The phenomenon of child abuse has become all too familiar to us, and awareness of its existence and seriousness has been greatly increased in recent years. Adult abuse can be equally devastating for its victims, but has not got the public recognition that child abuse has. The reasons for this are numerous, but include a lack of understanding of what constitutes ‘adult abuse’. So, what is it? Well, just like child abuse, it does not take on a single form, but consists of deliberate acts as well as acts of neglect. The No Secrets document published in the UK in 2000 suggests a definition of abuse as being: ‘a violation of an individual’s human and civil rights by any other person or persons’ (2.5). Seen in this way, it is evident that many situations can be deemed as abusive. You may be able to identify examples of abuse in relationships you know of as well as in situations where people who need support are being abused by their carers or even by other people who also need support. A distinction is usually drawn in policy between people who are able to take advantage of the legal framework to address issues of having their rights violated (for example, someone who is subject to domestic violence or who has had money stolen from them) and people who need support to do this. People who are subject to such wrongs, but who have the ability to take these issues up themselves are not usually included in policies which cover ‘adult abuse’ as they do not need specialised support. The people for whom policies in relation to adult protection are written are those who would be prevented from accessing the relevant legislation to have their rights recognised and any violation of them addressed. The people who can fall into this category are learning disabled adults, adults with mental health needs or a physical impairment, and this can include many older people. The No Secrets document (2.7) then categorises abuse as follows:
• Physical abuse
• Sexual abuse
• Psychological abuse
• Financial or material abuse
• Neglect and acts of omission
• Discriminatory abuse.
Where you live may be subject to different guidance and policies, but the categories probably will not differ greatly. Some acts are obviously abusive and clearly fall into one of the above categories, but others may not be as obvious. If an older people is being beaten or a learning disabled adult is being locked in their room without food, then these are clearly examples of abuse. If, however, an older person has dementia and is in danger of hurting themselves and their carer has to keep the door locked to prevent them from walking into the road and causing an accident, is this abusive? It is to address such dilemmas that professionals should work together with carers to find solutions and offer appropriate support.
Department of Health (2000) No Secrets: Guidance on Developing and Implementing Multi-Agency Policies and Procedures to Protect Vulnerable Adults from Abuse, London, HMSO.