ABUSE OF PERSONS WITH DEVELOPMENTAL DISABILITIES

Assessing, detecting and treating abuse. Beyond Abuse: Treatment Approaches for People With Disabilities, Part 2
by Virginia Focht-New, MSN, RN
Reprinted from Issues in Mental Health Nursing, 1996, Vol. 17(5), pp. 427-438
(Taylor & Francis, 1996. Used with permission)

If you haven’t time to read it (although we think you should) here are a few key points.

Be aware of changes in behavior, especially with people who have difficulty communicating verbally. If a person has crying spells, hits others or is aggressive in other ways (such as spitting, biting) or begins hitting or biting himself, all of these may be signs of a problem. Many individuals with developmental disabilities may already show this type of behavior, but if it becomes much more frequent, that, too, should be noted.

It is easier to spot signs of abuse or other concerns when there is at least one person who has a long period of experience working with an individual. Unfortunately, many people with developmental disabilities may have as many as ten different caretakers a year. They also may have caretakers who work in shifts and don’t talk to one another much. If you are the one person who has worked with an individual for a long time, even if you are not the staff member with the most degrees or professional experience, please speak up and voice any concerns. You may be the only voice that individual has.

If you suspect abuse, try to increase the supervision of any staff members working with the individual concerned. Also, try to keep a record of as much information as possible.

SEXUAL ABUSE OF WOMEN WITH DEVELOPMENTAL DISABILITIES

This is not a favorite topic of anyone we know, but it is crucial that families and staff member be aware of this issue. While exact statistics vary from one study to another all of them are clear that women with developmental disabilities are much more likely to be sexually assaulted than women without disabilities. There are a lot of reasons for this – they are less able to communicate to report assault so the abuser feels safer, they are put into contact with many different people due to the many services they receive, because of their disability, these women often receive physical contact from caregivers, due to high staff turnover, this care may be provided by people who are relative strangers. In one study, the largest proportion (27.5%) of sexual assaults were by special service providers.
For more information, click on the link below:
Faces of Violence Against Women with Developmental Disabilities

OTHER ISSUES YOU MAY NOT HAVE CONSIDERED…
Homophobia – what if you are working with a person with a developmental disability who expresses sexual interest in others of the same gender.One article on how NOT to do things and some useful advice can be found at this page on the University of Minnesota website.

Other types of abuse:
The University of Minnesota proposes a range of categories to encourage caregivers and others to broaden their definition of abuse. Check out this site at their Institute for Community Integration where they discuss the “Power and Control Wheel”.

The categories they use and a few of the examples are given below. We highly encourage you to visit their web page for the complete discussion.

Coercion & Threat: Threatening to hurt the person, withhold basic support and rights, terminate relationship and leave the person unattended, report noncompliance with the program, use more intrusive equipment. • Using consequences and punishments to gain compliant behavior.
Intimidation: Raising a hand or using other looks, actions, gestures to create fear.
Caregiver Privilege: Making decisions without asking the person with a disability who is affected by the decision.• Providing care in a way to make a person more dependent, for example, by feeding a person rather than taking the time to help him feed himself. • Giving an opinion as if it were the person’s opinion. • Denying the right to privacy.
Isolation: Keeping people from seeing their friends, family and neighbors. • Keeping people from using the phone.
Minimize, Justify, Blame: Denying or making light of abuse. • Justifying rules that limit freedom, dignity, and relationships for program’s convenience, for example, having an aide bathe a person because she “takes too long” to get undressed, shower and dress again, due to a physical disability.
Withhold, Misuse, or Delay Needed Supports: Using medication to sedate the person for agency convenience. • Taking away a wheelchair, crutches or walker to keep a person from getting around.
Economic Abuse: Using person’s property and money for staff’s benefit.
Emotional Abuse: Refusing to speak, ignoring requests. • Being disrespectful of the person’s culture, traditions, religion and personal tastes.