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Types of abuse

Types of abuse

There are many forms of abuse that can be experienced. Here we explain a little more about the types of abuse and the signs to look for.

Domestic abuse (including coercive control and stalking)
Financial and material abuse
Modern slavery and criminal exploitation
Neglect and acts of omission
Organisational abuse
Self neglect and hoarding
Drug and alcohol misuse / dependency
Sexual abuse and exploitation
Psychological or emotional abuse
Physical abuse

What is domestic abuse?

Any incident or pattern of incidents of controlling, coercive, threatening behaviour, violence or abuse between anyone who has been ‘personally connected’. This includes current/ex partners, family members regardless of gender or sexuality.

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 with both children and adults, is in fact concerned with domestic abuse.

On 29 April, 2021, the Domestic Abuse Act 2021 became law. This has provided us with a statutory definition of domestic abuse, emphasising that domestic abuse is not just physical violence, but can also be emotional, controlling or coercive, and economic abuse.

In addition, the Act:

Extends the controlling or coercive behaviour offence to cover post-separation abuse.
A child who sees, hears, or experiences the effects of domestic abuse and is related to the person being abused or the abuser, will also to be regarded as a victim of domestic abuse in their own right.
Extends the offence of disclosing private sexual photographs and films with intent to cause distress (known as the “revenge porn” offence) to cover threats to disclose such material.
Creates a new offence of non-fatal strangulation or suffocation of another person.
Enables domestic abuse offenders to be subject to polygraph testing as a condition of their licence following their release from custody.
Places the guidance supporting the Domestic Violence Disclosure Scheme (“Clare’s law”) on a statutory footing.
Provides that all eligible homeless victims of domestic abuse automatically have ‘priority need’ for homelessness assistance.

Spotting the signs of domestic abuse

Sometimes it can be difficult to think of yourself as a victim of abuse. This helpful diagram demonstrates how perpetrators use power and control over their victims (this model can be applied to both males and females).

What is coercive control?

Domestic abuse is not always physical abuse. Coercive control is a pattern of behaviour that aims to threaten, humiliate, intimidate, punish or frighten their victim.

They may use other controlling behaviours to make a person dependent by isolating them from their family or support, depriving them of independence and going about their everyday lives. They may initially be groomed into the relationship and then isolated.

Coercive control is a criminal offence. It creates a sense of fear that impacts on all elements of a victim’s life.

Spotting the signs of coercive control:

Isolating the person from friends and family
Making the person feel that nobody else cares, creating a dependence on the abuser
Preventing or controlling basic needs, such as food and drink
Monitoring time, whereabouts, and actions
Preventing work
Monitoring the person by using online tools / cameras
Control over ability to use phone, internet, social media etc
Taking control over aspects of your everyday life, who the person sees, what they can wear and when they sleep
Preventing access to support services, such as medical services, dentist etc.
Repeatedly putting the person down
Humiliating, degrading or dehumanising behaviour
Controlling of money
Intimidating or threatening behaviour
Jealousy and unreasonable demands

What is stalking?

Stalking is classed as any behaviour from another person which is persistent, unwanted and harassing; anything that causes any kind of fear or anxiety. Some examples can include; unwanted or malicious communications, unwanted attention, watching or following someone or loitering where the person frequents, monitoring usage of someone’s internet, email or other electronic communications, damaging a person’s property.

In the majority of stalking cases the victim will know the stalker (such as a partner or ex-partner for example), however there have been cases where the victim does not know the offender.

In some cases stalking can escalate to physical abuse.

If you feel that you are a victim of stalking or harassment you should contact the police.

What is Clare’s Law?

Under the Domestic Violence Disclosure Scheme (also known as Clare’s Law), an individual can ask the police to check whether a new or existing partner has a violent or abusive past. This is the ‘right to ask’.

If records show that an individual may be at risk of domestic abuse from a partner, the police will consider disclosing the information if it is legal, proportionate and necessary to do so.

‘Right to know’ enables an agency to apply for a disclosure if the agency believes that an individual is at risk of domestic violence from their partner. The police can release information if it is lawful, necessary & proportionate to do so.

How to Make a Clare’s Law Request

Remember, if somebody is at immediate risk always call the police.

Domestic Violence Protection Notices and Orders (DVPOs)

A DVPO is a power which puts in place protection in the immediate aftermath of a domestic violence incident. It means a perpetrator can be banned with immediate effect from returning to a residence and from having contact with the victim for up to 28 days. This allows the victim time to consider their options and get the support they need.

Tools for assessing domestic violence and abuse

The Domestic Violence Risk Identification Checklist (RIC or DASH) is a tool to help identify adult victims of domestic violence and abuse.

When would you use it?
Here are some example scenarios:

A woman seems to be being stalked by her ex-partner. It appears he has been harassing her and there are domestic abuse concerns – does he pose a risk to her?
There is evidence of potential domestic abuse within a household, is it significant?

What is it?

The purpose of the Dash risk checklist is to give a consistent and simple tool for practitioners who work with adult victims of domestic abuse in order to help them identify those who are at high risk of harm and whose cases should be referred to a Multi-Agency Risk Assessment Conference (MARAC) meeting in order to manage their risk. The score provides evidence required to refer to Family Safety Unit.
Whilst domestic abuse is most often perpetrated by men towards women in an intimate relationship such as boyfriend/girlfriend, husband/wife, this checklist can also be used for lesbian, gay, bisexual relationships and for situations of ‘honour’-based violence or family violence.

Multi-agency Risk Assessment Conference (MARAC) – support for victims

A MARAC is a multi-agency meeting which has the safety of high risk victims of domestic abuse as its focus. It involves the participation of all the key statutory and voluntary agencies who may be involved in supporting a person experiencing domestic abuse.

Support is most frequently provided by the Independent Domestic Violence Advocate (IDVA) based within the Family Safety Unit. The IDVA is a specialist advisor who has received accredited training to work with high risk victims of domestic abuse from the point of crisis.

The MARAC will identify “high risk” victims/survivors of domestic violence, and will offer professional support and guidance, which will reduce the threat of further harm and repeated domestic violence to the victim/survivor and their immediate family members.

Referral – All partner agencies have a designated point of contact for the MARAC. Where domestic abuse is disclosed or suspected the point of contact in each agency will follow the Domestic Abuse referral pathway to ensure appropriate action is taken to safeguard individuals and refer into MARAC.
HM Government multi-agency statutory guidance on FGM (published April 2016):

Read more about Domestic Abuse

Financial and material abuse

What is financial abuse?

This includes theft, fraud, internet scamming, coercion in relation to an adult’s financial affairs or arrangements, including in connection with wills, property, inheritance or financial transactions, or the misuse or misappropriation of property, possessions or benefits (Care Act 2014).

Financial or material abuse can occur in isolation, but research has shown where there are other forms of abuse, there may be financial abuse occurring. Although this is not always the case, everyone should be aware of this possibility.

Spotting the signs of financial abuse:

Change in living conditions, which can include lack of heating, clothing or food
Inability to pay bills/unexplained shortage of money
Unexplained withdrawals from an account
Unexplained loss/misplacement of financial documents
The recent addition of authorised signers on a client’s or donor’s signature card
Sudden or unexpected changes in a Will or other financial documents
Unexpected changes/renovations to the adult’s home
Transferring financial liabilities into an adult’s name
Workmen visiting to complete unplanned and or seemingly unnecessary building/garden work
Sudden new friends/acquaintances taking trips together, making joint financial commitments or planning to move in

Who are the most common victims of financial abuse?

Older people living alone, in receipt of services, in poor or very poor health, divorced, separated or lonely. Additionally, those with disabilities are at a greater risk, and in some cases, there can also be a link to domestic abuse.

Who are the most common abusers?

It is often those people who the elderly trust the most who are usually the perpetrators of financial abuse, such as a family member or a friend. Unfortunately, the elderly or vulnerable are also often targeted for scams.

Commonly, financial abuse occurs in the adult’s own home or a care home. Abusers can often have drug, alcohol, relationship, financial or gambling problems.

Warning signs linked to domestic abuse:

Refusing to contribute to household or other costs, including child maintenance payments
Transferring financial liabilities into a victim’s name
Not contributing to joint bills
Getting the victim to take out credit
The abuser using all joint resources
The abuser controlling access to the victim’s income, banking or savings
The abuser controlling or interfering with the adult’s benefits

What are scams?

Scams come in many forms and can be received by email, letter, telephone or in person, making false promises to con victims out of money. The most common are fake lotteries, deceptive prize draws or sweepstakes, clairvoyants, computer scams, and romance scams.

A mass marketing scam is a misleading or deceptive business practice where the adult receives an unsolicited or uninvited contact (e.g. by letter, email, phone or advertisement) and false promises are made to con the recipient out of money. A doorstep scam is when people are cold called at their homes and persuaded to part with money as a result of rogue trading activity.

How to prevent financial abuse

Discuss money management with family: It is important that adults and their family members have an ‘estate plan’ for how finances are to be managed if an individual becomes unable to look after them, and if possible allocate responsibilities to different family members to create appropriate checks and balances. Adults can nominate a Power of Attorney in advance to support with finances when they may no longer be able to. You can also apply to be a ‘deputy’ which is a representative for someone who lacks capacity (visit www.gov.uk)
Monitor bills and check bank statements: If bills are left unpaid or large sums of money have come out of an adult’s account, this could be an indication that they are not managing financially.
Check that large amounts of cash are not being kept in the home: This could be a sign someone is putting themselves at unnecessary risk of theft.
Accompany elders to meetings with financial advisors: Financial advisors who are paid on commission may ‘recommend’ unnecessary financial products. This is particularly relevant due to recent changes in relation to pensions.
Seek financial advice and support: Your bank manager can look at extra support that may be available and ways of managing money, for example, using a signature card instead of a PIN.
Stay safe online: make sure you have strong passwords and suspicious of any links or emails you do not recognise
Stay active within your local community: Social isolation can put people more at risk of financial abuse.
Set up a Lasting Power of Attorney (LPA): This enables individuals to choose someone they can trust to make decisions on their behalf about things such as paying bills and collecting income if they become unable to take those decisions (visit www.gov.uk)
Consider displaying a ‘no cold callers’ sign.
Stop junk mail and unwanted telephone calls: There are a number of ways to do this such as signing up to the Mailing Preference Service and Telephone Preference Service (see useful websites below)
Only ever use reputable or recommended builders – Knowsley Council operates the Trader Approved Scheme Knowsley (TASK) which holds a list of traders who have been vetted by Trading Standards and have agreed to abide by a code of practice.
Run background checks on caregivers or personal assistants
Protect valuables: List and photograph all of your valuables. Keep the items in a locked drawer and the photographs in a different location. Doing so could be useful if the valuables are stolen, as you can prove they actually belong to you/a relative.
Check up on them: The best way to prevent problems or at least identify them quickly is to check up on your relatives regularly.

You also find useful information from the links below:

Modern slavery & criminal exploitation

What is modern slavery?

Modern slavery encompasses human trafficking, forced labour, domestic servitude and can have links to sexual exploitation. Traffickers and slave masters use whatever means they have at their disposal to force individuals into a life of abuse and inhumane treatment. Modern slavery is a largely covert crime and victims tend to be controlled and hidden away.

Slavery is when someone is:

Forced to work through mental or physical threat
Owned or controlled by an ’employer’, usually through mental, physical or sexual abuse, or the threat of abuse
Dehumanised, treated as a commodity, or bought and sold as property or for the purposes of sexual exploitation
Physically constrained or has restrictions on his or her freedom of movement.

What is human trafficking?

Human trafficking involves an act of recruiting, transporting, transferring, harbouring or receiving a person through a use of force, coercion or other means, for the purpose of exploiting them.

It takes various forms and affects people of all ages, gender and races, with many victims targeted because of existing vulnerabilities including, learning disability, mental health problems and homelessness.
If you suspect this type of abuse is happening, you should report it to the police or relevant local authority – they will make a referral through the National Referral Mechanism (NRM).

Poverty, limited opportunities, lack of education, unstable social and political conditions, economic imbalances and war are the key driving forces that contribute to the trafficking of victims into, through and across the UK. A common misconception is that victims are transported from another country into the UK, however people can still be trafficked from one borough to another within the UK.

What is forced labour?

Forced labour is any work or service which people are forced to do against their will, under threat of punishment.

It is most often found in industries with a lot of workers and little regulation such as:

Agriculture and fishing
Domestic work
Construction, mining, quarrying and brick kilns
Manufacturing, processing and packaging
Prostitution and sexual exploitation
Market trading and illegal activities

What is domestic servitude?

Domestic servitude is a specific type of forced labour and takes place in a private establishment. People may be promised employment and instead find themselves trapped in someone’s home with little or no money and coerced into staying for fear of punishment to themselves or their family.

What is sex trafficking?

Sex trafficking is the recruitment, transportation, transfer, harbouring or receipt of persons who are under threat through force, coercion, fraud, deception or abuse of power and are sexually exploited for the financial gain of another.

Spotting the signs of modern slavery:

Physical appearance – victims may show signs of physical or psychological abuse, look malnourished or unkempt, or appear withdrawn, scared or frightened.
Isolation – victims may rarely be allowed to travel on their own, rarely interact or appear unfamiliar with their neighbourhood or where they work.
An unknown person may appear to be monitoring the movements of a worker or appears to be controlling them in some way. This may include the worker being collected and dropped off at work each day.
Poor living conditions – victims may be living in a dirty, cramped or overcrowded accommodation, and/or living and working at the same address.
Few or no personal effects – victims may have no identification documents (including access to their passport), have few personal possessions and always wear the same clothes day in, day out. What clothes they do wear may not be suitable for the work they are doing, and may not be appropriate for the season/weather.
The person may not have been provided with the appropriate personal protective equipment linked to the work they are doing, for example, safety gloves, goggles or boots.
Reluctance to seek help – victims may avoid eye contact, appear frightened or hesitant to talk to strangers and fear law enforcers for many reasons, such as not knowing who to trust or where to get help, fear of deportment, fear of violence to them or their family.

Support for victims of modern slavery or forced labour

If you think you are a victim or work with or employ someone who may be a victim of modern slavery or forced labour you can call a helpline on 0800 0121 700 and talk through your concerns or visit the Modern Slavery Helpline website.

If you think you’ve identified a trafficker or illegal gangmaster call the police on 101 or 999 in an emergency.

Neglect and acts of omission

What is neglect or an act of omission?

A person who has responsibility for the charge, care or custody of an adult with care and support needs who fails to provide the amount and type of care required to meet those needs. Neglect can be intentional or unintentional.

Some examples are listed below:

Ignoring medical, emotional or physical care needs
Failure to provide access to appropriate health, care and support or educational services
The withholding of the necessities of life, such as medication, adequate nutrition and heating

Spotting the signs of neglect:

Poor environmental conditions
Inadequate heating and lighting
Poor physical condition of the vulnerable adult
Clothing is ill-fitting, unclean and in poor condition
Malnutrition
Failure to give prescribed medication properly
Failure to provide appropriate privacy and dignity
Inconsistent or reluctant contact with health and social care agencies
Isolation – denying access to callers or visitors.
Inappropriate cancellation or reduction of support services
Failure to allow choice and preventing people from making their own decisions
Ignoring or isolating the person
Not taking account of individuals’ cultural, religious or ethnic needs
Not taking account of educational, social and recreational needs

Medication errors

There are various processes in place within adult health and social care settings to help prevent medication errors from occurring. Improving awareness of changes to legislation, guidelines and sharing good practice are also key to prevention.

Organisational abuse

What is organisational abuse/neglect?

Organisational abuse (sometimes referred to as institutional abuse) is neglect and poor care practice within an institution or specific care setting such as a hospital or care home. This can range from a one-off incident to on-going ill-treatment.

Spotting the Signs of Organisational Abuse/Neglect

Run-down or poor facilities, including the standard of heating and ventilation
Overcrowded facilities
Abusive and disrespectful attitudes towards people using services
Lack of respect for dignity and privacy
Not providing adequate food or drink or assistance with eating
No flexibility or a lack of choice in relation to daily routines and diet
Not promoting independence
Misuse of medication
Tasks not being completed on time or correctly due to staffing pressures
Poor moving and handling practices
Lack of care plans
Poor record-keeping and lack of procedures
High staff turnover resulting in poor quality care
Failure to provide care with dentures, glasses and hearing aids
Discouraging/refusing visits or involvement of relatives, friends or carers
Lack of personal items, clothing or possessions
Few social, recreational and educational activities.

What a good organisation should look like:

Leadership and management

The manager of the service provides effective leadership, supporting, training, coaching and directing staff to do their jobs properly
The manager is visible, approachable and available
There are sufficient staff to meet the needs of adults receiving care
There are low levels of staff turnover
There is limited reliance on agency staff
The service does not accept referrals for people whose needs cannot be met
The manager informs relevant professionals when they are unable to meet an adult’s individual needs
Policies and procedures are readily available and are followed correctly
Problems are proactively recognised and responded to effectively
High or low trends for Safeguarding Concerns, Quality Concerns, Complaints and Incidents are evaluated transparently and considered carefully
External incident reporting to the police, Care Quality Commission and the local authority is robust, effective and open
Services are audited effectively and appropriately by the provider.

Staff behaviour and attitudes

Staff have up to date and good knowledge of the individual needs of the adults they are supporting
Members of staff use appropriate and non-judgmental language about the adults they support
Members of staff provide personalised care, providing the adult with choice and control
There is effective verbal and written communication between staff members
Any negative behaviour is challenged and there is a culture of zero tolerance towards abuse
Staff always treat people with dignity and respect
Best Interests decisions are made appropriately in line with guidance and documented effectively
Staff adhere to and proactively support the principles of the Mental Capacity Act.

Environment and basics of care

Support is provided to ensure the adult’s personal hygiene and appearance is maintained
There are sufficient bathroom facilities provided to meet the personal care needs of the adults who use the service
Personal possessions are treated with respect, and care is taken to ensure these are not lost or misplaced
The environment is always very clean and there are no unpleasant smells
The environment is well maintained and there are no health & safety hazards
There is a varied programme of activities and resources to help keep people active and occupied
Activities are provided in multiple locations offering options and choices
Staff are proactive in understanding and minimising the potential for conflict between adults they support
Adults are always dressed in clothing that is appropriate to their needs and or the weather
Staff promote independence and support the skills of the adult
Medication is always administrated with care using appropriate and up to date guidance.

Service design and delivery

Adults needs are being met in line with identified, relevant care plans
There are high quality care plans providing an accurate record of the individual’s needs
Care plans and risk assessments are updated and reviewed regularly to reflect any changes to personal circumstances
Staff carry out actions that are recommended by other practitioners from outside the service
The group of people using the service are compatible and have similar needs, helping to minimise the potential for conflict and pressure on staff/resources
Safeguarding policies and procedures are applied consistently and correctly.

Openness

There is regular and appropriate input from other professionals outside of the service
Individuals have frequent contact with family, friends and other staff not directly employed by the service
External appointments are met
Members of staff have a wide network of colleagues outside of the service
Appropriate referrals are made to speech and language therapy, GP, dieticians, community psychiatric and other nurses
Management and staff create a relaxed environment that encourages and values professional challenge from outside the service, as well as transparency in relation to complaints from family members
The service facilitates appropriate, private consultations with professionals from outside the service
Family contact is proactively encouraged and supported.

Self neglect and hoarding

What is self-neglect?

Self-neglect is when someone:

Neglects their personal hygiene
Neglects to care for their own health and/or care needs (this can include drug or alcohol misuse/dependency)
Neglects to care for their own surroundings
Hoarding (excessive collection and retention of any material to the point that it impedes day to day functioning). This can include things like:
- Clothes
- Books, magazines, newspapers
- Toys, videos, DVDs, CDs
- Letters, leaflets and papers
- Food/packaging
- Animals

Self-neglect may also involve refusal of services, treatment, assessments or intervention, which could potentially improve self-care or care of one’s environment.

Self-neglect differs from other safeguarding concerns as there is no ‘perpetrator’ of abuse, however, abuse cannot be ruled out as a purpose for becoming self-neglectful. Self-neglect can be a complex and challenging issue for practitioners to address, because of the need to find the right balance between respecting a person’s autonomy and fulfilling a duty to protect the adult’s health and wellbeing.

The Mental Capacity Act 2005 is crucial in determining what action may or may not be taken in cases of Self-neglect.

Spotting the signs of self-neglect:

Poor hygiene
Dirty or inappropriate clothing
Poor hair and/or nail care
Malnutrition
Obesity
Unmet medical or health needs
Alcohol and/or drug misuse/dependency
Eating disorders
Social isolation
Unsanitary, untidy or dirty conditions which create a hazardous situation that could cause serious physical harm to the individual or others or a potential fire risk
Poor maintenance of property
Keeping lots of pets which are poorly cared for
Vermin at the adult’s property
Lack of heating
No running water and or lack of sanitation
Poor financial management, including not paying bills which leads to utilities being cut off
Refusal of care services in home
Refusal of care services in care environment
Refusal of health assessments
Refusal of health interventions

Help for hoarders

The following organisations offer support and help for hoarders:

What is drug and alcohol misuse/dependency?

Drug and alcohol misuse is defined as drug and/or alcohol taking, which causes harm to the individual, their significant others or the wider community. The term ‘drug’ refers to ‘psychoactive drugs including illicit drugs, ‘legal highs’ and prescribed and non- prescribed pharmaceutical preparations.’ The term misuse refers to the ‘illegal or illicit drug taking or alcohol consumption, which leads a person to experience social, psychological, physical or legal problems related to intoxication or regular excessive consumption and/or dependence’.

Alcohol or drug misuse/dependency may lead or escalate to self-neglect.

Sexual abuse and exploitation

What is sexual abuse and exploitation?

Sexual exploitation is the sexual abuse of an adult in exchange for attention, affection, food, drugs, shelter, protection, other basic necessities and/or money, and could be part of a seemingly consensual relationship. There can also be links to grooming.

There are many types of sexual abuse. Some victims may not even realise that they’ve experienced sexual abuse unless they become educated about the different forms of this violent act. Any type of non-consensual sexual activity or contact qualifies as sexual abuse, including:

Rape
'Date rape'
Attempted rape
Inappropriate touching
Sexual harassment

Any sexual act or contact that makes someone feel uncomfortable, afraid, or intimidated could fall in the category of sexual abuse. The person being exploited may believe their abuser is their friend, boyfriend or girlfriend. The abuser may:

Physically or verbally threaten the victim
Take indecent photographs of them and circulate to others
Be violent towards them
Try to isolate them from friends and family.

Spotting the signs of sexual abuse/exploitation:

Unexpected or unexplained changes in behaviour
Sudden withdrawal from social activities
Cutting off ties with friends and family
Fixation with a new mobile phone and a desire to hide who they are talking to
Bruising, injury or sexually transmitted diseases

Often people who are being sexually exploited are unaware that they are victims of such abuse.

There can also be links with modern slavery where a person is trafficked and becomes a victim of sexual abuse.

What is consent?

Consent can never be assumed, even in a relationship or marriage. It doesn’t matter what you were wearing at the time, or how you were behaving — sex without your consent is rape.

You may not be able to give your consent if you were under the influence of alcohol or drugs, didn’t understand what was happening or were asleep. If you don’t have the capacity to give your consent, it cannot be assumed.

You’re allowed to change your mind — if at first you wanted to have sex but then decided against it, that’s ok and no-one has the right to force you to continue. If they don’t stop, then what they are doing is sexual assault or rape.

The age of consent in the UK is 16 and a child under the age of 13 cannot legally consent to any sexual activity.

Sources of support:

Emotional and psychological abuse

What is psychological abuse?

Psychological abuse (sometimes referred to as emotional abuse) is common, but too few people understand the definition of this well enough to spot it at an early stage, and therefore prevent this from becoming worse. Without the visible signs of physical abuse, psychological abuse can stay hidden for years. Psychological abuse may start small at first and build into something that can be frightening and threatening.

Types of psychological or emotional abuse:

Enforced social isolation – preventing someone accessing services, educational and social opportunities and seeing friends
Removing mobility or communication aids or intentionally leaving someone unattended when they need assistance
Preventing someone from meeting their religious and cultural needs
Preventing the expression of choice and opinion
Failure to respect privacy
Preventing stimulation, meaningful occupation or activities
Intimidation, coercion, harassment, use of threats, humiliation, bullying, swearing or verbal abuse
Addressing a person in a patronising or infantilising way
Threats of harm or abandonment
Cyber bullying

Possible indicators of psychological or emotional abuse:

An air of silence when a particular person is present
Withdrawal or change in the psychological state of the person
Insomnia
Low self-esteem
Uncooperative and aggressive behaviour
A change of appetite, weight loss/gain
Signs of distress: tearfulness, anger
Apparent false claims, by someone involved with the person, to attract unnecessary treatment

Support

Psychological abuse can be damaging, and often taps into earlier patterns in a person’s life. It is important that adults seek help and support to prevent the abuse from becoming entrenched. Acknowledging that a relationship is abusive can be a useful call to action.

Barriers to seeking help may arise from the emotional and psychological impact of domestic abuse, as well as practical, social or cultural reasons. Many are also similar to those preventing people from seeking help about other safeguarding issues.

Please see section on domestic abuse for further details.

Physical abuse

What is Physical abuse?

Physical abuse is an act of violence or force that causes bodily harm to someone else, typically in the form of physical discomfort, impairment, injury or pain. A person does not have to show signs of an injury or bruises to have experienced physical abuse.

Spotting the signs of physical abuse:

Black eyes
Bruises
Burns
Cuts
Restraint or grip markings
Unusual pattern of injury; repeated trips to Accident and Emergency.

While these signs of physical abuse may seem obvious, most victims may try to cover them up to hide evidence of the abuse due to fear of further abuse or shame about the abuse (particularly in instances of domestic abuse).

While the above signs of physical abuse are visible, other signs of physical abuse may be more subtle. These may include:

Abuse of alcohol or other drugs
Anxiety, including panic attacks and post-traumatic stress disorder (PTSD)
Depression
Fearfulness
Pelvic pain; vaginal or urinary tract infections
Sexual problems
Social isolation or withdrawal
Unwanted pregnancy; lack of prenatal care
Vague medical complaints such as chronic headaches, fatigue or stomach pain
Injuries are inconsistent with the account of how they happened
No explanation of how injuries happened
Injuries are inconsistent with their lifestyle
Multiple bruising / marks on the body including slap marks and finger marks
A history of unexplained falls/minor injuries
Injuries at different stages of healing
Burns (especially if they are inconsistent with the lifestyle of the adult)
Immersion burns or rope burns on arms, legs or torso
Induced injuries or physical symptoms that are falsely claimed or exaggerated on behalf of the adult at risk by a paid or unpaid carer to attract treatment
Misuse of medication (e.g. excessive repeat prescriptions)
Unexplained loss of hair in clumps
Cuts that are not likely to be a result of self-injury
Subdued behaviour in the presence of a carer
Being left in wet clothing or bedding
Malnutrition when the adult at risk is not living alone
Seeking medical treatment too late or not at all.

Types of physical abuse:

Assault, hitting, slapping, punching, kicking, hair-pulling, biting, pushing
Rough handling
Scalding and burning
Physical punishments
Inappropriate or unlawful use of restraint
Making someone purposefully uncomfortable (e.g. opening a window and removing blankets)
Involuntary isolation or confinement
Misuse of medication (e.g. over-sedation)
Forcible feeding or withholding food
Unauthorised restraint, restricting movement (e.g. tying someone to a chair)

Physical abuse may often be linked to domestic abuse.