Program Description
• Abuse and Neglect in Health Care: What Every
Health Care Professional Needs to Know is a 1
hour mandatory training session that provides
information on abuse and neglect including:
a) Definitions of abuse and neglect
b) Types of abuse and neglect
c) Indicators of abuse and neglect
d) Causes and abuse and neglect
e) Effects of abuse and neglect
f) Prevention of abuse and neglect in health care

Learning Objectives
• Upon completion of this 1 hour mandatory
training program, the learner will be able to:
1) Define abuse and neglect
2) List 8 types of abuse and neglect
3) Identify indicators of abuse and neglect
4) List causes of abuse and neglect
5) Understand affects of abuse and neglect
6) Understand prevention of abuse and neglect in
health care

Introduction to Abuse and Neglect
• Elderly people in general are a high risk
population for abuse or neglect
• Those living in residential settings such as
long-term care facilities, assisted living centers
or group homes, may be particularly
vulnerable to abuse or neglect
• We believe that each year over 2 million older
people are abused or neglected in the United
States

Introduction to Abuse and Neglect
• Lots of people live in residential care settings
• Over 1.5 million live in nursing homes
• Almost 1 million live in other settings like assisted living
and group homes
• These residents are at a higher risk for abuse and
neglect because so many of them have compromised
physical and mental health
• They may be ill, frail, confused, and require a great deal
of assistance or total assistance from their caregivers
• The cornerstone to prevention of abuse and neglect is
education and training

1. Defining Abuse
• What is abuse?
• It involves inflicting some kind of harm –
psychological, emotional or physical – on an
older adult
• Other forms of abuse include financial
exploitation and sexual abuse
What is Neglect?
• Is considered a passive form of abuse in which
the caregiver does not provide something that
the care recipient needs or wants
• It is the withholding of something
• It can also be defined as failing to provide
proper supervision, medical treatment or
nutrition and hydration

2. 8 Types of Abuse and Neglect
1) Passive neglect – unintentional; may be due to
caregiver overload
2) Active neglect – intentionally failing to provide
for the person’s needs
3) Physical abuse – intentionally causing harm to
an older person; involves rough handling like
grabbing and pushing; also includes excessive
forms of restraints
Types of Abuse and Neglect
4) Psychological abuse – intentionally causing
mental or emotional distress; includes verbal
insults or assaults to threats
5) Financial Abuse – exploiting an older adult by
misusing their funds, property or material
possessions
6) Sexual abuse – any kind of sexual activity
without consent – and many may not be able
to give consent
Types of Abuse and Neglect
7) Violation of Basic Human Rights – violation of
any of the resident or patient rights
8) Self-neglect – allowing the elderly individual
to neglect their own psychological, physical
and/or social needs

3. Indicators of Abuse and Neglect: Physical
• Trauma such as bruises,
scratches, cuts and
burns
• Repeated injuries such
as fractures or sprains
• Unexplained injuries
• Inconsistent
explanations for injuries
• Restraint trauma –
welts around the wrists,
rope burns
• Fear of being touched
• Frequent complaints of
unexplained pain

3. Indicators of Abuse and Neglect: Psychological
• Anxiety or nervousness
• Depression or
withdrawal
• Confusion and
disorientation
• Shame
• Agitation
• Evasive to questions
• Trembling
• Clinging to others
• Poor or no eye contact

3. Indicators of Abuse and Neglect: Financial
• Money and personal
possessions are missing
• Signatures on financial
documents like checks
are not those of the
individual
• Large withdrawals from
bank accounts
• Switching accounts
from bank to bank
• Bank statements go to
someone other than
the elderly person
• Elderly person
complains that they are
signing financial
documents they know
nothing about
• New people in the
elder’s life

3. Indicators of Abuse and Neglect: Sexual
• Trauma to sexual organs
• Appearance of sexually transmitted diseases
• Frequent and recurring infections
• Unusual discharges
• Any signs of psychological trauma, fear or
paranoia

3. Indicators of Abuse and Neglect: Basic Rights
• Stealing, keeping or reading mail without
permission
• Not allowing elder to attend religious services
• Obstructing dietary preferences, visits, outings
• Interfering in quality of life
• Obstructing privacy, information, transfer and
discharge, etc.
• Any signs of psychological abuse

3. Indicators of Abuse and Neglect: Passive and Active Neglect
• Pressure sores
• Skin tears
• Malnutrition
• Dehydration
• Chronic or severe health problems
• Chronic or severe psychological problems
• Severe weight loss
• Personal care seems significantly lacking

3. Indicators of Abuse and Neglect: Self-Neglect
• Social isolation and withdrawal
• Malnutrition or dehydration
• Substance abuse
• Cognitive impairments
• Self-injury
• Over- or under-medicating
• Depression, anxiety, severe adjustment disorders
• Poverty

4. Causes of Abuse and Neglect
1) Caregiver Stress or Burnout
2) Lack of Training with Special Populations
3) Poor Staffing or Under-Staffing
4) Dependency of the Care Recipient
5) Organizational Stress
6) Personal Problems of the Caregiver
7) Social Isolation
8) Inter-generational Belief that Violence is
Acceptable

5. Effects of Abuse and Neglect
1) Physical Effects: chest pain, high blood pressure,
heart problems, breathing problems, stomach
ulcers, gastrointestinal problems, early death
2) Psychological Effects: Depression, anxiety, panic,
paranoia, fear, appetite and sleep disturbance,
substance abuse
3) Financial Effects: Financial distress, poor quality
of living, poverty, poor nutrition, not enough
money for medications and care

6. Prevention of Abuse and Neglect
• Here is where you can and must make a
difference
• Create good, genuine and lasting relationships
with those you care for
• Communicate openly about issues that your care
recipients are concerned about
• Get them socially involved with others in the
facility and community
• Watch for signs or symptoms of abuse or neglect
and report them immediately

6. Prevention of Abuse and Neglect – Make the Phone Call!
• Always start by reporting suspected or actual
abuse or neglect to your managers and
supervisors
• You or they may have to make some phone calls
to:
a) Adult Protective Services
b) Long Term Care Ombudsman
c) Local Area Agency on Aging
d) Local Law Enforcement (911)

6. Prevention of Abuse and Neglect – Other Things to Think About
• Proper and adequate staffing
• Well-trained staff
• Promoting resident and patient rights
• Family involvement
• Promoting awareness of abuse and neglect in
your facility and in the community
• Get to know your residents, patients or clients
and get to know their families as well
• Watch out for caregiver stress and burnout
• Take care of yourself!

Final Words and A Commitment
• We have covered some territory in this program on
abuse and neglect
• There is a lot to know and understand
• Please make sure you stay well-informed and be aware
of what is taking place in your facility
• No one deserves to be abused or neglected – no one!
• Develop and endorse a zero tolerance policy and put it
into action
• Make a commitment based on what we have discussed

Thank You!