What is abuse?

There are many different ways in which someone can be abused. Assumptions must not be made, but it is enough to suspect abuse to report it.

People may report abuse to you in many ways, for example:

  • They may tell you
  • Another person who knows them may tell you; this may be a family member, colleague or member of the public
  • You may see something such as a bruise or other mark, or notice a change in the person’s behaviour

Here is a list of types of abuse with examples and potential indicators. In all examples there may be other signs as this is not a complete list. Read more about:

Physical abuse

This includes: hitting, slapping, pinching, pushing, misuse of medication and inappropriate holding or restraint. It may also include inappropriate sanctions or punishment and rough handling.

Possible indicators:

  • History of unexplained falls
  • Unexplained bruising in well protected or soft parts of the body e.g. ears or buttocks
  • Multiple bruising in different stages of healing
  • Unexplained burns – unusual location or type
  • Unexplained fractures
  • Unexplained lacerations or abrasions
  • Slap, kick punch or finger marks
  • Injury shape similar to an object
  • Untreated medical problems
  • Weight loss due to malnutrition or dehydration

Sexual abuse

Examples: rape, indecent exposure, sexual harassment, inappropriate looking or touching, sexual teasing or innuendo, sexual photography, subjection to pornography or witnessing sexual acts, sexual acts or indecent exposure to which the adult has not consented or was pressured into.

Possible indicators:

  • Sudden change in behaviour
  • Sudden onset of confusion
  • Incontinence
  • Withdrawal
  • Overt sexual behaviour/language by the adult
  • Self-inflicted injury
  • Disturbed sleep pattern/poor concentration
  • Difficulty in walking
  • Torn, stained underwear
  • ‘Love bites’
  • Pain/itching/bleeding or bruising in genital area
  • Sexually transmitted disease/urinary tract/vaginal infection
  • Bruising to upper arms and thighs
  • Frequent vaginal and urinary tract infection
  • Severe upset or agitation when bathing
  • Pregnancy in a person who is unable to consent

People find sexual abuse particularly difficult to speak about. Patience and empathy is essential.

Financial abuse

Examples: fraud, theft, taking property without permission, assuming ownership of money or items, scamming (which can be in person, by letter, phone and internet), coercion in relation to an adult’s financial affairs including the writing of or changing a Will, and misuse of benefits. Financial abuse can involve small and large amounts of money or value of property.

Possible indicators:

  • Sudden inability to pay bills
  • Sudden debt
  • Unexplained or unusual patterns of cash withdrawal from an account
  • Lack of belongings that the adult can clearly afford
  • Resistance by family to give explanation for unusual financial activity
  • Extraordinary interest by family in an adult’s assets
  • Purchase of items that the adult would not usually buy or need
  • Personal items going missing
  • The main interest shown by a family member is financial and not the in relation to the care of the adult

Find out ways in which financial abuse can be prevented from occurring by using the SSASPB Financial Abuse (727 KB) guidance.

Discriminatory abuse

Examples: discriminatory abuse is often on the grounds of age, race, gender or gender identity, culture, religion, sexual orientation or disability.

Other examples of abuse include:

  • Hate crime (acts of violence or hostility directed at people because of who they are or who someone thinks they are)
  • ‘Mate crime’ (sometimes used to describe a crime committed against an adult by someone who has befriended them)
  • Derogatory comments
  • Harassment
  • Being made to move to a different resource/service based upon an adult’s age
  • Being denied medical treatment on grounds of age or mental health

Emotional/Psychological abuse

Examples: threats of harm or abandonment, blackmail, deprivation of contact, humiliation and ridicule, blaming, controlling, intimidation, coercion, harassment, isolation, cyber bullying, shouting and swearing, unreasonable support of services or support networks, denial of cultural or religious needs, denial of access to the development of social skills.

Possible indicators:

  • Change in appetite, weight loss or gain
  • Low self esteem
  • Upset and tearfulness
  • Confusion and agitation
  • Insomnia
  • Avoiding eye contact, withdrawal
  • Isolation, unable to make contact
  • Distress
  • Poor hygiene, resulting from restricted access to facilities
  • Uncharacteristic behaviour

Neglect (and acts of omission)

Examples: ignoring medical, emotional or physical needs; failure to provide access to appropriate health, care and support or educational services; withholding the necessities of life including medication, adequate nutrition and heating.

Possible indicators:

  • Poor environmental conditions
  • Inadequate heating and lighting
  • Poor physical condition of the adult
  • Malnutrition
  • Clothing is ill-fitting, unclean or in poor condition
  • Isolation of the adult
  • Withdrawal, unhappiness or change in demeanour
  • Carer’s reluctance to engage with professionals
  • Carers not allowing contact by professionals with the adult

Self neglect

Examples: self neglect can sometimes be as a result of a person’s choice of lifestyle and covers a wide range of behaviour including neglect to care for one’s personal hygiene, health or surroundings and can include hoarding when it becomes extreme (including animal hoarding). In these circumstances there is no abuser.

Possible indicators:

  • Living in grossly unsanitary conditions
  • Suffering from untreated illness or disease/condition
  • Suffering from over or under eating to the extent that if untreated the adult’s physical or mental health could be impaired
  • Creating a hazardous situation that would likely cause serious physical harm to the adult or cause substantial loss of assets

Organisational/Institutional abuse

Examples: Neglect, poor practice within an institution such as a care home or hospital and also poor practice in relation to care provided in the adult’s own home. This can be only one incident or a series of incidents which are neglect or poor practice as a result in organisations poor policies, procedures and practice.

It is important not to jump to the wrong conclusions too quickly but the following list may be possible indicators of institutional abuse:

  • No flexibility in bedtime routine and/or deliberate waking 
  • People left on a commode or toilet for long periods of time 
  • Inappropriate care of possessions, clothing and living area 
  • Lack of personal clothes and belongings 
  • Un-homely or stark living environments 
  • Deprived environmental conditions and lack of stimulation 
  • Inappropriate use of medical procedures such as enemas, catheterisation 
  • Batch care - lack of individual care programmes 
  • Illegal confinement or restrictions 
  • Inappropriate use of power or control 
  • People referred to, or spoken to with disrespect 
  • Inflexible services based on convenience of the provider rather than the person receiving services 
  • Inappropriate physical intervention 
  • Service user removed from the home or establishment, without discussion with other appropriate people or agencies because staff are unable to manage the behaviour

Domestic abuse

The Home Office definition of domestic abuse (2013):

  • Incident or pattern of incidents of controlling, coercive or threatening behaviour, violence, or abuse by someone who is or has been an intimate partner or family member regardless of gender or sexuality
  • Includes psychological, physical, sexual, financial, emotional abuse; so called ‘honour’ based violence; Female Genital Mutilation; forced marriage
  • Includes anyone aged 16 or over

Many people think that domestic abuse is about intimate partners, but it is clear that other family members are included and that much safeguarding work that occurs at home is, in fact is concerned with domestic abuse.

Modern slavery

Modern slavery includes slavery, human trafficking, forced labour and domestic servitude.

Traffickers are those who arrange for the people to move from place to place to do the tasks that they are made to do. It includes moving within the UK and doesn’t have to be from abroad. You may often hear the words ‘harvesters’ or gardeners’ used in relation to the victims of modern slavery being made to grow and look after cannabis farms. Very often the traffickers trick victims into believing that they are arranging for them to have a better life and genuine employment.

If you think that someone is the victim of Modern Slavery ring the Modern Slavery National Helpline on 08000 121 700.