Abuse and Neglect

Nursing Education and Professional

Development

Objectives
Differentiate different types of abuse
experienced by patients in health care
settings
Recognize signs and symptoms of abuse
Understand staff responsibility in reporting
suspected abuse and neglect
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Abuse and Neglect

Abuse
1. Physical: Intentional use of physical force
resulting in pain or bodily harm

2. Sexual: Sexual contact or exposure without

consent

3. Psychological/Emotional: Infliction of mental

anguish threat, humiliation, intimidation, isolation or
abusive conduct

4. Financial/Material: Unauthorized use of

money, property or other resources
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Abuse and Neglect

NEGLECT
Intentional: The conscious & deliberate attempt
to inflict physical, emotional or financial harm
Unintentional: An inadvertent action which
results in physical, emotional or financial harm.
Usually due to ignorance, inexperience, inability
or lack of desire to provide care.

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Abuse and Neglect

Examples: Neglect
Purposeful withholding of food / fluids /
medication / treatment.
Ignoring requests for help; making patients wait
for staff convenience
Failure to provide a safe environment
Absence of supervision of children
SIGNS: May include dehydration, pressure
ulcers, malnutrition, poor hygiene, withdrawal

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Abuse and Neglect

Domestic Violence Wheel

Adapted from Domestic Abuse Intervention Project, Duluth Minnesota

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Abuse and Neglect

Equal Opportunity Crime

Domestic violence can happen to anyone
Teens, adults, elderly, disabled
African American, Asian, Caucasian,
Hispanic
Wealthy, middle income, poor
All educational levels
All religious backgrounds
Straight, gay, bisexual or transgender
Male or female
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Abuse and Neglect

Domestic Violence StatisticsU.S.

Female
85%

Male
15%

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Nearly 1 in 4 women
and 1 in 7 men
experience violence in
their lifetime by spouse
or partner
1 in 6 women and 1 in
19 men experienced
stalking in their lifetime

Abuse and Neglect

Impact on Children

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Abuse and Neglect

Domestic Violence Continuum

Increases in intensity and frequency

over time
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Abusive Relationships: Why

Do People Stay?
Safety Concerns
-Victims (and possibly their children) are most
at risk when LEAVING an abuser
Lack of resources/Isolation
- Financial, housing, jobs, child care
Emotional/Psychological Barriers to Leaving
- Fear of the abuser
- Fear of being alone
- Fear of failure/shame
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Why Do People Stay?

Emotional/Psychological Barriers
- Traumatic bonding/love for partner
- Hope for change
- Feelings of ambivalence
- Internalization of emotional abuse
- Wish for family to remain intact
- Concerns about children
- Family, culture, or religious pressures
- Low self esteem from the abuse
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RADAR

R = Routine screening
A = Ask direct questions
D = Document findings
A = Assess patient safety
R = Review options and referrals

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When to Suspect Abuse:

Red Flags

Stories & injuries do not match

Frequent medical visits
Delay in seeking medical care
Partner insists on staying close and
answers questions directed to patient
Non-compliance with appointments,
medications, and safe sex practices
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What do I do?
Mandatory reporting for all licensed staff in
state of PA for suspected:
Child abuse < 18
Elder abuse > 60
Report suspected cases of abuse / neglect
related to pre-hospitalization to the Care
Manager in your department.

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Suspect Abuse or Neglect?

What if I suspect or have witnessed
abuse/neglect of a patient while theyre
in the hospital?
You must report all incidences or suspicions
of abuse/neglect to your manager or
supervisor.
A full investigation will follow. Social
services may be contacted.
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Domestic Violence
Hot Line Numbers
Philadelphia County: 1-866-723-3014

Bucks County: 1-800-220-8116

Montgomery County: 1-800-773-2424
National Hotline: 1-800-799-SAFE
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Teen Dating Violence

Crises Counseling Hot Line

215-686-4420

Youth & Emergency Services

215-787-0633

Gay & Lesbian Counseling

215-732-8255

Woman Organized Against

Rape (WAR)

215-985 - 3333

National Dating Abuse Helpline

(866) 331-9474
Text number - loveis77054
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Teen Dating Violence

Resources on the Internet
www.loveisnotabuse.com
loveisrespect.org
www.breakthecycle.org
www.seeitandstopit.org
www.thatsnotcool.com
www.teenwire.com
www.ndvh.org/educate/teen

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How to Help A Friend

Believe the survivor and normalize the experience:
You are not alone

Acknowledge unacceptability of the violence:

You have a right to be safe and no one has the right to hurt you

Offer support and encouragement, do not blame the victim:

Its not your fault

Acknowledge her strength and courage:

You are a survivor

Explore options, do not give advice:

If you want, there are agencies that have a 24-hour hotline,
a shelter, and/or counseling services
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