Safeguarding Adults and Promoting Independence

M1- Assess the likely immediate effects of two different forms of abuse on the health and wellbeing of adults D1- Evaluate the potential long-term effects of these two types of abuse on the health and wellbeing of adults M2- Describe legislation and regulations, working strategies and procedures used in health and social care to reduce the risk of two types of abuse

Abuse and violence can take lots of different forms. Physical abuse is where someone is physically injured by someone else.

Sexual abuse involves someone being made or forced to do any kind of sexual activity. I am choosing these two types of abuse to write about the immediate and long term effects.

Case study

‘Carolyn is 21-years-old, and autistic with moderate intellectual disabilities. She attends a special school program to assist with her disabilities. On a recent field trip, Carolyn’s teacher left her and two male students unsupervised in the school van for a brief period of time.

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While the teacher was gone, one of the young men took Carolyn’s shirt off, fondled her bare breasts, and took a picture of them. When the students returned to school, he showed the pictures to other students. Carolyn told her mother about what happened and her mother contacted APS for help.’

Case study . Available: From this case study I can see that this was an act of sexual abuse. Carolyn is very vulnerable already because she is autistic with intellectual disabilities and might lack the capacity to give consent to this happening.

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People who have autism find it difficult to communicate and relate to other people and affects how they make sense of the world around them. Carolyn might have not realised that what was happening was wrong and found it hard to tell them to stop at the time because she got very confused. Carolyn’s teacher should not have left her with the two men not just because they were students, because of this she can’t have had the correct training to deal with abuse. Her teacher is not providing the correct care for Carolyn by leaving her unattended. Carolyn was obviously very confused and unhappy about the situation so she told her mother looking for advice and help.

The pictures that were taken without her consent were shown around to other students this would have made her feel very self-conscious and violated. Knowing this Carolyn probably would not have wanted to go to school again, which would be an immediate effect from the abuse. This would affect her work and her learning in school which can affect her long term. She would not get any of the grades expected so in the long term she will not be able to get into the career she wants. If Carolyn went straight back to school after this terrible incident then she may suffer from depression because of the emotional and psychological impact it had on her.

This will not just be an immediate effect on Carolyn but also a long term effect, it can impact on her health, having trouble sleeping, not eating much or over eating etc. Depression is known to link to suicide, she may suffer with suicidal thoughts this will make her very anxious and she may not want to leave the house or socialise with anyone that was close to her so friendships will be lost. All of these are disadvantages of depression. But there can also be advantages, “Every great change in my life was precipitated by insights gained during depression. Depression has served the function of changing my life for the better” Wootton, T . The depression advantage .

Tom Wootton. p47

When Carolyn overcomes depression she might realise that even though she found it so difficult, it may eventually change her life for the better. So after overcoming all the disadvantages to depression she will then be able to recognise those feelings again, so it will be less likely that she will have the mental illness again. It is possible that Carolyn may suffer with post-traumatic stress disorder. Post-traumatic stress disorder is an anxiety disorder that can result from a traumatic event. There are three main symptoms for post-traumatic stress disorder which include, Re-experiencing:

feeling like you are reliving the event through flashbacks, dreams, or intrusive thoughts

intentionally or subconsciously changing your behavior to avoid scenarios associated with the event or losing interest in activities you used to enjoy

feeling “on edge” all of the time, having difficulty sleeping, being easily startled, or prone to sudden outbursts RAINN. 2009. RAINN. [ONLINE] Available at: [Accessed 22 April 15].

Carolyn may have a lower mental age than her actual age because of her disabilities; which may then class her as a child. Carolyn might suffer from flashbacks. ‘A flashback is when memories of a past trauma feel as if they are taking place in the current moment. That means it’s possible to feel like the experience of sexual violence is happening all over again.’ RAINN. 2009. RAINN. [ONLINE] Available at: [Accessed 22 April 15]. There could be advantages and disadvantages from having flashbacks. It could be an advantage because an individual will know for certain what is bothering them, which will then help them tackle the problem because they will not be confused about why the flashbacks are happening.

The disadvantages would be that they bring back bad memories about what has happened and then makes it hard for them to overcome the problem and tackle it. Flashbacks can be a weakness in people if they are not correctly dealt with. Sexual violence can affect people in many ways, including perceptions of the body and feelings of control. This could be an advantage to Carolyn, after this happening to her she may realise that it is wrong what the man done to her.

Carolyn will then be more aware of what is happening in the future so then this is less likely to happen again. On the other hand if Carolyn has different perceptions about her body that are negative it may lead to her getting suffering with obesity or anorexia, this will be a disadvantage. The men that fondled her breasts will be classed as sexual assault under the Sexual Offences Act 2003. This will be under part 3 (a+b) of the Act, ‘Sexual Assault

(1)A person (A) commits an offence if—
(a)he intentionally touches another person (B),
(b)the touching is sexual,
(c)B does not consent to the touching, and
(d)A does not reasonably believe that B consents.’

A legislation that prevents sexual abuse for people like Carolyn would be Safeguarding Vulnerable Groups Act 2006 this act aims to prevent unsuitable people from working (either paid or unpaid) with children or vulnerable adult. It does this by vetting all those who wish to do such work vulnerable groups and barring those where the information shows they pose a risk of harm. There are also prevention strategies that people should be aware of so a situation like this could potentially be avoided like, avoiding dangerous situations (be aware of surroundings and always make sure you carry a mobile phone with you), computer safety (edit privacy settings and find a safe computer) and avoid peer pressure etc. RAINN .

Available :

Although some of this could be difficult for someone with a disability like Carolyn it is still important that she is aware of all of these things. Case study ‘An older man was partially paralysed as a result of a stroke. He had carers who came into his home three times a day, but his wife cared for him the rest of the time. Over time, his wife became increasingly aggressive. One night, when he asked her to help him to the toilet, she pushed him and he fell, hitting his head. She then helped him up and slapped him across the face. Unwilling to call Social Services, the man called the Action on Elder Abuse helpline who advised him to work out a schedule with family and friends so that his wife would get some free time and feel less isolated. Such a schedule was developed and life at home improved significantly.’

Case study . Available: This would actually be classed as physical abuse; his wife is obviously very tired and stressed out about the situation they are both in. He is unable to do many things anymore so when the careers are not there he complete relies on his wife. The immediate effect of his wife hitting him will be the physical marks on his body, he may feel ashamed of this and try and hide them from people so they do not find out. There could be an advantage to him having physical marks on his body; if someone else noticed them they would become concerned. That will then help him, the police may then be called and the physical abuse could then stop eventually once the abuser knows the consequences. The disadvantages would be the persistent physical pain and soreness and the mental state of the elderly man. This can lead to a long term affect, when she pushed him he fell and hit is head, this could have caused damage to his brain depending on how hard he fell.

If damage was done to his brain in the fall then long term effects would affect his health. Alzheimer’s can be linked to having a stroke and also from brain damage. He is an elderly man so this also increases his risk of having the disease. This man also may suffer from sleep disturbances; he may not be able to sleep because he thinks she may abuse him in the night. This could be due to fear/anxiety reactions. Also increased risks for premature death are known to people who are suffering from physical abuse. A long term effect he may suffer with is trembling, clinging and cowering. This may last for months especially if the physical abuse is ongoing. Some abused older adults may start to eat less, use more medications or drink more alcohol to help cope with the emotional and physical hurt. The advantage of this may be that for the individual it may get rid of the pain mentally but will lead to a disadvantage because of the damage he will be doing to his body.

Elder abuse consequences . Available: If an excessive amount of alcohol is drunk then this could lead to an alcohol problem which would be a long term condition that will deteriorate his health. The Action on Elder Abuse helpline actually told him some strategies to help them overcome this situation which was to give his wife some time to herself so she was not always being put under a lot of pressure. A legislation that promotes the well-being of individuals is The Care Act 2014, local authorities have the duty to care and promote well-being to individuals and also Safeguarding Vulnerable Groups Act 2006 protects people from abuse.

The man in this case study will be classed as a vulnerable adult because he is unable to do everything for himself independently. Safeguarding Vulnerable Groups Act (SVGA) 2006 was passed to help avoid harm, or risk of harm, by preventing people who are deemed unsuitable to work with children and vulnerable adults from gaining access to them through their work. Although his abuser is his wife so this is not act would not be suitable.

It is very likely that the abuse is happening because of the lack of support his wife gets with her husband. She has to deal with all of his problems; if a career was employed they would be able to take over from his wife so she feels less stress and then will know he is being cared for professionally. The couple’s relationship may be at risk, the elderly man may feel very distant from his wife because of the physical abuse he is suffering. A relationship breakdown will be a long term effect because if it breaks down it will take a very long time to get the relationship back on track, especially building up his trust again for her and overcoming the mental difficulties he might be facing.

Local authorities, police, the health service and the Care & Social Services Inspectorate Wales (CSSIW) now work together to try and prevent abuse occurring and stopping it when it does happen. . Last accessed 22/04

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Safeguarding Adults and Promoting Independence. (2016, Sep 25). Retrieved from

Safeguarding Adults and Promoting Independence

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