Recognising adult abuse, exploitation and neglect

Identifying an adult at risk

An adult at risk of harm is a person aged 18 or over, whose exposure to harm through abuse, exploitation or neglect may be increased by their personal characteristics or life circumstances.

Their personal characteristics may include:

• age
• physical or mental disabilities
• special educational needs
• any illness, mental or physical they may have

Their life circumstances may include:

• isolation or loneliness
• finances and work
• living conditions

Identifying adult abuse

It is abuse when someone misuses their power or control over another person, causing harm or distress.  The abuser could be in a close relationship with the adult at risk. They could be someone the adult at risk depends on and trusts.

An abuser could be a:

• partner
• relative or other family member
• person entrusted to act on behalf of the adult in some aspect of their affairs
• service or care provider
• neighbour
• health or social care worker or professional
• employer
• volunteer or another service user
• person or people who have no previous connection to the victim

If you suspect abuse, exploitation or neglect, it is important that you report your concerns to the Adult Protection Gateway Service at your local Health and Social Care Trust or the police.

• Who to contact if you suspect abuse, exploitation or neglect

Physical abuse

Physical abuse is physical force or mistreatment of one person by another which might or might not cause physical injury. This type of abuse includes:

• hitting
• pushing
• rough handling
• exposure to heat or cold
• force feeding
• improper administration of medication
• denial of treatment
• misuse or illegal use of restraint
• not being allowed to go where you wish, when you wish

Signs of physical abuse are:

• fractures
• bruising
• burns
• pain
• marks
• not wanting to be touched

Psychological or emotional abuse

Psychological or emotional abuse is harmful behaviour that can cause mental distress. It can involve both verbal and non-verbal abuse which can scare, humiliate and isolate a person. This may include:

• threats
• humiliation or ridicule
• provoking fear of violence
• shouting, yelling and swearing
• blaming
• controlling
• intimidation
• coercion

Signs of psychological or emotional abuse are:

• being withdrawn
• too eager to do everything they are asked
• showing compulsive behaviour
• not being able to do things they used to
• not being able to concentrate or focus

Financial abuse

Financial abuse happens if someone tries to steal, steals or defrauds you of your money, goods or property. This includes:

• exploitation
• embezzlement
• withholding pension or benefits  
• exerting pressure around wills, property or inheritance

Signs of financial abuse are:

• having unusual difficulty with finances
• not having enough money
• being too protective of money and things they own
• not paying bills
• not having normal home comforts

Sexual abuse

Sexual abuse is unwanted sexual activity or sexual behaviour that happens without consent or understanding.

Sexual violence and abuse can be physical contact or non-contact sexual activities, such as:

• indecent exposure
• stalking
• grooming
• forced to look at or be involved in producing sexually abusive material
• forced to watch sexual activities

Possible signs are:

• genital itching, soreness or having a sexually transmitted disease
• using bad language
• not wanting to be touched
• behaving in a sexually inappropriate way
• changes in appearance

Institutional abuse

Institutional abuse is the mistreatment or neglect of an adult at risk by a regime or individuals. It takes place within settings and services that adults at risk live in or use, including any organisation, in or outside the Health and Social Care sector.

Institutional abuse may occur:

• when routines, systems and regimes result in poor standards of care
• when poor practice and behaviours are in place
• within strict regimes and rigid routines which violate the dignity and human rights of the adults and place them at risk of harm
• within a culture that denies, restricts or curtails privacy, dignity, choice and independence

Possible signs are:

• the person has no personal clothing or belongings
• there is no care plan for them
• they are admitted often to hospital
• professionals having treated them badly or unsatisfactorily or acting in a way that cause harm to the person

Identifying neglect

Neglect occurs when a person deliberately withholds, or fails to provide, suitable and adequate care and support needed by another adult. It may be through a lack of knowledge or awareness, or through a decision not to act when they know the adult in their care needs help. It may impair the health or well-being of an adult.

Possible signs are:

• having pain or discomfort
• being very hungry, thirsty or untidy
• failing health

Identifying exploitation

Exploitation is the deliberate maltreatment, manipulation or abuse of power and control over another person. It is taking advantage of another person or situation usually, but not always, for personal gain.

Exploitation comes in many forms, including:

• slavery
• being controlled by a person or a group
• forced labour
• domestic violence and abuse
• sexual violence and abuse
• human trafficking

Recognising signs of harm or abuse

You might become aware that an adult is at risk of harm when:

• you see or hear something
• they tell you about abuse, exploitation or neglect happening to them
• a friend, family member or somebody tells you something that causes you concern
• you notice injuries or physical signs that cause you concern
• you notice the victim or abuser behaving in a way that alerts something may be wrong

More useful links

• Who to contact if you suspect abuse, exploitation or neglect
• Help and support for victims
• Adult Safeguarding Policy