Definitions of abuse: vulnerable adults

Physical abuse
This involves non-accidental harm caused by the use of force, ill-treatment or rough handling. It can include:
hitting, slapping, pushing;
the use of inappropriate restraint or sanctions;
restricting freedom of movement;
the misuse of medication;
placing a vulnerable person in an unsafe environment;
any form of physical chastisement.

Emotional or psychological abuse
Emotional or psychological abuse is behaviour that has a harmful effect on a vulnerable adult ;s emotional health and development. Such abuse can include:
threats of harm or abandonment;
imposed isolation, or withdrawal of support networks;
verbal abuse or other actions intended to place a person in fear;
manipulation or misuse of power;
bullying, humiliation or harassment;
overriding the person ;s rights e.g. to privacy or choice, or using coercion;
deliberate isolation or deprivation of social contact.
Spiritual abuse is a form of emotional abuse and can include:
forcing religious ideas onto a vulnerable person where there is either no capacity to engage in debate, or undue pressure to lay aside the person ;s own views; inappropriate use of religious belief or practice e.g. intrusive healing or deliverance ministries to which the vulnerable person has not given informed consent. In a church setting, this might involve pressure on someone who is receiving support from a church-led service to convert to the church or to the worker ;s beliefs about spiritual matters. Remember that a vulnerable adult may still have capacity to make decisions in some areas if not in others; it is important not to take charge ; unnecessarily, or rush someone into making choices.

Financial or legal abuse
The use of a vulnerable adult ;s property, assets or income without their informed consent constitutes abuse. For example:
extortion or manipulation of a vulnerable person ;s legal or civil rights;
misappropriation of money or goods;
misuse of finance or property, including the exploitation or fraudulent use of a person ;s resources;
exerting pressure on a vulnerable person to make gifts or legacies, or to change a will.
In a church context, repeated or direct requests to a vulnerable person to contribute to fundraising initiatives or to leave bequests in a will could be seen as abusive.

Neglect
Neglect involves a lack of appropriate care or a failure to meet an individual ;s basic needs that leads to a risk of harm to a vulnerable person, and can include:
failure to intervene where a vulnerable person is at risk of harm;
withholding appropriate personal or nursing care;
deliberately withholding food, drink or equipment (e.g. mobility or hearing aids);
refusing or restricting access to medical or legal services;
exercising inappropriate control over a person ;s right to have contact with friends and family etc.
The duty to bring concerns about the care or treatment of a vulnerable adult to the attention of the appropriate agencies is relevant to everyone in the church community.

Sexual abuse
Sexual abuse is the involvement of a vulnerable adult in sexual activities or relationships which are for the gratification of another person and to which the vulnerable adult has not given free and informed consent. Examples of sexual abuse can include:
sexual comments, suggestions or innuendo;
introduction to indecent or sexually provocative material;
indecent exposure;
pressure to consent to sexual intercourse or sexual acts of any kind;
physical sexual assaults e.g. rape, indecent assault, forcing a vulnerable person to engage in sexual acts with other people.
Church workers providing a service to vulnerable adults must be careful to observe appropriate professional boundaries in the working context, and not lay themselves open to abuse of their role by flirting ; or developing romantic or sexual relationships with those for whom they hold a position of trust.
Where any kind of sexual relationship develops between adults, the issue of capacity ; is key to whether or not the balance of power is equal. Any sexual act carried out by one person without the informed consent of the other is abusive, whether or not it involves physical contact. Consent obtained under pressure is not regarded as free or informed consent. The Diocese of Ely behavioural guidelines make clear that no-one should enter a sexual relationship with a person for whom they have pastoral responsibility or for whom they have a duty of care.

Institutional Abuse
This involves the collective failure of an organisation to provide an appropriate and professional service to vulnerable people. It can be seen in attitudes and behaviour that amount to prejudice, ignorance, thoughtlessness or stereotyping. It also involves failing to have appropriate safeguards in place to protect vulnerable adults from harm. Institutional abuse can be deliberate or unwitting; it can be embedded into the accepted culture and customs of an organisation or seen through the behaviour and attitudes of its representatives.
In a church context, this points to the need for a clear safeguarding policy and appropriately trained workers. It also requires that we treat people as individuals, rather than carriers of labels. A person with learning disability, for example, may find some things very difficult, but talk through with the person what s/he CAN do rather than automatically rule him/her out of certain activities.