Factors that may lead to abusive situations

Adults Most at Risk
A vulnerable adult is someone aged 18 or over who may receive community care services because of a disability, age or illness, or may be unable to take care of themselves or protect themselves against significant harm or exploitation. Older people are especially vulnerable, for example those with health issues who are unwell, confused and unable to stand up for themselves due to how frail they are. Because of their defencelessness and vulnerability elderly people are more at risk to abuse. Other vulnerable adults include people who are open to abuse because of learning difficulties, physical disabilities or mental illness. Those with learning difficulties may be taken advantage of due to their lack of awareness. People who are physically disabled may rely on help and support from others during every day activities. Due to this reliant lifestyle and dependability of care, they are more susceptible to abuse. Those who have mental health issues require a certain degree of care and support from social workers, psychiatrists, care workers and doctors, this dependability of another person increases their risk of being harmed and abused.

People who may abuse
Vulnerable adults who rely on some sort of support or care, may be abused by a wide range of people, such as: a member of staff, a carer or service manager
a volunteer or member of a community group such as place of worship or social club another service user
a relative, friend, associate or neighbour
a person who deliberately targets vulnerable people in order to exploit them Some abusers may have learnt to abuse from earlier childhood experiences, a history of receiving abuse themselves or seeing others abused. The abuser may be uneducated or untrained, so their actions may have been learnt from health professionals with poor competence who also commit abuse, working in the same environment. Abusive behaviour may come from mental health issues. Someone with anger management or a drinking or drug problem may easily get out of control with a lack of patience resulting in verbally or physically lashing out. A vulnerable adult relying on care and support who is being abused is in need of someone who has a lot of patience and understanding. The abuser will not have this patience, optimistic attitude or emotionally competent way of thinking, causing the abuse to escalate from minor, irritable remarks to physical abuse.

Environments which abuse may occur
Abuse of vulnerable adults may occur at the adult’s home, in a supportive accommodation such a hospital, care home or nursing home, independent living accomadtation, health services such as GP surgeries, public settings and local community or other places previously assumed safe. Where the abuse occurs will be determined by the setting in the environment. Nursing care homes, surgeries and hospitals usually have strict regulatory controls to ensure adequate care is being given, however paid care staff in domiciliary homes may work with little or no supervision. Where there is poor management, little assessment and no enforced legislation in place, those receiving support are more likely to receive inadequate care; this is when abuse starts to occur.

Contexts
Those who are in an authoritative position over someone and in a position of care for example, family members, friends or professional health workers (such as a carer, staff member in a residential or nursing home or hospital), can put vulnerable people at risk of abuse. Because of the vulnerable person’s dependency on the person committing the abuse, they may feel shame or fearful about reporting it. Adults with communication difficulties who are socially isolated are more at risk of abuse as they have no way of revealing they are being abused. Those especially dependent on personal care are also at more risk of abuse along with adults with a lack of mental capacity who aren’t aware that the abuse has taken place. In these circumstances the abuser will manipulate and persuade, creating a feeling of dependency upon the service user to feel isolated and that nobody else cares for them and that they’re on their own. Hereby they a more susceptible to a correlation of abusive situations, so it is unlikely that the vulnerable adult will report the abuse to someone.