Safe guarding in health and social care

Safe guarding in health and social care
Safe guarding in health and social care

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Safe guarding in health and social care

Reasons particular people are 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 and therefore need safe guarding in health and social care.

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).

Safe guarding in health and social care

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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 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).

Safe guarding in health and social care

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 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).

 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).

Safe guarding in health and social care

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 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 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).

Safe guarding in health and social care

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Risk factors which may lead 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).

Safe guarding in health and social care

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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 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).

Safe guarding in health and social care

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 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).

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).

Safe guarding in health and social care

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 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).


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 finds. BMJ, h4643.

Older people have high risk of suicide after self-harm. (2012). Mental Health Practice, 15(9), 5-5.


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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