Reports of being hit or mistreated
Sexual abuse is any forced or nonconsensual sexual activity of any kind. Physical indicators of sexual abuse, particularly in minors, include:
- Torn, stained, or bloody undergarments
- Unexplained and frequent sore throats, yeast infections, or urinary tract infections
- Somatic complaints, such as irritation of the genitals
- Sexually transmitted diseases
- Bruises or bleeding from genitalia or anal region
As with physical abuse, there are also behavioral indicators, some of which are subtle.
- Regressive behaviors in children, such as bedwetting or thumb sucking
- Inappropriate promiscuity or seductive behaviors
- Disturbed sleep patterns
- Unusual or age-inappropriate interest in sex and sexuality
- Avoidance of undressing
- Decline in school performance
- Difficulty sitting or walking
Emotional abuse can be subtle, and difficult for medical professionals to recognize and identify. It is the infliction of anguish, pain, or distress through verbal assaults, threats, intimidation, and other non-physical means. It can have lasting effects on a person’s self-esteem and mental health.
There are a few physical indicators that can point toward emotional abuse, despite its primarily non-physical nature:
- Eating disorders, including obesity, anorexia, or bulimia
- Speech disorders, like stammering or stuttering
- Developmental delays in speech or motor skills
- Weight or height substantially below normal
- Nervous disorders of a somatic nature, such as hives, tics, or stomach aches
Behavioral indicators include:
- Habit disorders, such as rocking or head-banging
- Cruel behavior, such as pleasure taken in harming people or animals
- Emotional upset or agitation
- Withdrawn demeanor
Neglect is also a form of abuse, especially when children or the elderly are the victims. Unfortunately, neglect of elders is frighteningly common in nursing homes. Some of the physical signs of ongoing neglect in a child or senior include:
- Poor hygiene
- Unsuitable clothing
- An untreated illness or injury
- Lack of immunizations or necessary medications
- Indicators of prolonged exposure to the elements, such as sunburn or insect bites
- Hazardous or unsafe living conditions, such as not having running water or heating
- Unsanitary living conditions
Some of the behavioral indicators that neglect is taking place include:
- Age-inappropriate behaviors in children, such as bedwetting or self-soiling
- Withdrawn demeanor
Financial abuse is a form of abuse that’s often carried out against geriatric patients. It’s probably the least well-known form of abuse, but it’s frighteningly common, and it’s something that you, as a nurse, can report to the proper authorities.
Signs of probable financial abuse include:
- Sudden changes in a person’s bank account or banking practice, such as an unexplained withdrawal of a large sum
- Inclusion of additional names on a bank card
- Unauthorized withdrawal of funds using the person’s ATM card
- Abrupt changes in a will, advance directive, or other documents
- Substandard care or unpaid bills, despite the availability of adequate finances
- An unexplained sudden transfer of assets to someone
- The person reporting financial exploitation
Your Legal Obligations
If you have evidence that a patient is the victim of abuse, you must report it. While state laws vary, you most likely have a legal obligation to do so.
If a child is being abused, you should contact your local Child Protection Services. If a person between 18 and 22 is mentally disabled, they are still considered a child, and so contacting CPS is still appropriate.
If you suspect elderly abuse, you may be subject to specific laws in your state. In New Hampshire, for example, elderly abuse is covered under the Adult Protection Law. If you have reason to believe that a geriatric patient is being subject to abuse or neglect, you must contact the Bureau of Elderly & Adult Services.
If you’re not sure where to report elderly abuse, look for specific regulations and agencies in your state of residence. Similar state-level regulati