What is adult abuse & neglect?

Important information for family physicians, nurses and health-care professionals about the abuse, neglect and self-neglect of vulnerable adults.

What is abuse?

Abuse is the deliberate mistreatment of an adult that causes physical, mental or emotional harm, or causes damage to or loss of assets.

Types of abuse include physical, sexual, financial & psychological

  • Physical abuse is any act(s) of violence or rough treatment to coerce or inflict bodily harm. It often causes physical discomfort, pain or injury, but the person doesn't have to be injured to have experienced physical abuse. Examples include punching, burning, pushing, tripping, and spitting.
  • Sexual abuse is any sexual behaviour directed toward a person without his/her full knowledge and consent. Examples include sexual assault, sexual harassment, unwanted touching, or the use of pornography.
  • Financial abuse is the misuse of a person's funds and assets, obtaining property and funds without his/her knowledge and full consent, or in the case of an elderly person who is not competent, not in his/her best interests. 
  • Psychological abuse is any act, including confinement, isolation, verbal assault, humiliation, intimidation, infantilization, or any other treatment which may diminish the sense of identity, dignity, and self-worth. 
  • Other forms of abuse can include over or under medication, censoring mail, violation of civil and human rights, denial of access to visitors, , or invasion or denial of privacy. 

What is neglect?

Neglect is the failure to provide necessary care, assistance, guidance or attention that causes, or is reasonably likely to cause the person physical, mental or emotional harm or substantial damage to or loss of assets. 

Some people have a legal or social responsibility to care for and support an adult who cannot meet those needs on their own. "Neglect" occurs when the other person fails to live up to that responsibility. It may be active neglect (intentional) or passive neglect (lack of experience, information or ability).

Examples of neglect, according to Justice Canada, include failing to provide:

  • adequate nutrition, clothing and other necessities,
  • adequate personal care, e.g. failing to turn a bedridden older adult frequently,
  • safe and comfortable conditions,
  • a clean environment & personal cleanliness,
  • sufficient space for a bathroom & personal privacy,
  • transportation to necessary appointments, and
  • (At least occasional) outings.

It may also include leaving incapacitated adults alone too long, and failing to remain with those who need help or abandonment.

What is self-neglect?

Self-neglect is any failure of an adult to take care of themselves that causes, or is reasonably likely to cause within a short period of time, serious physical, mental or emotional harm or substantial damage to or loss of assets. 

Self-neglect can happen as a result of an individual's choice of lifestyle, or the person may be depressed, have poor health, have cognitive (memory or decision-making) problems, or be physically unable to care for self.

Self-neglect includes:

  • living in grossly unsanitary conditions;
  • suffering from an untreated illness, disease or injury;
  • suffering from malnutrition to such an extent that, without intervention, the adult's physical or mental health is likely to be severely impaired;
  • creating a hazardous situation that will likely cause serious physical harm to the adult or others or cause substantial damage to or loss of assets; or
  • suffering from an illness, disease or injury that results in the adult dealing with his or her assets in a manner that is likely to cause substantial damage to or loss of the assets.

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