P1- Describe forms of abuse which may be experienced by adults.

P2- Describe indicators that abuse may be happening to adults.

Types of Abuse, the Definition of the Abuse, Example of the Abuse and Indicators
Of The Abuse.
Physical
: Physical abuse is abuse involving contact intended to cause
feelings of intimidation, injury, or other physical suffering or bodily harm.
Striking, punching, pushing, pulling, slapping, biting, whipping, striking with an
object, kicking, tripping, kneeing, strangling, rape, placing in stress positions
(tied or otherwise forced) and withholding food or medication.
Injuries
(bruises, lacerations, cuts, burns, bite marks, fractures, etc.), drug/alcohol
misuse, depression, isolation, self-harming, suicidal, nightmares/flashbacks, low
self-esteem, low confidence, fear, panic attacks, and mistrust.
Domestic: Domestic abuse is the abuse of an individual within an intimate or
family relationship. It is the repeated, random and habitual use of intimidation to
control a person. This abuse can be physical, emotional, psychological, financial
or sexual. This can include hitting, kicking, biting, shoving, restraining, slapping,
throwing objects, threats, controlling or domineering behaviour, intimidation and
stalking. Physical injuries, depression, anxiety, nightmares/flashbacks, fear, panic
attacks, anger confusion, low self-esteem, lack of confidence, mistrust, suicidal,
shame and difficulty to establish trust in new relationships.
Discriminatory: Discriminatory abuse involves picking on or treating someone
unfairly because something about them is different, for example it may be: age,
clothing or appearance, ethnicity, nationality or culture including traits like
language, gender, health (such as AIDS) or disability (i.e. mental disorders),
lifestyle or occupation, race or skin colour, religion or political affiliation,
sexuality and sexual orientation, social class, or weight and height.
Discriminatory abuse may include: Racist comments, sexist comments, verbal
abuse or harassment on the basis of a disability, comments or harassment on
the basis of sexual preference, age discrimination, race discrimination and
discrimination of a persons beliefs or religion. A person is overly concerned
about race, sexual preference, a person tries to be more like others, a person is
overly critical/anxious about these areas, and a person is made to dress
differently.
Sexual: Sexual abuse is any sort of non-consensual sexual contact. Forcing
someone into sexual activity without his or her consent, Sexualised language or
conversation, inappropriate touching, kissing, fondling, exposure, Inflicting
pornography on someone, rape and Penetrating someone's mouth/anus/vagina
(with finger, penis or other object).
Physical injuries, isolation, depression, self
harm, sexual infections, nightmares, mistrust, anxiety, low self-esteem,
avoidance of sexual intimacy and feeling suicidal.
Financial: Financial abuse is a form of mistreatment in which an abuser forcibly
controls a victims economic means. It can involve stealing money, not allowing a
victim to take part in any financial decisions, or preventing a victim from having
a job. Financial abuse includes: taking money or property, forging a person's
signature, getting someone to sign a deed, will, or power of attorney through
deception, coercion, or undue influence, using a person's property or possessions
without permission, confidence crimes (cons) are the use of deception to gain
victims' confidence, scams are fraudulent or deceptive acts, fraud is the use of

deception, trickery, false pretence, or dishonest acts or statements for financial

gain, telemarketing scams and using a persons credit cards without
authorization. Stress, depression, unpaid bills, eviction notices, or notices to
discontinue utilities, withdrawals from bank accounts or transfers between
accounts that cannot be explained, unusual activity in a person's bank accounts
including large, unexplained withdrawals, frequent transfers between accounts,
or ATM withdrawal, belongings or property are missing, suspicious signatures on
checks or other documents, and absence of documentation about financial
arrangements.
Bullying
: Bullying is when someone keeps doing or saying things to have
power over another person. This can include many different types of abuse.
Physical assault, ridiculing, cyber bullying, name calling- psychological
abuse, threatening, intimidating. Fear, reduced socialisation, isolation,
depression, self harming, suicidal and avoidance of certain situations.
Psychological: psychological abuse also referred to as emotional abuse or mental
abuse includes a range of non-physical controlling behaviours that cause
emotional damage and undermine a persons sense of well-being. Telling
someone they are worthless, telling them no one else wants them, forcing
someone to do things at an exact time or in an exact way, undermining a
persons actions, thought and beliefs, making someone believe they are mad,
telling someone that the domestic violence and abuse is their fault, not allowing
someone to have visitors, controlling who a person is friends with, not allowing
them to go out, and locking someone in a room or house. Isolation, depression,
anxiety, fear of failure, overly high standards, fears consequences of actions
-often leading to lying, extreme withdrawal or aggressiveness, mood swings,
extreme attention-seeking behaviours, poor peer relationships, self- harming,
suicidal, and runaway attempts.
Self-harm: Self-harm is defined as the intentional, direct injuring of body tissue
most often done without suicidal intentions. It can take a variety of forms, and be
undertaken for a variety of reasons. It is most visible in young adults and
adolescents, but it may affect people of any age. Self inflicted cuts on the
forearms/wrists, burns, bruising. Unexplainable physical damage, isolation,
depression, low self-esteem, lack of confidence, withdrawal from socialising,
alcohol/drug abuse, suicidal and also some forms of self-harm have been related
to eating disorders such as anorexia and bulimia.
Neglect: Neglect is a passive form of abuse in which the perpetrator is
responsible to provide care for a person who is unable to care for oneself, but
fails to provide adequate care to meet a persons needs, thereby resulting in a
persons demise. Neglect can include: ignoring medical or physical care needs,
failure to provide access to appropriate health, social care or educational
services, the withholding of the necessities of life, such as medication, adequate
nutrition and heating. Malnutrition, rid or continuous weight loss, not having
access to necessary physical aides, inadequate or inappropriate clothing,
untreated medical problems, dirty clothing/bedding, Lack of personal care.
Institutional: Institutional abuse can typically occur in a care home, nursing
home, acute hospital or in-patient setting and can be any of the following:
discriminatory abuse, financial abuse, neglect, physical abuse, psychological and
emotional abuse and sexual abuse. Unsatisfactory living conditions, ignoring
medical or physical care needs poor care standards, dirty clothes, soiled bedding,

and physical injuries. Decline in social activity, withdrawn, poor appearance,

mood swings, depression, lowered self-esteem, low confidence, inadequate
staffing and an insufficient knowledge base within the service and rigid routines.
P3 - Explain factors that may lead to abusive situations
Abuse is hurtful mistreatment of other people. It may include physical, sexual, or
emotional mistreatment of children or adults. There is no single cause for
abusive behaviour, but there are many factors that seem to make it likelier that
an adult will abuse others. Growing up in an abusive family is one contributing
factor. Other factors include:

Alcohol or substance abuse that leads to loss of self-control

Unemployment, lack of education, discrimination, and other factors that

cause financial difficulties

Marital problems

Undiagnosed mental illness

Antisocial personality disorder that leads the abuser to disregard the rights
of others
Family violence may lead to "learned helplessness," a form of passivity and
hopelessness that people experience when they believe that abuse is an
inevitable and inescapable part of their lives. Shelters often offer counselling and
therapy to help battered women learn how to overcome learned helplessness
and escape from abusive situations.
Stock Boston

Lack of coping skills to deal with anger and impulsive behaviour

Lack of coping skills to deal with stressful situations, such as the care of a
disabled child or a dependent elder.
Abusers often want to deny the seriousness of the problem, evade responsibility
for their own abusive behaviour, and shift blame to the other person. Abusers
may say that the person being abused was "asking for it," but abuse is not the
fault of the child or adult who has been abused. No one "deserves" to be abused
or neglected.
Emotional Abuse
Abuse does not always cause bruises that one can see. Emotional abuse targets
the feelings and spirit of the person being abused, instead of the body. Forms of
verbal and emotional abuse may include repeated name calling, hurtful ridicule
(RI-di-kyool), harsh criticism, cruel and disrespectful words, bullying, and threats
of violence or harm. Emotional abuse can have serious long-term consequences:
1.
It may damage a developing child's sense of self-esteem.
2.
It may make it difficult for a child to make friends.
3.
It may make it difficult for a child to concentrate on schoolwork.
4.
It may make a child cautious or fearful about his or her safety, even in
safe surroundings and situations.
5.
It may make a child seem too grown-up in behaviour.
6.
It may be contribute to feelings of depression, hopelessness, and anger.
When verbal abuse includes threats of violence, it may indicate that physical
abuse and sexual abuse also are occurring.
Learned Helplessness
"Why doesn't she just leave him?" observers often wonder when they become
aware of family violence. The answer most likely is what psychologist and

researcher Martin Seligman and his colleagues call "learned helplessness," a

form of passivity and hopelessness that people experience when they come to
believe that abuse and violence are inevitable and inescapable components of
their lives. People who experience violence regularly may give up trying to avoid
or escape that violence. They may become passive and unable to create safety
for themselves or their families.
In her work on battered wives, psychologist Lenore Walker discovered that these
women often remain with battering husbands because of learned helplessness.
She found that battered wives who had learned to be helpless and passive
needed counselling and therapy before they could learn how to escape from the
abusive situation. Even if abused partners want to leave their abusers, leaving
may not be an easy option. The abusing partner may increase the level of
violence if the abused partner tries to leave the home. The abusing partner also
may forbid contact with friends, neighbours, or in-laws; may withhold money or
car keys; may stalk the abused partner; or may threaten children or pets.
Physical Abuse: Physical abuse affects the body as well as the head, heart, and
spirit. Physical abuse may include a pattern of hitting, kicking, pushing, shoving,
shaking, spanking, and harsh physical punishment. It may cause bruising or
more serious injury, and even if it is called "tough love," it is in fact a form of
violence. Physical abuse, particularly family violence, often is kept secret by the
abuser, by the person being abused, and by other family members who fear the
consequences of confronting the abuser. Signs that a child may be abused may
include:

Unusual injuries that are not the result of normal play activities, for
example, black eyes; injuries to cheeks and ears; injuries to stomach, back,
thighs, and buttocks; human bite marks; and cigarette burns

Unusual tiredness or trouble sleeping or nightmares

Unusual sadness or crying

Unusual violence toward classmates or siblings or pets

Avoidance of parents or caregivers, such as reluctance to go home after

school

The same behaviours that result from emotional abuse

Family violence
Family violence often is referred to as domestic abuse. It includes all forms of
intimate partner violence (spouse abuse or wife battering), child abuse and
neglect, elder abuse, and child sexual abuse. Intimate partner violence most
often involves men who are abusive toward female partners. Female-to-male
domestic abuse also occurs, as does male-to-male and female-to-female abuse
in same-sex couples.
Research shows that child abuse and spouse abuse often happen in the same
families. But even if child abuse does not take place along with spouse abuse,
the child who witnesses family violence experiences many problems. Family
violence limits the child's ability to feel safe and protected at home, and it may
force the child to favour one parent over the other. It also may cause emotional
and behavioural problems for the child at school or among peers. It may also
lead to a broken home or custody dispute if a wife leaves the home for a
battered women's shelter or if a child is removed from the home by a
government child protection agency.
Elder abuse and neglect
Elder abuse may occur in families or in institutions such as nursing homes. Abuse
may include neglect, hitting, pushing, shaking, giving elders too much
medication, and putting elders in restraints that prevent them from leaving a bed

or wheelchair. Elders who cannot take care of themselves, who are incontinent * ,
who need assistance with activities of daily living, or who wander away due to
dementia * may be difficult and frustrating to caregivers, but it is never okay to
hit or push an elderly person.
Sexual Abuse
Sexual abuse is unwanted, inappropriate, or forced sexual touching, contact, and
behaviour. Abusers may be male or female, and the person who is sexually
abused may be adult or child, male or female, very young or very old, intimate
partner or spouse, neighbour, student, or date. Incest is the term for sexual
abuse by a member of one's own family. Sexual abusers often believe that the
activity is a form of love or intimacy. Abusers may claim that the victim said "no"
but that the abuser knew the victim meant "yes." But people who have been
abused experience the violation of their personal boundaries and privacy as
assault and violence.
Repressed memories
If thinking about the abuse is particularly difficult, children may lock away all
knowledge of the abuse in the deepest part of their memories, keeping the
abuse secret even from themselves. This form of amnesia, or memory loss, can
last for many years according to many experts. Adults who have been abused as
children report sometimes discovering a key to the deepest parts of the memory
many years after the abuse has stopped. Known as "repressed memory," adult
recall of child sexual abuse is considered a controversial topic.
Discrimination and Hate Crimes
Sometimes people are abused because of race or ethnic background, disabilities,
gender, sexual orientation, or religious beliefs. White supremacy, lynching, gay
bashing, and ethnic cleansing are a few of the terms associated with these forms
of abuse and violence. In many areas of the United States and the world, hate
crimes are not yet specifically against the law.
M1. Assess the likely immediate effects of two different forms of abuse on the
health and wellbeing of adults.
Health Effects
Abuse and neglect are a major source of stress and can have long-term effects
on the health and well-being of older adults.The stress of abusemay trigger chest
pain or angina, and may be a factor in other seriousheart problems. High blood
pressure, breathing problems,stomach problems (ulcers), and panic attacks are
common stress-relatedsymptoms among older people who experience abuse.
Abuse has a significant impact on people at any age, but older adults can be
especially vulnerable. In general, older adults have less physical strength and
less physical resilience than younger persons. Some older adults may be very
frail, or already have disabilities or impairments that leave them particularly
vulnerable. Older bones break more easily and take longer to heal. An injury or
accumulation of injuries over time canlead to serious harm or death. For
example, physical abuse may result in a hip fracture.
Many older adults experiencing abuse or neglect are isolated.Individuals who
abuse or neglect older adults often threaten, harass, or intimidate them. For
example, some abusers threaten to not let older adults see their grandchildren.
Others may prevent older adults from having visitors, or may threaten to leave
them alone.
As a result of abuse or neglect, older adults often experience worry,
depression, or anxiety. These signs may be mistaken for memory loss or

illness, when really they are the effects of stress or worry. An older adult
may also feel shame, guilt, or embarrassment that someone in the family
or someone close has harmed them.
Some abused older adults may start to eat less, use more medications or drink
more alcohol to help cope with the emotional and physical
hurt. They may have difficulty sleeping or sleep too much. Some abused
or neglected older adults may lose interest in life or become withdrawn.
Some may have suicidal thoughts.
Between 44% and 62% of abused older adults experience some level
of depression. Up to 6% of abused older adults become severely
depressed.
Living with abuse and neglect can also significantly increase the
person's chances of becoming ill or may make other health
problems worse.
4PREPARED BY PENNY BAIN AND CHARMAINE SPENCER FOR
FEDERAL/PROVINCIAL/TERRITORIAL MINISTERS RESPONSIBLE FOR SENIORS IN
CANADA
p3
factsheet
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Abused or neglected older adults have a 200% increased risk of
early death.The stress of living in an abusive situation shortens
older peoples lives by several years on average.
Financial Effects
Financial abuse can have a negative impact on older adults' health and
wellbeing. Many older adults who experience financial abuse also face
emotional abuse.
Financial abuse can lead to ongoing distress and financial strain in
the older person's life. Stolen or forged income cheques can leave a
low-income senior without money for food, medications, or transportation.
Financial abuse may involve loss of a home through deceit, loss of
beloved personal assets through theft, or loss of money from improper
use of a power of attorney.
When abusers steal or control older adults' money or other
property, older adults may have fewer resources to take care of their
own health, housing, good nutrition, and activities.
Social Effects
The effects of abuse and neglect can carry from generation to
generation. For example, grandchildren who witness such abuse may
come to view negative behaviours toward older adults as acceptable and
perpetuate disrespect. Abuse and neglect of older adults is not a private
matter. It affects individuals, families, communities and ultimately society
at large.
Though severe cases of elder abuse exist, more often the abuse is subtle,
making it hard to distinguish interpersonal stress from external abuse and
neglect, according to the American Psychological Association. Elderly persons
most vulnerable to abuse and neglect are frail, terminally ill, and mentally and
physically impaired. In addition, victims of elder abuse are usually abused by
members of their immediate families, other household members and hired
caregivers.
Physical Markings
The physical effects of elder abuse stem from the infliction of physical, emotional
and/or psychological trauma. Most often, physical markings of elder abuse are

presented in forms of bruising or grip marks around the arms, legs or neck;
sunken eyes; extreme weight loss; bed sores; and broken bones. Such physical
marks generally come from the abuser hitting, beating, pushing, neglecting to
feed, burning, under medicating, excessive restraining or biting the abused.
Elders who are sexually abused may also have vaginal or anal bleeding, bruised
breasts and venereal diseases or vaginal infections.
Language
Elder abuse also impacts the language of the abused. The effects of this abuse
are uncommunicative and unresponsive coping mechanisms, dismissive attitude
or statements about injuries, and inability to verbalize or explain repeated
injuries. When elders are abused, such signs as trembling, clinging and cowering
are present. The repercussions of these effects present challenges for
interventions. The abused are to afraid to speak up or have difficulty verbalizing
what has happened.
Significance
Elder abuse can occur in the elderly person's home, the home of a relative or
other caregiver, or a facility for elderly people, such as a nursing home. The
issue does not receive as much attention as it should, in part because many
cases of elder abuse go unreported, according to the National Center on Elder
Abuse, or NCEA. The NCEA estimates that more than 10 percent of the elderly
population in the United States may experience abuse, yet people report less
than 20 percent of those cases. Consequently, most abused senior citizens who
need help never receive it.
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Authorities receive more than 500,000 reports of elder abuse each year, and
many of the guilty parties are the same people entrusted with caring for the
elderly victims, notes Helpguide.org. Sometimes relatives of the abused senior
may either commit the abuse or eventually discover or witness the abuse. It is
common for family members to be the abuser since most caregivers for seniors
are relatives, reports the NCEA. Abusive relatives often mistreat elderly family
members they care for because they are unable to cope with the stress of being
a caregiver, which can produce anxiety, depression and exhaustion.
Signs
Abused seniors frequently do not say anything to anyone about the situation,
according to the NCEA. As a result, relatives and other people in their life need to
remain alert for signs of mistreatment in order to help them. Such signs
commonly include a strained relationship with the abusive caregiver,
unexplained weight loss or personality changes like withdrawal, bedsores,
inadequate hygiene and physical injuries like abrasions and bruises, which may
not have received treatment. Another major warning indicating elder abuse is an
emotionally or verbally abusive caregiver who uses ridicule or threats to
maintain control over the senior.
Effects
The effect that elder abuse has on the family members of mistreated seniors
depends on whether they are the abusers or not. Relatives who learn an elderly
family member has been abused often feel both anger and grief, especially if the
senior is badly injured or dies, according to the Superior Court of California,
County of Santa Barbara. The emotions typically occur because the relatives
were unaware of the situation or were not able to prevent it. Family members
who abuse seniors related to them may feel anger and guilt also, sometimes

because they understand they are mistreating their relative but feel unable to
stop.
Prevention
Both seniors and their family members can help reduce the likelihood of elder
abuse by performing certain actions. The NCEA recommends that seniors take
good care of themselves to remain as healthy as possible, plan for their future
care ahead of time to avoid family problems and participate in community and
family activities to remain connected with other people and reduce social
isolation. Relatives with an elderly family member who requires care should
remain involved in the life of their elderly relative, research elder abuse to
educate themselves and speak up or seek advice--from a trusted doctor or
friend, for example--if they suspect an elderly relative is in danger.