Health and Social Care - Suspecting Abuse in Vulnerable Adults

What should care workers do if they suspect abuse?
Most people working in health and social care settings are familiar with the terms ‘abuse’ and ‘vulnerable adult’, but what should a care worker do if they suspect a vulnerable adult is being abused?

Who are vulnerable adults?
A vulnerable adult is a person aged 18 or over who is:

• In need of community care services by reason of their age, or their mental or other disability
• Unable to take care of him or herself
• And is unable to protect him or herself against significant harm or exploitation

This definition includes older people, adults of working age who may have a learning disability, mental health issues or any other condition which makes them temporarily or permanently vulnerable.  It is the inability to protect themselves from significant harm or exploitation that makes individuals vulnerable to abuse.

Abuse is the intentional harm done to another person through mistreatment or ill-treatment, or failing to act to prevent harm.  It affects all groups, all social classes, both genders; all ages; all abilities, all cultures and ethnic groups.  

How might a care worker spot abuse?
It is not easy to identify abuse; being one reason it is so prevalent.  However, there are actions care workers can take to minimise or preclude abuse being inflicted on individuals in their care.

1. Be aware of the potential for abuse.  Is the individual living in an environment where there has been, or is, domestic violence, drug or alcohol misuse, or financial strains?
   
   
2. Share any concerns they might have that an individual is being abused.  Things to look out for include:
   - Physical abuse: burn or scald marks, bruising or unexplained bone fractures and other injuries
   - Psychological and emotional abuse: poor or a loss of confidence, or appearing frightened or worried.
   - Material and financial abuse: possessions going missing or being ‘borrowed’, not having any money or another person having access to their bank account
   - Neglect or omission: is the individual clean and dressed appropriately for their age, gender or the weather? Are they hungry or showing signs of dehydration or malnutrition?
   - Sexual: are they in pain sitting or walking with a strange gait?
   - Discriminatory: are they being treated with the same consideration as other people of a different ethnic or cultural background, or because of their sexuality?
   - Institutional: do any of the above occur in a hospital, care home or other institution where they are living or being treated?
   
   
3. If a care worker suspects abuse they should record their suspicions and tell someone – usually their line manager
   
   
4. Make sure that any reporting is followed up.  Ask if it was investigated
   
   
5. Most importantly, do something – don’t just do nothing if you suspect abuse 

John Rowe works for the Open University and has a wealth of practice experience in health and social care settings.