lives.

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What can you do if you are being abused?

• Talk with someone you trust a friend or
  relative, a neighbor, coworker or religious or
  spiritual advisor.
• Tell your physician, nurse, psychiatrist or
  therapist about the abuse.
• Call the National Domestic Violence Hotline
  1-800-799-SAFE (7233), your state domestic

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Recommended Questions for healthcare workers

• Are you in a relationship in which you have been
  physically hurt or threatened?
• Has your partner ever destroyed things you care
  about?
• Do you have guns in the house?

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Management of Domestic Violence

• Follow hospital policy 242
• Provide information about local organizations for
  assistance
• Believe her
• Tell her she is not alone
• Do not pass judgment
• National Domestic Violence Hotline
• 1-800-799-SAFE

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Elder Mistreatment and Abuse
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Types of Elder Mistreatment

• Physical Abuse acts of violence that may result
  in pain, injury, impairment, or disease
• Physical Neglect failure of the caregiver to
  provide the goods or services that are necessary
  for optimal functioning or to avoid harm

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Types of Elder Mistreatment

• Psychological (Emotional) Abuse Willful
  infliction of mental anguish or the provocation
  of fear of violence diminishes the identity,
  dignity, and self-worth of the person
• Psychological Neglect Failure to provide a
  dependent older adult with social stimulation

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Types of Elder Mistreatment

• Financial / Material Abuse Misuse of the older
  persons income or resources for the financial or
  personal gain of a caretaker or advisor
• Financial / Material neglect Failure to use
  available funds and resources necessary to
  sustain or restore the health and well-being of
  the older adult

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Types of Elder Mistreatment

• Violation of Personal Rights Ignoring the older
  persons rights and capability to make decisions
  for himself / herself
• Self-abuse or Self-neglect - It characterized as
  the behaviors of an elderly person that threaten
  his/her own health or safety.

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Indicators of Elder Mistreatment

• Physical Unexplained injuries
• Inconsistent explanations
• Welts, lacerations, fractures, burns, rope marks

• Psychological Excessive weight gain or loss
• Insomnia or excessive sleeping
• Signs of infantile behavior
• Expressions of ambivalent feelings toward
  caregivers or family members

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Interventions

• Coordinate with Social Worker on your unit
• If patient is willing to accept voluntary
  services
• Educate the patient
• Implement a safety plan
• Provide assistance that will alleviate causes of
  mistreatment
• Refer patient to appropriate services social
  work, counseling, legal assistance, and advocacy

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State Requirements

• Maryland Law requires that each health
  practitioner must report suspected abuse or
  neglect of a child or vulnerable adult
• A vulnerable adult is a person 18 or older who
  lacks the physical or mental capacity to provide
  for his or her daily needs.
• When reporting, you are protected from liability
  when acting in good faith

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