It is hard to understand why people abuse others, but it does happen, and especially to those who are inherently vulnerable.
Older and disabled people are at a particular disadvantage, because as adults, they’re extra-aware of how much they rely on others to help them live in the way they are accustomed. Sometimes the people who abuse them may also be their carers or family.
It can also be quite difficult to define exactly what has happened, especially if the person is not very good at communicating, or has a barrier to communication.
How to recognise when abuse is taking place
Not all abuse is physical or sexual. Nor is it necessarily intentional. It may be financial, verbal, social, or emotional. You may not feel qualified to spot abuse taking place, but there are a few common sense attitudes you should apply at all times to help prevent it.
Listen to the person you care for
If a person you are helping to take care of tells you that they are being abused, you must take it seriously. If they tell you something about a relationship they have with someone else, and you recognise that as being possibly abusive, you should also take that seriously, even if the person has dementia.
Sometimes the issue may not appear to cause the person distress, but because older people do not always explain how they feel about something, that isn’t your call to make.
For example, imagine that you work for a lady – say she is 85. She tells you that her daughter gets cross with her a lot. Now, if that lady is of sound mind; if she likes to have big ‘discussions’ or if she revels in arguments, that’s one thing.
However, if she’s a lady who gets very upset by arguments; or if she has dementia or another mental illness that makes it difficult to think clearly, this may be a situation where abuse is taking place.
Verbal abuse can be just as damaging to a person’s self-esteem and mental health as any other kind, particularly if it is delivered by a member of the person’s family.
Observe what happens around the person
Sometimes abuse – neglect especially – can occur through omission. Most families of older people undertake certain jobs like shopping or cleaning to enable that person to live comfortably, and to reduce the burden on care workers.
“As a care worker, I once observed a family bringing home the shopping for themselves. They brought bags and bags of shopping into the house. Then they brought the person’s food in. Three tins of soup. By the end of that week, I had to buy food so that the person could eat.”
There were many other issues in the same home, and each one on their own may have just been a simple omission. Altogether, however, they added up to neglect.
Sometimes families aren’t able to fulfil their duties to the person who needs care. For example, if a key person becomes ill, they may not be able to keep up with everything they said they would do. This is why you do have to be sensitive to family needs, as well as to the person you care for.
Observe and understand the person you care for
Sometimes no one will say anything, and you won’t see any signs of abuse yourself. Changed behaviour of the person you are looking after, however, may indicate that something isn’t right.
For example, perhaps you’re asked to visit a lady unexpectedly, to replace another worker who has been delayed. You know the lady very well, so you’re surprised when you walk in that she does not look up and greet you with her customary smile. Instead, she remains with her head down, unsmiling, and mutters something you can’t hear.
You touch the lady on the arm and she realises it is you. She smiles, and everything seems normal, but you’re now aware that there is some emotional issue around the worker that she was expecting. It may not be abuse. Perhaps they just don’t get along very well.
Situations may start as one thing but can progress into abuse unintentionally. Good observation is essential when working with vulnerable people, because to be forewarned is to be forearmed.
What to do if you suspect abuse is taking place
Read and follow the safeguarding policy
The company you work for will have a policy on adult safeguarding, so you must read it and note the people that you are expected to inform if you come across abuse. These will most likely include your manager and supervisor.
Talk to the person sensitively
You can ask the person very gentle, open, non-leading questions, but should be as tactful and diplomatic as possible, in case you are wrong. Putting ideas in people’s heads by asking leading questions, or making them think they are being abused when they may not be could constitute ‘tampering with evidence’, which is something you must not do.
Inform the right people immediately
However, you must speak to your supervisor and your manager immediately, so that they can make important decisions around the situation. You should also record any information or observations you have made, on paper, so that you can refer back to it later.
You can’t always help people the way you want to…
In many cases, if the person does not want to allow an investigation, or press charges against the abuser, there is little that can be done. As long as they are considered to have mental capacity, the person has the right to make their own decisions about their own lives.
Sometimes the care company may find that they effectively enable abuse or neglect by providing the person with essentials so that they can survive in minimal comfort. In cases like this, the care company has the choice to stay or pull out; a very hard decision to make when you know that someone is suffering.
The Care Act 2014 is recent legislation that has been brought to solidify the position of various agencies around care delivery and abuse. You can read more about it here.
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