Training Material
Abuse and Neglect in the Home Environment
It is Hiawatha HomeCare’s policy that Clients have the right to be free from mental physical sexual and verbal abuse, neglect, and exploitation.
Agency personnel shall assess each client individually to determine the client’s vulnerability to abuse or neglect. All personnel providing service in a client’s home are mandated to report abuse and/or neglect (including suspected abuse or neglect) of the vulnerable adult/child to the appropriate authorities.
Abuse, neglect or exploitation of a client or the failure to report knowledge of these actions is considered unacceptable conduct and may result in disciplinary action, including termination.
As a nurse in the home environment you have the duty to ensure your client is free from:
- Mental Abuse
- Physical Abuse
- Sexual Abuse
- Verbal Abuse
- Neglect
- Exploitation
What is a vulnerable adult?
Anyone eighteen (18) years of age or older, who regardless of where the person is living, is unable or unlikely to report abuse or neglect without assistance because of mental or physical function impairment or his/her emotional status.
What is a vulnerable child?
Anyone under eighteen (18) years of age, who regardless of where the person is living, is unable or unlikely to report abuse or neglect without assistance because of mental or physical function impairment or his/her emotional status.
What is abuse?
It is the intentional and non-therapeutic infliction of pain or injury or any persistent conduct that causes physical harm, pain, mental or emotional distress.
- Any sexual contact between an agency staff member and a client of the agency, or
- The illegal use of a vulnerable adult’s/child’s person or property for another person’s profit or advantage, or
- The breach of a fiduciary relationship through the use of a person or a person’s property for any purpose not in the proper and lawful execution of a trust, or
- Any aversive and deprivation procedures that have not been authorized.
What is neglect?
The failure by a caregiver to supply the vulnerable adult/child with necessary food, clothing, shelter, health care or supervision, or
- Failure to provide medical care for physical or mental health needs.
- Failure to meet the individuals need for affection, attention, and emotional nurturance.
- Failure to protect from health or safety hazards.
What is self neglect?
Self neglect is the result of an adult’s inability, due to physical and or mental impairments or diminished capacity to perform essential self care tasks i.e.:
- Providing essential food, clothing, shelter, and medical care,
- Obtaining goods and services necessary to maintain physical health, emotional well-being, and general safety, and/or
- Managing financial affairs
What is abandonment?
When a person who has the care of, or custody of, another and leaves them in circumstances where a reasonable person would continue to provide care or custody.
What is exploitation?
The illegal use of an incapacitated adult or his resources for another’s profit or advantage.
What is sexual exploitation?
Any person who knowingly promotes, aides or assists, employs, uses, persuades, induces, or coerces a child to engage in prostitution or a live performance involving obscene sexual conduct; any person who depicts a child in print, film, photograph or slide in which a child is engaged in sexual conduct.
What is sexual abuse?
It is the sexual battery, rape, incest, sodomy, oral copulation, or penetration of a genital or anal opening by a foreign object.
What is a mandated reporter?
All professional and nonprofessional caregivers who have knowledge of the abuse or neglect of a vulnerable adult/child, have reasonable cause to believe that a vulnerable adult/child is being or has been abused or neglected, or who have knowledge that a vulnerable adult/child has sustained a physical injury which is not reasonably explained by the history of injuries of the vulnerable adult/child that has been provided by the caregiver(s).
Any licensed personnel are mandated to report abuse and neglect, including suspected abuse or neglect, of vulnerable adult or child to the proper authorities.
Anyone reporting in good faith will have immunity from civil liability.
Signs of abuse, neglect, or vulnerability in a child:
- Unexplained injuries
- Changes in behavior
- Regression
- Fear of going home
- Changes in eating
- Changes in sleep
- Changes in school performance or attendance
- Lack of personal care or hygiene
- Risk taking behaviors
- Inappropriate sexual behaviors
Signs of abuse, neglect, or vulnerability in an adult:
- A combination of old and new bruises
- Untreated injuries in various stages of healing
- Unkempt appearance or poor hygiene
- Broken eyeglasses or frames
- Sudden change in the elder’s behavior
- Caregiver’s refusal to allow visitors to see an elder alone
- Injuries incompatible with explanation of elder or caregiver
What are my responsibilities as a care giver???
Assess the vulnerability status of each client upon admission. A client’s susceptibility to abuse, including self abuse and neglect, includes:
- Physical components, such as impairments and the ability of the client and/or caregiver to provide adequate care
- Mental impairments, such as mental retardation, Alzheimer’s disease, disorientation, confusion, etc
- Emotional status, such as passive personality, depression, etc
- Physical environment, such as safety in or outside the home
Assessment of vulnerabilities is a component of the comprehensive assessment and is incorporated into the clinical record. This information will be addressed in the Plan of Care.
Implement the plan immediately and evaluate at least every 60 days or more frequently, if necessary. The documentation will include results of the implementation.
When abuse or neglect is suspected or identified, the employee is to report the observations or findings.
Internal reporting:
- The employee shall immediately make an oral report by phone or otherwise to the Director of Clinical Services or Administrator.
- The employee shall be instructed to complete a written report of the suspected abuse and/or neglect. (See state specific requirements for reporting time frames and types of report required.)
- The Director of Clinical Services/designee will review the information presented and investigate to determine if this is a reportable incident. If so, the information will then be reported to the appropriate county social service Agency or Adult/Child Protection Agency by the Administrator or an appropriate designee.
- A copy of the report will be sent to the appropriate county social service Agency or Adult/Child Protection Agency as required by state and local law.
- Agency will follow specific procedures identified in that area.
If you ever have any questions or concerns, ALWAYS call your RN Case Manager or Director of Nursing. They are your primary supporters in helping make a decision if you are uncertain about potential abuse.
You may also contact Common Entry Point for the county your client resides in.
Common Entry Point is a system put into place to act upon potential cases of abuse. Once a report is made they complete an investigation and put safeguards in place to prevent it from continuing to occur.
If you are ever in a dangerous situation, call 911 for immediate assistance.
Abuse and Neglect Quiz
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