Chapter 21. Abuse. Abuse. Canadian Charter of Rights and Freedoms

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1 Chapter 21 Abuse Abuse Abuse is physical or mental harm caused by someone in a position of trust such as a family member, partner, or caregiver. Abuser has control over the victim. Victim is physically, emotionally, or financially dependent on the abuser. Occurs at all social levels and in all cultures. Slide 2 Canadian Charter of Rights and Freedoms States that Canada values equality and diversity and that no one should be abused or has the right to treat others unfairly. Canadians are legally obligated to respect your rights and the rights of others. Box 21-1: The Rights and Freedoms of All Canadians (p. 363) Slide 3 1

2 Types of Abuse Physical Force or violence causing pain injury, sometimes death Sexual Unwanted sexual activity, including sexual harassment (conduct, comment, gesture, threat, or suggestion that is sexual in nature) Emotional Words or actions that inflict mental harm Financial Misuse of money or property Neglect Failing to meet basic needs Slide 4 Cycle of Abuse Abuse often follows a pattern: Tension-building phase Abusive phase Honeymoon phase Time between episodes gradually shortens over time, and abuse becomes more frequent and intense. Slide 5 Signs of Abuse Support workers are responsible for recognizing signs of abuse. BUT Support workers are not qualified to judge whether or not a client is being abused. Immediately report suspicions or observations of abuse to your supervisor. Box 21-2: Signs and Symptoms of Abuse (p. 365) Slide 6 2

3 Abusive Relationships Abusive relationships are complex no single cause for the abuse. A person is more likely to be abusive if: Has problems with alcohol or drugs Has a mental illness; severe personality flaws (e.g., explosive temper) Has been abused as a child Is going through period of high stress (e.g., divorce, unemployment, poverty, illness) Slide 7 Spousal Abuse Occurs between intimate partners in marriage or common-law relationships One partner has power and control over the other through abuse. Abuse may be physical, sexual, verbal, economic, or social. Usually more than one type of abuse is present. Both men and women can be abused. Women often more severely injured by abuse. Often choose to stay with partner financial reasons, guilt, concern for children. Slide 8 Child Abuse Parent, guardian, or caregiver mistreats or neglects child. Occurs at every social level. Gross misuse of caregiver s position of trust and authority. Lasting effects on social adjustment. Abused children are at greater risk of themselves becoming abusers and criminals. Slide 9 3

4 Child Abuse (Cont d) Types of abuse include: Physical neglect Depriving a child of food, clothing, medical care Emotional abuse Not meeting child s need for affection, humiliating, rejecting, calling names Sexual abuse Rape, molestation, incest, pornography, prostitution Other types Intimidation, exploiting, terrorizing Slide 10 Situations that Increase Risk of Child Abuse Family crisis Divorce, unemployment, poverty Single-parenting Stress, financial problems Isolation No close family member or other relationships Caring for children with special needs Failure to thrive Below the norms for body weight, growth, development Slide 11 What Can Be Done to Prevent Child Abuse? Parenting education Child abuse prevention programs Being supportive Teaching children to recognize and say no to abusive or exploitive behaviour Slide 12 4

5 Abuse of Older Adults Older adults are at risk for all types of abuse. Most common are financial and emotional abuse Abuser is usually family members. Older adult s primary caregiver Older adult does not report. Fear of the abuser or fear of being moved to a facility Family caregivers are more likely to be abusive when they resent their role. Slide 13 Abuse of Older Adults (Cont d) Includes Neglect Verbal abuse Involuntary seclusion Financial exploitation or misappropriation Emotional abuse Sexual abuse Abandonment NO EXCUSE FOR ABUSIVE BEHAVIOUR FROM SUPPORT WORKER Slide 14 Factors that Might Increase an Older Person s Risk for Abuse Stress taking care of older adult can be extremely stressful Caregiver exhaustion Ageism bias discrimination against older adults Do not respect the dignity or abilities of older adult Vulnerability Inadequate housing, racism, homophobia, disability, lack of access to community, lack of access to justice system Slide 15 5

6 Abuse of Clients in a Facility or Home Setting Abuse can happen in facilities/home care setting by any member of the health care team. Clients are at risk for all types of abuse (physical, sexual, emotional, financial). For example, violating client s rights by providing care against the person's wishes Often happens when worker is under stress Some clients are abusive and difficult to work with; worker must avoid becoming abusive in such circumstances. If necessary, request another assignment. Slide 16 Reporting Abuse Abuse is a crime. Canadian law states that we must report if we suspect that a child, person with mental or physical disability, or older adult is being abused. Abuse has one or more of these elements: Willful causing of injury Unreasonable confinement Intimidation Punishment Depriving the person of the goods or services needed for physical, mental, or psychosocial well-being Slide 17 Reporting Abuse (Cont d) The person reporting is protected from any kind of legal action, provided the report is not falsely made and motivated by malice. Contact: Child welfare agency Social service agency Police department Hospital Mental health centre Distress centre Other community service organization that provides counselling and support to children and families Slide 18 6

7 Abuse of Health Care Workers Caregivers are at risk of abuse from: Family or other member of the team Clients with mental illness, dementia Employer Never ignore or accept abuse. If abuse occurs: Discuss with supervisor put it in writing, keep records May need to report it to the police Slide 19 Sexually Aggressive Clients Behaviour may or may not be intentional. Flirting, expose themselves, masturbate, inappropriate touching Be professional ask person not to touch you. Inform person you will not do what they want. Tell them those behaviours are unacceptable and uncomfortable. Discuss situation with nurse in charge. Box 21-4: What to do when a client is abusive (p. 372) Slide 20 Sexual Harassment Sexual comments, gestures, threats or suggestions If behaviour offends you or makes you uncomfortable, it is harassment. Could be from client, family, co-worker Tell person firmly and assertively this is unacceptable and unwelcome. Discuss with supervisor; may need to keep private documentation. All employers are required to prevent sexual harassment and have policies on how to deal with this. Slide 21 7

8 Your Legal Responsibilities You are legally required to report child abuse, witnessed and suspected, directly to local child welfare agency. Failing to report child abuse can result in fines or imprisonment. Several provinces have laws that require health care workers to report witnessed or suspected abuse of elderly or disabled. Report to public authority Slide 22 How to Report Abuse Record all your observation; be very specific and make report in writing. Keep all your notes for later recall. Record victim s and alleged abuser s name, address, age, specific time, and dates. State all facts. Protect privacy; only tell the people who need to know. Slide 23 Client Speaks Assure the client that you will do what they want. Listen attentively and make notes. Reassure clients you believe them; be nonjudgemental. May be necessary to identify bruises, etc. Provide emotional support. Report to supervisor. Slide 24 8

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