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4. Report problems. Legal and ethical

10. Child protection

10.3. Abuse and indicators

Now look at some of the more specific signs (select each title to read more).

  • a person discloses the abuse
  • evidence of physical injury that would not likely be the result of an accident
  • bruises or burns on body areas
  • bone fractures
  • cuts or grazes
  • multiple injuries (old and new). 
Reference: Identify signs of child abuse, Victorian Government. 

  • threatening, bullying or controlling behaviour from family members 
  • dementia-like behaviour from consumer which is not in keeping with their previous behaviour
  • increased or new self-harm or self-abusive behaviours
  • increased challenging/extreme behaviours
  • clinical depression or fearfulness
  • seemingly  decreased  interpersonal skills
  • unusual attention-seeking behaviour
  • feelings of helplessness
  • insomnia
  • unusual passivity or anger.
Sexual abuse is undesired sexual behaviour from one person towards another which usually involves force or taking advantage of a position of power to coerce the other person using intimidation.  This can involve a range of physical or non-contact sexual activity.

Reference: What is the definition of abuse? Slater and Gordon Lawyers. 

  • a person discloses the abuse
  • injury to genital areas or to other areas of the body
  • fear or wariness of a person
  • changes in sleeping patterns
  • changes in behaviour: withdrawn, passive, aggressive, destructive.
Reference: Identify signs of child abuse, Victorian Government. 

Neglect is the continued failure to provide a person with the basic necessities of life such as food, clothing, shelter, hygiene, medical attention or adequate supervision, to the extent that the health, safety or development of the person is impacted.

Indicators of neglect
  • a person discloses harm that is believable, realistic and plausible
  • malnutrition
  • untreated injury, illness or other medical conditions
  • unattended health problems and lack of routine medical care
  • homeless and/or does not have a safe and fixed address
  • inadequate shelter and unsafe or unsanitary conditions
  • abnormally high appetite, stealing and/or hoarding and/or gorging food
  • consistently poor hygiene (oral, hair, toileting and/or menses), malodourous, dirty and unwashed
  • consistently inappropriately dressed for weather conditions.
Reference: Indicators of abuse or neglect, Child Protection SA 

Indicators of healthcare fraud
  • duplicate medical bills
  • evidence of over/under- medication
  • evidence of inadequate care pertaining to the amount paid
  • problems in the care facility.

Financial abuse is a type of family violence is when one person uses power and control over another. Withholding money, controlling the household spending or refusing to include you in financial decisions can be defined as family violence. Financial abuse can be present with other forms of abuse, like physical or emotional abuse, but can also be present without these other behaviours.

Reference:Financial abuse, Wire 

Indicators of financial abuse
  • a person discloses the abuse
  • a person controls access of another person to money 
  • a person has little money to spend
  • a person uses another person’s money without their knowledge or consent
  • a person forges or forces a person to sign legal documents.

Reference: Financial abuse, MoneySmart. 

Exploitation is a form of abuse where offenders use power over another person to abuse them. 

Indicators of exploitation
  • a person discloses the exploitation
  • changes in behaviour
  • unexplained gifts or new possessions
  • drug and alcohol abuse
  • secretive, inappropriate behaviour
  • unexplained injuries.

Reference: Child exploitation, Newham London 


Important

Clients living with impaired cognitive or physical function are especially vulnerable to abuse and neglect. As an healthcare worker, you are in a good position to identify changes that may suggest a client is being abused or neglected. Be observant and aware. Abuse can be physical, psychological, emotional, sexual, and financial. Neglect is the failure to meet the needs of the client.