Domestic Violence

Domestic Partner Abuse
Physical abuse of intimate partners is much more common than most people believe. 8% of women will report of history of such violence, while 29% will report such a history, if asked. Intimate Partner Abuse encompasses child abuse, elder abuse, and both male and female partner physical abuse.

Elder Abuse
Domestic elder abuse is the maltreatment of an older person by someone within a domestic relationship. Institutional abuse is committed by individuals in residential facilities against the older person. There are 7 forms of elder abuse:

• • Physical abuse
  • Sexual abuse
  • Emotional or psychological abuse
  • Neglect
  • Abandonment
  • Financial or material exploitation
  • Self neglect, in which the older person is allowed to make decisions which clearly and adversely affect their health and well-being.

Elder abuse is common, with over 250,000 new cases reported each year. Reported cases are estimated to comprise about 20% of the actual cases of elder abuse.

Elder abuse may occur in a number of ways:

• • Physical abuse occurs when an elder is hit, kicked, pushed, slapped, burned or injured by some show of force.
  • Sexual abuse is when an elder is forced to participate in a sexual act without their consent.
  • Emotional abuse are behaviors that harm an elder’s sense of well-being, such as name calling, scaring, embarrassing, or isolating them from friends and family.
  • Neglect is the failure to meet an elder’s basic needs of food, housing, clothing and medical care.
  • Abandonment is when a caregiver leaves an elder alone and stops providing care.
  • Financial abuse is illegally misusing an elder’s money, property or assets.

Risk factors for elder abuse include:

• • Depression
  • Alcohol and drug abuse
  • Lack of training
  • Lack of social support
  • High emotional or financial dependence on the elder
  • High levels of stress

Every state has agencies designated to help resolve cases of elder abuse. In many states, the Adult Protective Services agency will serve this role. Other local agencies may also help.

For further information, contact

National Center on Elder Abuse

www.ncea.aoa.gov

or call the Elder Abuse Helplines and Hotlines at 1-800-677-1116.

Child Abuse

It is estimated that over 1.5 million children in the United States will be victims of some form of child abuse each year. Risk factors include:

• • Female children are more likely to be sexually abused
  • Male children are more likely to be physically and emotionally abused
  • Single parent families increase the risk, as does large families and low-income families.

Child abuse spans not only Physical, sexual and emotional abuse, but also Neglect, or the failure to meet a child’s basic needs of housing, food, clothing, education and access to medical care.

Children are never to blame for the harm others inflict on them. But certain risk factors increase the likelihood of child abuse occurring.

Children under 4 years old are at the greatest risk for severe injury and death from abuse.

Families with a history of violence, substance abuse, poverty, chronic health problems, and those without nearby friends, relatives or other social support are at the greatest risk.

Ongoing violence in the community may create an atmosphere that is unusually tolerant of child abuse.

To report a concern about possible child abuse, contact

the National Child Abuse Hotline at 1-800-4-A-CHILD, or get more information at

Child Welfare Information Gateway

www.childwelfare.gov

Dating Partner Abuse

About half of women report dating relationships that involve some degree of violence. Among adolescents, the rate is higher with about one in four reporting extreme violence, including rape or the use of weapons.

Three common types of dating violence occur among teenagers.

Physical—for example, if a partner is pinched, hit, shoved, or kicked.

Emotional—Examples include name calling, teasing, threats, bullying, keeping him/her away from friends and family.

Sexual—or forcing a partner to engage in a sexual act when he or she does not or cannot consent.

Dating violence may have lasting effects. Teenage victims are more likely to do poorly in school, and engage in unhealthy behaviors, like drug and alcohol use. Anger and stress may lead to eating disorders and or depression. Some teenage victims consider suicide. Physically abused teens are three times more likely than their non-abused peers to experience violence during college.

People who harm their dating partners are more depressed, have lower self-esteem, and are more aggressive than their peers. Other warning signs for dating violence include:

• • Use of threats or violence
  • Anger management problems
  • Alcohol or drug use
  • Problems at school
  • Poor social skills
  • Lack of parental supervision

For additional online information, go to

National Youth Violence Prevention Resource Center

www.safeyouth.org

National Sexual Violence Resource Center

www.nsvrc.org

Screening for Intimate Partner Abuse

There are a number of good ways to screen for this problem. Among them are these questions:

• • In the last year, has anyone physically hurt you by slapping, kicking, or hitting?
  • In the last year, has anyone made you do something sexual you didn’t want to do?
  • In the last year, has someone made you worried about the safety of your child?
  • Are you afraid of your partner or anyone else?
  • Does your partner ever humiliate you in public, keep you from seeing your friends or doing things you want to do?

Victims of intimate partner abuse will sometimes answer these questions “no” even though they should answer them “yes.” Reasons for this response include:

• • Not wanting to upset domestic relations
  • Lack of alternative support services
  • Fear of retaliation
  • Economic dependency
  • Embarrassment or shame

Risk Assessment

If you believe the patient may be a victim of partner abuse, it is important to assess her degree of risk, particularly in these areas:

• • Immediate danger to the woman or her children
  • Weapons in the home
  • Recent escalation of violence
  • Is there a plan? (bags packed, extra keys, money, safe haven, emergency phone numbers)

Make sure the patient is aware that help is available and effective. Ultimately, there are resolutions to this problem, including counseling, temporary or permanent separation, and removal of the abuser through judicial proceedings. Provide her with a list of resources, including law enforcement, local shelters, child protective agencies, and telephone hotlines. Some women keep copies of these phone numbers on a small piece of paper that they wear inside their shoes, hidden from sight but always available.

I’d like to leave you with points of contact for four groups who can provide more information and help you with this difficult but serious problem:

National Domestic Violence Hotline

1-800-799-SAFE (7233), 1-800-787-3224 TTY, or

www.ndvh.org

National Coalition against Domestic Violence

www.ncadv.org

National Sexual Violence Resource Center

www.nsvrc.org

Futures without Violence

www.futureswithoutviolence.org