The assessment process
Meeting needs
Carers
Black and minority ethnic communities
AbuseWhat you can do if you suspect abuse
Institutional abuse
Types and indicators of abuse

Law and policy
References
Credits

Assessing the mental health needs of older people

Types and indicators of abuse

The following is based on a list developed by the Multi-Agency Adult Protection Policy for Kent and Medway.

Physical abuse: types
•Hitting, slapping, scratching
•Pushing or rough handling
•Assault and battery
•Restraining without justifiable reason
•Misuse of medication
•Inappropriate sanctions including deprivation of food, clothing, warmth and health care needs

Physical abuse: indicators
•A history of unexplained falls or minor injuries especially at different stages of healing
•Unexplained bruising in well-protected areas of body, e.g. on the inside of thighs or upper arms etc.
•Unexplained bruising or injuries of any sort
•Burn marks of unusual type, e.g. burns caused by cigarettes and rope burns etc. •A history of frequent changes of general practitioners or reluctance in the family, carer or friend towards a general practitioner consultation
•Accumulation of medicine which has been prescribed for a client but not administered
•Malnutrition, ulcers, bed sores and being left in wet clothing

Sexual abuse: types
•Sexual activity which an adult client cannot or has not consented to or has been pressured into
•Sexual activity which takes place when the adult client is unaware of the consequences or the risks involved
•Rape or attempted rape
•Sexual assault and harassment
•Non contact abuse e.g. voyeurism, pornography

Sexual abuse: indicators
•Unexplained changes in the demeanour and behaviour of the vulnerable adult
•Tendency to withdraw and spend time in isolation
•Expression of explicit sexual behaviour and/or language by the vulnerable adult which is out of character
•Irregular and disturbed sleep pattern
•Bruising or bleeding in the rectal or genital areas
•Torn or stained underclothing especially with blood or semen
•Sexually transmitted disease or pregnancy where the individual cannot give consent to sexual acts

Psychological abuse: types
•Emotional abuse
•Verbal abuse
•Humiliation and ridicule
•Threats of punishment, abandonment, intimidation or exclusion from services
•Isolation or withdrawal from services or supportive networks
•Deliberate denial of religious or cultural needs
•Failure to provide access to appropriate social skills and educational development training

Psychological abuse: indicators
•Inability of the vulnerable person to sleep or tendency to spend long periods in bed
•Loss of appetite or overeating at inappropriate times
•Anxiety, confusion or general resignation
•Tendency towards social withdrawal and isolation
•Fearfulness and signs of loss of self-esteem
•Uncharacteristic manipulative, uncooperative and aggressive behaviour

Financial abuse: types
•Misuse or theft of money
•Fraud and extortion of material assets
•Misuse or misappropriation of property, possessions or benefits
•Exploitation or pressure in connection with wills, property or inheritance

Financial abuse: indicators
•Unexplained inability to pay for household shopping or bills etc.
•Withdrawal of large sums of money which cannot be explained
•Missing personal