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abuse and neglect

Alternative Names 
physical abuse, emotional abuse, sexual abuse, domestic violence

Definition
Abuse can take many forms. It may be physical, psychological, sexual, or financial. One type of abuse is neglect. It occurs when a caretaker fails to fulfill the basic needs of a child, elder, or dependent adult.

What are the signs and symptoms of the injury? 
A person who has been abused or neglected may have many problems. Anxiety, sleep disorders such as insomnia, and other related conditions can be indications of stress. Injuries in various stages of healing and unexplained injuries might be present. A neglected person may show signs of poor nutrition or hygiene. His or her medical needs, such as healthcare appointments and medication prescriptions, may not be getting met.

A person who has been abused or neglected may:
  • be dehydrated
  • be poorly nourished
  • have untreated medical conditions
  • have poor personal hygiene
  • be living in unsafe, unsanitary, or unclean conditions
  • wear inappropriate or inadequate clothing
  • have unexplained bruises, cuts, head injuries, or broken bones
What are the causes and risks of the injury? 
A combination of psychological, social, and economic troubles may contribute to abuse and neglect. such as financial hardship from drug abuse or addiction or chronic medical conditions raises the risk that abuse and neglect will occur. The risk is highest among families with many serious problems. Children who have been abused may grow up to abuse others.

Abuse and neglect can also happen in nursing homes or other care settings. Overworked, poorly trained staff might be more likely to abuse vulnerable residents.

The long-term effects of abuse and neglect are many and varied. Emotional, psychological, and physical damage can take years to heal. In some cases, the trauma is never completely resolved. Death can occur in extreme situations.

What can be done to prevent the injury? 
Prevention begins with awareness. Campaigns and programs that broadcast the warning signs of abuse and neglect may help prevent these problems.

Friends, neighbours, and family members can help by:
  • asking a child or adult directly about signs of possible abuse
  • talking with the person who is being abused and being supportive. This can make him or her feel less isolated.
  • showing concern, so that the person knows there is someone to turn to for help
How is the injury recognised? 
Abuse may be suspected if signs listed above, such as unexplained injuries, are noted. Neglect may be suspected if a child is often absent from school, tardy, or arrives unusually early. A child might show up for school inappropriately dressed for the weather. A child who is not gaining weight at an expected rate might be a victim of neglect. Sometimes a problem can be detected just by talking to a child.

Most states require doctors to report all cases of suspected abuse. Whether or not the law requires this, a person who has reason to suspect that a child might be the victim of neglect, physical or sexual abuse, or threatened harm, should report this.

If an adult relative, friend, or neighbour may be suffering from abuse or neglect, it may help to talk to the person about options or call adult protective services. Bedsores and weight loss in an elderly person may be reason to suspect neglect. Financial abuse might also be present.

Child or adult protective services will investigate any suspected abuse or neglect.

What are the treatments for the injury? 
Treatment depends on the type of injury sustained. The goal is to ensure the physical and emotional safety of the victim. Doctors, nurses, social workers, and other professionals may be involved in helping to meet the person's needs. Hospitalisation may be required if malnutrition or other serious physical conditions are present. counselling services may help with emotional and psychological problems. If a person is in danger, he or she should be taken into protective custody.

Treatment should include other family members and caretakers.

What are the side effects of the treatments? 
In cases of severe abuse or neglect, the victim may need to be moved from the home or care setting. He or she may have to live with someone else, in a shelter, or in a nursing home, to be safe.

What happens after treatment for the injury? 
Child and adult protective services perform follow-up visits in cases of abuse or neglect.

Medical follow-up care is important, too. This helps to ensure a person's return to good health. It is also a way to check on whether caretakers are behaving responsibly.

Author: Gail Hendrickson, RN, BS
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 13/1/2005
Contributors
Potential conflict of interest information for reviewers available on request
 


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