Safe guarding in health and social care

  1. Explain why particular individuals and groups may be more vulnerable to abuse and
    harm self and others .
  2. Review risk factors which may lead you to incidents of abuse and harm self and
    others.

Safe guarding in health and social care

Explain why particular individuals and groups may be more vulnerable to abuse and
harm self and others
A vulnerable group includes peoples who are eligible or are in receipt of community care.
This includes people with physical disabilities, learning disabilities, and people with
cognitive deficits, people who are frail physically and mentally. Drug addicts and alcoholics
are also identified as vulnerable group. These people are generally weak and are unable to
defend themselves from harm or abuse. In this context, abuse refers to the violation of a
person’s human rights as well as their civil rights by another stronger being. Abuse takes
many forms including sexual abuse, emotional abuse, and psychological abuse, physical,
financial or institutional abuse (Callewaert, 2011). Some of the signs and symptoms include
unexplained injuries and frequent illnesses. If the care giver gives implausible injuries
explanation is an indicator of neglect or physical abuse. Other indicators include frequent
ER visits for vulnerable people with chronic diseases or if the functionally impaired
vulnerable person comes to the hospital without any company (Podnieks, Penhale, Goergen,
Biggs & Han, 2010).
Sexual abuse includes all sexual practices where the vulnerable people have not given
consent such as rape, sexualised language and inappropriate touching. Physical abuse
includes pushing, pulling, burning, forcefully restraining a person and misusing their
medication. Psychological abuse includes all activities that cause a person to have emotional
distress such as verbal abuse, humiliation, intimidation and harassment. Financial abuse

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includes stealing from the person, fraud and resource exploitation. Neglect is a type of abuse
that involves denying the vulnerable person the adequate medical and social care (Alexandra
Hernandez-Tejada, Amstadter, Muzzy & Acierno, 2013).
In discrimination type of abuse, the person is treated in unfavourable manner due to their
gender, age, type of disability and ethnic background. Lastly, the institutional abuse includes
failing to give services to the vulnerable person due to reason to another. It is important to
note that abuse can take place in various settings including the vulnerable person’s homes,
nursing homes, state facilities, and at the hospitals. The main issue is early identification of
abuse. This is because of the many abuse of the vulnerable people, only a small fraction of
them is detected (Ansello & O’Neill, 2010).
The vulnerable groups are at risk of self-harm and abuse mainly because they often
dependent of care givers to manage their daily activities such as dressing, bathing and in the
maintenance of their personal hygiene. Additionally, these people tend to have little ability to
utilize their self-defence tactics or mechanisms to avoid violence. It is also commonly
assumed that these people with disability do not comprehend what is happening to them;
hence, even when the persons disclose what has happened to them, they are often not
believed. The following are the reasons why the some people are vulnerable to abuse and
self-harm.
One of the reasons for vulnerability of the special group is the issue of dependency. The
special group are more vulnerable if they are dependent to other people for daily activities.
Evidence base studies reports that 97%-99% of the people who abuse the vulnerable
individuals are care givers and trusted individuals, and it is estimated that 44% of the victims
relate to the persons extent of disability. In most cases, the abuse may not be reported because
of fear of the vulnerable person’s safety, shock, and reluctance of the witnesses to get
involved or in breaking the silence code (Callewaert, 2011).

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Communication abilities are other reasons why vulnerable individuals are prone to abuse or
self-harm. The vulnerable person may lack means of communicating to others about their
abuse. This could be due to poor articulation and lack of effective expressive skills. In some
cases, the vulnerable person may need assistive devices to communicate which could be lost,
taken away or even become misplaced, hindering communication between the abused person
and the person in charge. In some cases, the vulnerable may lack enough resources (in terms
of monetary), which can be used to replace the faulty or lost communication devices. This is
worse of the person is physically unable to move due to the nature of their disability, which
would make themselves unable to move or run way from the abusive situation. In adequate
resources will make the individual person run away from the abuser or terminate their
services (Podnieks, Penhale, Goergen, Biggs & Han, 2010).
Other reasons that are associated with increased vulnerability include social isolation where
the vulnerable person lives in over protected environments. The lack of physical access
makes the vulnerable individual lack skills to communicate to the community that they are
suffering. The presence of misleading roles as well as expectations in the society can make
the abused individual remain silent, increasing risk of abuse. For instance, the vulnerable
groups are normally advised to be submissive and compliant, and are not support to question
their authority. This lack of social exposure could make the vulnerable person to continue to
suffer (Podnieks, Penhale, Goergen, Biggs & Han, 2010).
Stigmatization, discrimination and stereotyping are other reasons why the vulnerable persons
continue to be abused. For instable, the disable people may be discriminated in their work
environments. Most of the discrimination cases in the justice systems are often dismissed,
denying the vulnerable discriminated individuals their human and civil rights. It is often
believed that the vulnerable people such as the disabled are asexual. People believe that the
disabled people (for instance) cannot hold intimate relationships. It is also commonly

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4
assumed that the vulnerable people intellect is compromised. This makes it difficult for
people to believe their abuse complaints. In incidences where the vulnerable persons have
signs and symptoms of abuse, the abuser may quickly claim that they are self-inflicted,
putting the vulnerable person to greater risks of abuse and sexual assaults (Hawkes, 2015).
Review risk factors which may lead you to incidents of abuse and harm self and others
As mentioned above, vulnerable groups of people are likely to face abuse from their care
givers. Risk factors sometimes can be correlated with causes or causatives of abuse of the
vulnerable persons. In some cases, the risk factors could also be the risk indicators of the
confounders that influence the causal factors on abuse of the vulnerable group. For instance,
care givers mental status such as depression is causal factors that lead to abuse of the disabled
or elderly persons; it is also a risk indicator that this kind of care giver is likely to neglect the
disabled or the elderly persons because the care giver is socially withdrawn or lack of
interests associated with depression (Hawkes, 2015). Another example of causal relationship
is that of shared living with vulnerable person’s abuse.
Therefore, it is important to identify the risk factors that are associated with abuse incidences
as they help in identifying indicator of abuse or maltreatment. To begin with, the health status
of the person influences how the person will be treated. The vulnerable group have reduced
decision making ability due to their reduced cognitive functionality. Additionally, the
dynamic health status and restricted mobility makes it difficult for the vulnerable person to
seek refuge or rescue. The reduced energy levels in these people reduce their ability to
perform daily living activities or become independent (Callewaert, 2011).
The living arrangement has also been identified as a risk factor for abuse. Vulnerable people
living alone are likely to be less physically abused. One study conducted indicated that
Alzheimer patients living with their immediate families were more likely to be abused. This
is because shared residence tends to increase their contact opportunities with the care givers

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and relatives, hence increasing the rusk for abuse or violent behaviour. In nursing home
settings, abuse of the vulnerable groups is likely to take place if the standards of the nursing
home are low, the settings have inadequate staff. Interactions between untrained staff and the
vulnerable groups living in these home care settings. In most cases, these home care settings
have deficient physical environments and the policies in these institutions are based on the
homecare settings interests instead of the vulnerable groups (Hawkes, 2015).
Cultural factors are key determinants of abuse on the vulnerable people. For instance, in some
cultures, domestic violence is viewed as illegitimate and is most likely hidden. This is
because if family friends, neighbours and kin learn of the behaviour, they are likely to result
in informal sanctions. In this case, person’s abuse is likely to be hidden from the society and
the relevant authority. Other cultural factors include the general assumptions that vulnerable
people are weak, dependent and weak. In some cultures, there has been erosion of bonds
between the generations; especially where young people have migrated to the urban centres
in communities where the elderly people are cared for by their young ones. The elderly
people are left alone and become socially isolated (Callewaert, 2011).
The intra-individual characteristic of the abusers is another risk factor for patient abuse. If
the care giver suffers from psychotic disorders or is using substance use; then it is likely that
the care giver will mistreat the vulnerable person. The type of abuser dependency is another
risk factor that determines if the vulnerable will be abused or not. The risk of abuse is higher
if the vulnerable person depends financially on the care giver. The study indicates that
caregivers may lack coping strategies or lack resilience. This is often associated depression
and increased anxiety. In some cases, the perspectives of the care givers determine their
attitudes. Aggressive and abuse caregivers believe that the care giving on these vulnerable
persons as burdensome without any reward (Podnieks, Penhale, Goergen, Biggs & Han,
2010).

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The intra-individual characteristics of the victims also increase risk of abuse. One study
conducted in Netherlands found that victim’s verbal and physical aggression influenced how
they would be treated by the care givers. The study also indicated that financial mistreatment
of the care givers can make them become aggressive. Several studies have associated gender
as a risk factor for abuse; which reports higher number of victims with adults. The study
indicates that women tend to have more emotional and physical abuse as compared to males.
The relationship between the perpetrator and the victim has been investigated. Although the
study findings in inconclusive, it is believed that the most of the abusers are spouses of the
victims. Other studies have reported race or ethnicity as the key concern; but the study
findings cannot be generalized (“Older people have high risk of suicide after self-harm”,
2012).
Other risk factors mentioned include the intergenerational transmission. Research indicates
that adults who had undergone child maltreatment, neglect and abuse are likely to maltreat or
harm others. Similarly, social factors play a major role as risk factors for abuse of vulnerable
individuals. Poverty, unemployment and low socioeconomic status increases the likelihood of
the vulnerable groups to be maltreated or abused; especially if poverty interacts with other
social factors such as depression, drug use and social isolation. This could lead to aggression
of the care giver on the vulnerable persons (Parle, Kaura, Sethi & Jena, 2013).

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References
Alexandra Hernandez-Tejada, M., Amstadter, A., Muzzy, W., & Acierno, R. (2013). The
National Elder Mistreatment Study: Race and Ethnicity Findings. Journal Of Elder
Abuse & Neglect, 25(4), 281-293.
Ansello, E., & O’Neill, P. (2010). Abuse, Neglect, and Exploitation: Considerations in Aging
With Lifelong Disabilities. Journal Of Elder Abuse & Neglect, 22(1-2), 105-130.

Callewaert, G. (2011). Preventing and Combating Elder Mistreatment in Flanders (Belgium):
General Overview. Journal Of Elder Abuse & Neglect, 23(4), 366-374.

Hawkes, N. (2015). Young goths may be more vulnerable to depression and self harm, study

Older people have high risk of suicide after self-harm. (2012). Mental Health Practice, 15(9),
Parle, M., Kaura, S., Sethi, N., & Jena, P. (2013). ROLE OF MEDIA IN SAFE GUARDING
HEALTH OF THE SOCIETY. INTERNATIONAL RESEARCH JOURNAL OF
PHARMACY, 4(10), 16-20.
Podnieks, E., Penhale, B., Goergen, T., Biggs, S., & Han, D. (2010). Elder Mistreatment: An
International Narrative. Journal Of Elder Abuse & Neglect, 22(1-2), 131-163.

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