Abuse & Neglect for Learner

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A Client Care Module: UNDERSTANDING ABUSE & NEGLECT

©1998‐2011 May be copied for use within each physical location that purchases this inservice. Inservices For Nursing Assistants We hope you enjoy this inservice, prepared by A Client Care Module: registered nurses especially for nursing Understanding assistants like you.

Abuse & Neglect After finishing this inservice, you will be able to:

 Discuss the Instructions for the Learner differences between abuse and neglect. If you are studying the inservice on your own,  Name at least three please do the following: signs that may mean a client is being  Read through all the material. You may find it useful to have a abused physically, highlighting marker nearby as you read. Highlight any information emotionally or that is new to you or that you feel is especially important. financially.  If you have questions about anything you read, please ask  Name at least three ______. signs of neglect and self-neglect.  Take the quiz. Think about each statement and pick the best answer.  Explain how health  Check with your supervisor for the right answers. You need 8 correct care workers can to pass! help prevent abuse and neglect.  Print your name, write in the date, and then sign your name.  Describe the process  Keep the inservice information for yourself and turn in the quiz page at your workplace for to ______no later than reporting abuse and ______. Show your Inservice Club Membership Card neglect. to ______so that it can be initialed.  Email In the Know at [email protected] with your comments and/or suggestions for improving this inservice.

THANK YOU! A Client Care Module: Understanding Abuse & Neglect

AN OVERVIEW OF ABUSE & NEGLECT

Inside This Inservice: Abuse and neglect are serious problems in our communities and in our institutions. People are most at risk for How Much Do You 2 abuse and neglect when they are unable Know about Abuse? to take care of themselves. Can you Understanding Child 3 name the two groups of people that are Abuse least able to care for themselves? They are children and the elderly. Understanding Elder 4 Abuse What Exactly is Abuse? Types of Abuse 5-7 Abuse is some action by a trusted individual that causes physical and/or You will learn more about the types of Neglect 8-9 emotional harm to the victim. There are abuse and neglect, including self- a number of different kinds of abuse, If You Suspect Abuse 10 neglect, throughout this inservice. including: Avoiding Abuse & 11  Physical abuse (including sexual Where Do Abuse and Neglect Neglect Charges abuse) Happen? Reporting Abuse 12  Emotional abuse Abuse and neglect happen in every  Financial abuse community around the United States. Every day, there are children and elderly What Exactly is Neglect? people being abused in their own Neglect is when someone fails to do homes. The abuser is usually a family things that are necessary to meet the member, often someone with needs of a child or an elderly person. psychological problems. There are two types of neglect: Take a minute to jot down a Abuse and neglect can also happen in  Passive neglect is when people don't few things you already know an institutional setting, such as a day about abuse and neglect mean to do harm. Usually, this is care center or a nursing home. The most before reading this inservice. because of ignorance--they just don't common type of mistreatment in know any better. institutions is neglect. Often, these  Active neglect is when people know situations occur because the staff is better and still fail to do what is overworked, stressed out or poorly needed for the care of the child or trained. elderly person.

© 2011 In the Know, Inc. www.knowingmore.com May be copied for use within each physical location that purchases this inservice from In the Know. All other copying or distribution is strictly prohibited. A Client Care Module: Understanding Abuse & Neglect Page 2 © 2011 In the Know, Inc.

How Much Do You Know About Abuse?

Just take a guess...then turn this page upside down to see the answers!

1. In general, 3. Most abuse 6. People who victims of abuse: occurs: suspect A. Hate their A. In nursing someone is The death rate from abusers and homes. being abused child abuse has want to report B. In orphanages. should: increased more than 40% since 1985. them. C. In people’s A. Report their suspicions, even B. Have very little homes. if they might be money. D. In Europe. C. Exaggerate the wrong. B. Talk to a lawyer. problem. 4. TRUE or FALSE C. Keep quiet D. Are related to Most victims of abuse the abuser. unless they are female. witness the abuse. 2. TRUE or FALSE 5. TRUE or FALSE D. Try to get the Disagreements Verbal abuse, such as People who commit happen in any name calling, is not abuser to stop abuse are all hurting the relationship. But, really considered alcoholics or drug victim. when it becomes abuse. addicts. abuse, one person

dominates and 4. True, 5. False, 6. A A 6. False, 5. True, 4.

1. D, 2. False, 3. C, C, 3. False, 2. D, 1. controls the other person—often Facts About Abuse someone weaker.

 Over 2 million cases  Studies show that 1 toward preventing of child abuse and out of 4 girls and 1 the problem. neglect are reported out of 6 boys will be every year in the sexually abused in  The average age of United States, and at some way before elder abuse victims least one third of they turn 18. is about 78 years— them are confirmed and 75% of them are by authorities.  Child abuse and women. neglect costs the  In the U.S., 1,700 U.S. more than $100  By far, the majority children die every billion every year. of elder abuse year from child victims are white abuse and neglect.  Less than 10% of the and are abused by Elder abuse has risen Nearly 80% of them funds spent on an adult child or more than 100% since are under three abuse and neglect spouse. 1986—and continues years of age! every year go to increase every year. A Client Care Module: Understanding Abuse & Neglect Page 3 © 2011 In the Know, Inc.

Understanding Child Abuse

 Child abuse can happen in any type of family—small, large, rich, poor, white, black, etc. It can also happen to children of all ages.  Infants and toddlers are more likely than older children to be seriously injured or killed by child abuse. Child abuse victims know their abusers  Abuse to adolescents might go unrecognized, since teenagers might nearly 86% of the try to hide the problem. time: they are often family members,  Most often, children are abused by their families or guardians, but friends, neighbors or there are cases of children being abused by day care workers or other babysitters. caregivers.

Abused children might react by: Neglected children might react by:  Saying they deserve to be  Begging for or stealing food. punished.  Appearing in dirty or torn  Acting frightened of parents or clothing much of the time. other adults.  Missing a lot of school.  Getting scared when other  Acting very tired all the time. children cry.  Showing no emotion on their “Child abuse casts a  Being very quiet or very faces. shadow the length of aggressive.  Talking in a whisper or whine. a lifetime.”  Sitting and staring into space.  Trying to get attention by being Herbert Ward  Being afraid to go home. “naughty”.  Acting much older than they are.  Abusing alcohol or drugs.  Trying to get attention by being  Taking on adult responsibilities. “naughty”.  Talking about being left alone or  Trying to run away from home. left “in charge” of younger  Getting bad grades at school. siblings.  Attempting suicide.

Who Is At Risk For Child Abuse?

Studies have shown  Living in a family  Living with parents that certain things put where the parents who are children more at risk are having unemployed or for abuse. These marriage who have serious factors include: problems. money problems. Nearly 80% of neglect  Living with a  Being a “special  Living with a victims are neglected parent who has a needs” child, with parent who was by their parents— drug or alcohol physical and/or abused as a child. usually the mother. problem. mental disabilities. A Client Care Module: Understanding Abuse & Neglect Page 4 © 2011 In the Know, Inc.

Understanding Elder Abuse

 Elder abuse is  We can only guess Signs of Elder defined as harm at the number of Abuse done to persons elderly who are It should send up a over the age of 65 abused every year. red flag if: by someone who is The best estimate is In more than 2/3 of in a position of that there are about  The client is not allowed to speak all reported cases of being trusted. 5 million cases per to you unless a elder abuse, the year, but authorities family member is abuser is a family  There are two types say that only about present. member. of elder abuse. 750,000 of them are  The client is Domestic elder reported. punished for abuse happens in being incontinent. the person’s home.  Elders don’t always report the abuse  You see family Institutional elder members abusing abuse occurs in a because they are: drugs or alcohol. nursing home or  Afraid that the  You hear other long term abuser will find someone threaten As many as 13% of care setting. out and be angry. the client. elderly people are  Even if a caregiver  Afraid that the  You hear two different stories abused. The majority is trying to help, it authorities might of these are female, take their family about how the can be considered client got a bruise abusive if they use members away. although abuse of or other injury. elderly men is enough force to  Ashamed that cause unnecessary  A family member becoming more their family refuses to allow common. pain or injury to an member is you to complete elderly person. abusing them. the client’s care.

Who Is Most At Risk For Elder Abuse?

Abuse can happen to  Their condition is  Their caregivers are anyone. However, getting worse. stressed out. there are certain  Their caregivers are factors that seem to  They are isolated not trained for the increase the risk of from their family or job of client care. abuse. Elderly people community. are more likely to be  They are  Their caregiver is a abused if: family member dependent on Elders are also at risk others for all their with emotional for abuse if they have  They are physically problems or who is and/or mentally needs. a history of living with addicted to drugs domestic violence. impaired. or alcohol. A Client Care Module: Understanding Abuse & Neglect Page 5 © 2011 In the Know, Inc.

Physical Abuse

Physical abuse is the  Hair pulling.  Taking away all food use of physical force  Pinching or or water or forcing that may cause injury, scratching. food. pain or impairment.  Biting or spitting.  Putting someone out, Physical abuse unprotected, in Watch your clients  Burning. includes such things severe weather. for signs of physical as:  Using physical  Using physical abuse and discuss restraints  Striking, hitting, punishment. any suspicions you inappropriately. slapping or beating.  Making inappropriate have with your  Pushing or shoving.  “Restraining” sexual contact. supervisor. someone by giving  Shaking or choking. too much  Handling someone  Kicking. medication. roughly during client care.

What Are Some Signs of Physical Abuse?

 Burns, including cigarette or hot  Cuts, scrapes or bite marks. People who commit water burns.  Black eyes or broken eyeglasses. physical abuse are  Unexplained bruises, especially  Signs of sexual assault such as usually stressed bruises in the shape of a belt or bruises in the genital area, out or have fingers. unexplained vaginal bleeding, and emotional problems  Multiple bruises that are at bloody or torn underwear. of their own. different stages of healing. (New  Unexplained venereal disease. bruises are red, then they turn blue,  Spots where hair seems to have then black-purple, then dark green, been pulled out. then yellow.)  Rope marks, especially on wrists or Frequent trips to the emergency  ankles. room.

What Can You Do About Physical Abuse?

 While you want to do may make them  Reporting a situation your work efficiently, choke. Or, trying to when you’re not sure be careful not to transfer a heavy if it’s physical abuse hurry through it. client without help may seem wrong, When you rush, it’s may end up hurting but it isn’t. If there is easy to accidentally your back and giving abuse going on, you hurt someone. For the client a bruise or might save the example, both skin tear. While you client’s life and the Be sure you know children and the would never mean to abuser might get how comfortable elderly may have harm your clients, some psychological your clients are with trouble chewing and rushing through your help. If there is no physical contact. swallowing food— work may be seen by abuse, no one will be Some may welcome a and rushing them others as physical permanently hurt by hug and some may through a feeding abuse. the report. consider it an invasion. A Client Care Module: Understanding Abuse & Neglect Page 6 © 2011 In the Know, Inc.

Emotional Abuse

Emotional abuse is  Intimidation.  Giving someone the when someone causes “silent treatment”.  Harassment. anguish, pain or Keep in mind that  Humiliation, such as distress to another  Yelling or screaming. laughing when an verbal abuse, such as yelling and making person by what they  Treating an elderly elderly client wets threats, often sets say or do. Emotional person like an infant. their bed. abuse includes things the stage for like:  Constant criticism.  Keeping someone physical abuse. away from family,  Refusing to listen to  Insults. friends or the someone.  Threats. community.

What Are Some Signs of Emotional Abuse?

Be on the watch for clients who:  Never seem to get enough People who commit  Seem to be afraid of certain sleep. physical abuse seem caregivers or family members.  Have a sudden change in to abuse their victims  Are yelled at by family members appetite. just once in a while. or caregivers.  Have big changes in their People who commit  Are made fun of by family weight (either up or down). emotional abuse tend members or caregivers.  Seem very quiet or just stop to hurt their victims  Are suddenly very agitated. talking suddenly. on a regular basis—  Are suddenly confused or are  Talk about being helpless. even daily. more confused than usual.  Seem scared to talk to you  Talk about being worthless. about their lives or their health.  Cry all the time.  Are angry all the time.

What Can You Do About Emotional Abuse?

 Watch your clients  Avoid making jokes  Maintain a positive for signs of about your clients. It attitude with all your emotional abuse. may seem like a clients—even if they Don’t be afraid to harmless way to may be “difficult”. discuss a situation lighten the stress that you think might from your day, but  Report rude, Treat all your clients be emotional abuse what if the client or disrespectful with kindness and with your a family member behavior toward respect. Think of supervisor—even if hears you? It might your clients, even if how you would want it involves a be considered it comes from a your loved ones to coworker. emotional abuse. family member. be treated if they were clients. A Client Care Module: Understanding Abuse & Neglect Page 7 © 2011 In the Know, Inc.

Financial Abuse

Financial abuse  Forging checks.  Keeping someone includes the theft or away from his or her  Cashing someone misuse of someone’s else’s check without own home or money. money or property by Let your supervisor  Providing healthcare permission. know if you notice a trusted individual. services to a client  Using someone’s that your client’s This includes the that are not really ATM card without valuable possessions following activities: needed. permission. are suddenly  Committing fraud.  Promising care in disappearing.  Forcing someone to exchange for money  Getting money by change his or her lying about why it is and then not will. needed. following through.  Forcing someone to transfer property.

What Are Some Signs of Financial Abuse? There are some common signs that  Talk about having to give money to someone is being financially others. People who commit abused. Keep an eye out for your  Seem anxious about—or don’t financial abuse tend clients who: know—where their money is to be younger than  Can’t pay their bills for housing, going. other types of food, basic clothing or medications  Have a family member who even though they seem like they abusers. In half of all complains constantly about how have enough money to do so. reported cases of much the client’s care is costing.  Get credit card bills for stores they financial abuse, the  Have family members who appear abuser is under 40. have never been to. suddenly and claim they have a  Suddenly have new “best friends”. right to the client’s money.

What Can You Do About Financial Abuse?

 Watch your clients  Avoid buying food best way you can carefully for signs of and other necessities help is by telling your financial abuse. for your clients. It’s supervisor about the Report any easy to grow close to client’s financial suspicions to your your clients and problems. There may supervisor. come to think of be community them as your family. services that can  Never take money You might see that assist the client on a from a client—even they need help permanent basis. if it is offered as a gift. buying groceries and Otherwise, what It may be seen by you want to assist happens to the client Report it right away if others as financial them. Please when you’re not your client tells you abuse. remember that the there to help his or her Social anymore? Security or pension check is missing. A Client Care Module: Understanding Abuse & Neglect Page 8 © 2011 In the Know, Inc.

Neglect

Neglect is when  A parent who fails to  A caregiver who someone refuses or take a baby for refuses to help an fails to take care of regular checkups elderly person to the someone for whom and vaccinations. bathroom. they are responsible.  A babysitter who  A responsible person Your client may be Remember...neglect runs out for a pack of who deserts a child suffering from can be active, which is cigarettes, leaving or a helpless elderly neglect if he has a intentional, or passive, two toddlers in the person, such as a son medical condition which is due to home alone. who drops his elderly that is not being circumstances beyond  A daughter who father off at a treated. a caregiver’s control. leaves her elderly shopping mall and Examples of neglect mother in the same never comes back. include: clothes for a month.

What Are Some Signs of Neglect? If you wonder whether a client is  Don’t have the medications they Neglect is the most being neglected, keep an eye out need. for the clients who: common type of child  Have a dirty appearance or ripped and elder  Stay in an environment that is dirty, clothing. or smells of urine or feces. mistreatment. The  Are lying in soiled bed linens when number of neglected  Stay in an environment that has you arrive. health or safety hazards such as no children and elderly  Complain of not getting enough heat or no running water. persons has increased sleep. dramatically in the  Have an unusual weight loss.  Never seem to have to urinate. last decade.  Have rashes, sores or lice. (They may be dehydrated.)  Don’t have enough clothes to stay  Beg for food constantly. comfortable and/or warm.  Have muscles that are contracted.  Seem poorly fed or dehydrated.  Have chronic bed sores.

What Can You Do About Neglect?

 Watch your clients something on the basic needs—food, closely for signs of care plan. If you don’t water, comfort and neglect. Report any know how to perform use of the bathroom. suspicions to your a task, ask for help. You have a lot of supervisor. control over the  Take time to listen to quality of their lives,  Follow your clients’ your clients when and your professional Encourage your clients care plans carefully. they tell you what behavior will help to be as independent Check with your they need. Many of them live happier, as possible but never supervisor if you your clients depend more comfortable refuse to help if they don’t understand on you for their most lives. ask for your assistance. A Client Care Module: Understanding Abuse & Neglect Page 9 © 2011 In the Know, Inc.

Self-Neglect “Self-neglect” is the term However, it’s important and has been taught used for people who to remember that adults about his disease. He is a can’t care for themselves have the freedom to competent adult and because of physical or choose how they want knows what will happen if mental impairments. to live. People are not he doesn’t take his insulin. Their behavior is a threat considered to be self- If Mr. Smith still chooses The number of elderly to their health and neglectful if they are not to take his insulin, he people committing well-being. mentally competent and has that right—as long as suicide is increasing, understand what will he is only hurting himself For example, people who especially among older happen if they do things and not anyone else. men. Many of them don’t have the ability to that threaten their Because he is a suffered from get food, shelter, clothing health—and still choose competent adult, he depression. or medical care for to do them. would not be considered themselves may suffer self-neglectful according from self-neglect. For example, let’s say that to most state and federal Mr. Smith is a diabetic laws.

What Are Some Signs of Self-Neglect? There are about 150,000 reported The signs that someone is suffering  Being in generally poor health that cases of self-neglect from self-neglect include: is getting worse. every year. Many of  Being dehydrated.  Misusing medications. these people are  Being without food.  Failing to get necessary items such suffering from as dentures, glasses, hearing aids or  Freezing in the winter. depression, declining prosthetics. health, dementia or  Getting overheated in the summer.  Being unable to manage paying are dependent on  Not wearing suitable clothing for the bills every month. drugs or alcohol. the weather.  Refusing medical attention or  Having bedsores. missing medical appointments.  Being very dirty or bad-smelling.  Abusing alcohol or drugs.

What Can You Do About Self-Neglect?

 Watch your clients  Remember that if a immediately if your carefully for signs of client is choosing to client: self-neglect. Keep in live a certain way— Talks about wanting mind that many and is competent to to commit suicide. victims of self-neglect make that choice— Says things like, “I have Keep your clients’ suffer from then it is not no reason to keep on depression. For some considered self- rights in mind. Ask living.” of them, if their neglect. yourself if the client depression is treated, Tells you about a plan is choosing to live in they will stop the self-  Be sure to let your to commit suicide, a self-destructive neglect. supervisor know such as using a gun or way or if he or she taking too many pills. can’t help it. A Client Care Module: Understanding Abuse & Neglect Page 10 © 2011 In the Know, Inc.

If You Report Your Suspicions... You may be asked  What is the client’s some of the current living REMEMBER! following questions: situation? It is not a violation  Is the client in  Have you seen or of your client’s immediate danger? heard incidents of confidentiality for In most states, Adult yelling, hitting or you to give Protective Services is  Is the client in need other abusive information about the agency of emergency behavior? the client to the responsible for medical treatment? people who are investigating possible  Do you know the abuse cases.  Does the client responsible for identity of the investigating have any current abuser? medical problems? abuse and neglect allegations.

What Happens Next? Child abuse victims are removed from an  If the situation is an  Based on what the  Caregivers and/or abusive home only if emergency, the investigation shows, adult day care authorities forward the victim may be services. there are conditions the report to the moved to a safer  Food and/or food that threaten their police or location. stamps. paramedics. lives, their safety or  If the authorities  Home delivered their health.  The case is assigned find that it is safe for hot meals. to a staff member the victim to remain  Mental health who contacts the in his or her current assessments to victim. In some living situation (or see if the client is states, if the victim an adult victim capable of making is a competent refuses to leave), decisions. adult, he or she has they may arrange the right to refuse for a variety of  Counseling for the victim and/or the an investigation. support, including: abuser.  House cleaning.  If appropriate, the  Support groups authorities will  Home repairs for stressed-out conduct an and/or caregivers. investigation of the modifications, situation. They may such as a  Legal services such as interview health wheelchair ramp. care providers, restraining orders  Medical care. that keep an Generally, the police, clergy, authorities conduct neighbors, family  Medications. abuser away from the victim or follow up evaluations and friends.  Personal items lawsuits to get to make sure there is and clothing. no further abuse. back stolen funds. A Client Care Module: Understanding Abuse & Neglect Page 11 © 2011 In the Know, Inc.

Avoiding Abuse & Neglect Charges

As a health care worker, it’s important to understand how you can protect yourself against being charged with abuse or neglect. Here are some things to remember as you go about your daily work. Remember how important your work is. Your ALWAYS: clients need you!  Follow your clients’ care plans precisely, making sure you see to all of their basic needs.  Report any signs of abuse or neglect immediately. If you don’t, you may be considered guilty of neglect yourself.  Remember that clients from different cultures may communicate their needs in different ways. Listen to your clients with both your eyes and your ears.  Know your own limits. If you feel overstressed, talk it over with your In general, both supervisor. children and the  Remember that ANGER is just one letter short of DANGER! Breathe deeply elderly are unable to and count to ten if you feel yourself losing your temper during client care. stand up for  Tell your supervisor if you find yourself unable to handle a specific client. It themselves when may be that more training will help. (For example, an inservice on faced with abuse. Alzheimer’s disease may help you understand and deal with Alzheimer’s client’s better.) This makes them easy  Tell your supervisor if a client is refusing to eat or drink. If you forget, you targets for abusers. could be charged with neglect.

NEVER:  Ignore your clients’ requests for food, water or bathroom needs—unless what they are asking for is against physician or nursing orders. (For example, you would have to say no to a diabetic client begging you for some chocolate cake or a client on fluid restriction asking for a third glass of water.)  Keep quiet if the abuser is a coworker. While it may seem like you are “squealing” on a coworker, if you stay quiet you could be guilty of neglect. You will be helping both the client and the coworker if you speak up.  Take your personal problems out on the clients. Leave your problems at home.  Let “difficult” clients get the better of you. Think of how you would feel if you had to trade places with them. Treat them with kindness and lots of patience! Never leave your  Threaten or make fun of a client. Don’t stand quietly by while a coworker workplace before the does it either. end of your shift without telling your  Document that “the client is eating fine” if it’s not true. supervisor. You could  “Freak out” if a client or family member accuses you of abuse when you be considered guilty of know you didn’t do anything wrong. Discuss the situation with your neglecting your clients. supervisor, telling him or her all the facts. A Client Care Module: Understanding Abuse & Neglect Page 12 © 2011 In the Know, Inc.

Tips For Reporting Abuse & Neglect

Studies have shown that 93% of nursing assistants have seen or heard of a client being mistreated by a family member or a coworker. You and your coworkers have to work together to prevent abuse and neglect. All fifty states Tell your supervisor have laws about reporting abuse and neglect, but the laws are different in each if you are a victim of state. Check with your supervisor to learn about the abuse and neglect laws abuse by a client or where you work. family member.

ALWAYS:  Keep your suspicions about possible abuse and neglect confidential. Document and report the situation according to your workplace policy but don’t talk about it to anyone who doesn’t need to know.  Let your supervisor know if your client’s family members seem stressed out. (Abuse is more likely to happen when people are stressed. Your supervisor may have some suggestions for community resources to help the family members.)  Remember that keeping quiet about abuse and neglect of your clients is against the law in all by 8 states. For example, in California, if you fail to report what you know, you could be punished with 6 months in jail and a Remember that the $1000 fine. authorities work  Remember that you are not expected to prove that a client is being abused very hard to keep or neglected. That’s up to the authorities. You are expected to report families together. things that you have actually seen or heard that seem suspicious. Their goal is not to  Be sure to report just the facts about a situation. For example, instead of tear families apart. saying, “Mrs. Smith’s daughter was drunk and she was mean to the client.” It’s better to say, “Mrs. Smith’s daughter smelled like alcohol and her speech was slurred. I heard her tell the client, ’I wish you were dead’.”  Remember that for a report, you will probably be asked for the victim’s name, age, address and present location, along with the situation you have observed. Some states require that you give your name and address and some don’t.  Make sure you are clear about your responsibilities when it comes to reporting abuse and neglect.

NEVER:  Jump to conclusions. Stick to the facts when reporting any client situation.  Try to solve abuse and neglect situations on your own.  Stay quiet about signs of abuse and neglect because you don’t want to get involved.  Report your suspicions without telling your supervisor first. Your Don’t wait for proof of supervisor is responsible for the client, too. abuse or neglect before you report it.  Forget that you will not get in trouble for reporting suspected abuse— even if the authorities don’t find any abuse or the client refuses help form This could be deadly the authorities. for your client! A Client Care Module: Understanding Abuse & Neglect

Are You “In the Know” about Abuse & Neglect?

EMPLOYEE NAME (Please print): Circle the best choice and then check your answers with your supervisor! ______

1. TRUE or FALSE DATE: ______The majority of abuse victims are related to their abuser.

 I understand the information presented in 2. Most elderly abuse victims: this inservice. A. Report the abuse. C. Live by themselves.  I have completed this B. Complain constantly. D. Are women. inservice and answered at least eight of the test 3. You suspect Mrs. Smith is a victim of physical abuse because she: questions correctly. A. Doesn’t talk much. C. Tells you her back hurts. B. Has a bruise on her leg. D. Has bite marks on her shoulders. EMPLOYEE SIGNATURE: 4. TRUE or FALSE ______A client who tells you he is worried that his Social Security checks are being stolen is probably a victim of self-neglect. SUPERVISOR SIGNATURE: 5. Most abused children: ______A. Grow up to be abusers. B. Are abused by someone they know. C. Live in poor communities. D. Deserve to be punished.

6. TRUE or FALSE Many victims of self-neglect suffer from depression and/or dementia.

7. Children and elderly people are easy targets for abuse because they: A. Are unable to defend themselves. C. Cry frequently. B. Bruise easily. D. Have so many needs.

Inservice Credit: 8. TRUE or FALSE Giving an elderly client the “silent treatment” could be considered emotional abuse. 1 Self Study hour 9. TRUE or FALSE A coworker may be guilty of neglect if he knows his client has wet the bed but fails 1 Group Study the change the linens. hour 10. TRUE or FALSE File completed test in You must have proof of actual abuse before reporting the situation to the employee’s personnel file. authorities.