Chapter 2 Safeguarding vulnerable adults Summarised from The Management of Abuse: A Resource Manual For The Dental Team, By Elizabeth Bower et al.
There has been a growing awareness in recent years of the abuse of vulnerable adults, perhaps as a result of the similar exposure given to child abuse and corresponding child protection. Who is a vulnerable adult? A vulnerable adult is defined as a person aged 18 or over “who is or may be in need of community care services by reason of mental or other disability, age or illness; and who is or may be unable to take care of him or herself, or unable to protect him or herself against significant harm or exploitation” (Department of Health, 2000). This where community care services includes all care services provided in any setting or context. The weakness of this definition rests in its exclusion of a number of individuals who have mild or moderate learning disabilities and who manage their lives relatively independently but remain very vulnerable to exploitation within their local communities.
Defining abuse of vulnerable adults Abuse is defined as “the violation of an individual’s human and civil rights by any other person or persons”. Like the abuse of children, it can take the form of a single or repeated harmful act, or a failure to prevent harm. Abuse can be physical, sexual, psychological, or financial, and/or take the form of neglect. Examples of abuse are given in Table 1. The definition also encompasses discrimination, particularly in regards to the person’s age or disability, and institutional abuse, where the ethos, culture, management, and organisation of an institution lead to abusive practices at a corporate level. Examples of institutional abuse include poor care standards, inadequate staffing, a lack of responses to complex needs, rigid routines, a lack of training on antidiscriminatory practice, and an insufficient knowledge base within the service. Abuse can occur over a long period, such as in ongoing family problems where domestic violence between spouses or generations is a long term feature of family life. Alternatively, it may be situational, where abuse arises in a previously satisfactory relationship due to deterioration in the health or behaviour of the vulnerable adult or
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