Types of abuse and neglect

Psychological Abuse includes threats of harm or abandonment, humiliation, blaming, controlling, coercion, harassment, verbal abuse. Possible indicators of psychological abuse include:

• An air of silence when a particular person is present
  
• Withdrawal or change in the psychological state of the person
  
• Insomnia
  
• Low self-esteem
  
• Uncooperative and aggressive behaviour
  
• Signs of distress: tearfulness, anger
  
• Apparent false claims, by someone involved with the person, to attract unnecessary treatment

Financial and Material Abuse includes theft, fraud, exploitation, pressure in connection with financial matters, or the misuse of someone else's finances. Possible indicators of financial or material abuse include:

• Missing personal possessions
  
• Unexplained lack of money or inability to maintain lifestyle
  
• Unexplained withdrawal of funds from accounts
  
• Power of attorney or lasting power of attorney (LPA) being obtained after the person has ceased to have mental capacity
  
• Failure to register an LPA after the person has ceased to have mental capacity to manage their finances, so that it appears that they are continuing to do so
  
• The person allocated to manage financial affairs is evasive or uncooperative
  
• The family or others show unusual interest in the assets of the person
  
• Signs of financial hardship in cases where the person’s financial affairs are being managed by a court appointed deputy, attorney or LPA
  
• Recent changes in deeds or title to property
  
• Rent arrears and eviction notices
  
• A lack of clear financial accounts held by a care home or service
  
• Failure to provide receipts for shopping or other financial transactions carried out on behalf of the person
  
• Disparity between the person’s living conditions and their financial resources, e.g. insufficient food in the house
  
• Unnecessary property repairs

Modern Slavery includes human trafficking, forced labour and domestic servitude. Possible indicators of modern slavery include:

• Signs of physical or emotional abuse
  
• Appearing to be malnourished, unkempt or withdrawn
  
• Isolation from the community, seeming under the control or influence of others
  
• Living in dirty, cramped or overcrowded accommodation and or living and working at the same address
  
• Lack of personal effects or identification documents
  
• Always wearing the same clothes
  
• Avoidance of eye contact, appearing frightened or hesitant to talk to strangers
  
• Fear of law enforcers

Neglect and Acts of Omission include ignoring medical or physical care needs, and the withholding of necessities, such as medication and adequate nutrition. Possible indicators of neglect and acts of omission include:

• Poor environment – dirty or unhygienic
  
• Poor physical condition and/or personal hygiene
  
• Pressure sores or ulcers
  
• Malnutrition or unexplained weight loss
  
• Untreated injuries and medical problems
  
• Inconsistent or reluctant contact with medical and social care organisations
  
• Accumulation of untaken medication
  
• Uncharacteristic failure to engage in social interaction
  
• Inappropriate or inadequate clothing

Discriminatory Abuse includes abuse, such a harassment, slurs or hate crime based on a person's race, sex, disability, faith, sexual orientation or age. Possible indicators of discriminatory abuse include:

• The person appears withdrawn and isolated
  
• Expressions of anger, frustration, fear or anxiety
  
• The support on offer does not take account of the person’s individual needs in terms of a protected characteristic

Organisational Abuse is where any of these forms of abuse above are caused by the way an organisation practices. Possible indicators of organisational abuse includes:

• Lack of flexibility and choice for people using the service
  
• Inadequate staffing levels
  
• People being hungry or dehydrated
  
• Poor standards of care
  
• Lack of personal clothing and possessions and communal use of personal items
  
• Lack of adequate procedures
  
• Poor record-keeping and missing documents
  
• Absence of visitors
  
• Few social, recreational and educational activities
  
• Public discussion of personal matters
  
• Unnecessary exposure during bathing or using the toilet
  
• Absence of individual care plans
  
• Lack of management overview and support

Self-Neglect includes situations where a person is declining support with their care needs, hygiene, health or their environment, and this is having a significant impact on their overall wellbeing. Possible indicators of self-neglect include:

• Very poor personal hygiene
  
• Unkempt appearance
  
• Lack of essential food, clothing or shelter
  
• Malnutrition and/or dehydration
  
• Living in squalid or unsanitary conditions
  
• Neglecting household maintenance
  
• Hoarding
  
• Collecting a large number of animals in inappropriate conditions
  
• Non-compliance with health or care services
  
• Inability or unwillingness to take medication or treat illness or injury