A Vulnerable Adult is described as any person over the age of eighteen who is in need of or who receives community care services because they are either physically challenged, or unable to take care of themselves because of age, or they are unable to protect themselves from any significant harm for any reason whatsoever (Cornock, 2009). Vulnerable adults are often at risk of abuse from the people they live with, work with or people with ill motives. They cannot protect themselves in any way people may take advantage of them. Unlike normal adults who can take care of themselves, they often depend on other people for help, nurturing and their basic needs. Their dependence on others makes them susceptible to acts of cruelty, severe and even subtle abuse. They do not often interact with people outside their households; thus, they cannot report the abuse to anyone. Caring for vulnerable adults is a threefold job that involves the formal, informal carers and the societal institutions such as the government and non-governmental organizations (Cornock, 2009). There are legal frameworks in the form of acts that govern the care of vulnerable groups; they guide the care and provide for the protection of the client. Caring for vulnerable adult’s places a burden on the informal carers, and there still needs to be improvements in the financial support provided by the government. Caring for vulnerable adults takes the cooperation of all stakeholders, including the government and the community.
The law defines different forms of abuse that can be inflicted upon a vulnerable adult. Interestingly abuse can occur anywhere at home, at work, at the care facility even at the hospital. When it is inflicted on children, it is easier to identify because perplex are more aware of its existence within the society (Cornock, 2009). However, when abuse is inflicted on adults vulnerable or otherwise it can be easily ignored or go unnoticed for a long time especially in community care facilities or group homes. People are more ignorant of the challenges faced by vulnerable adults, both in their homes and the society in general. They also assume that the vulnerable adults are the responsibility of their families rather than the responsibility of the whole society.
The most popular form of abuse is physical abuse, and it may be in the form of physical violence, intentional infliction of pain by hitting, burning or subtler forms such as the withholding or misusing medication and the use of restraints. Sexual abuse is also a common form of abuse either through unconsented sexual relations or unwarranted touching of the genitals (Brown, 2010). Financial abuse occurs where the guardian withholds the victim’s inheritance or funds from them. They limit their access forcing them to grovel for their money or in extreme cases using the money for their needs without the consent or knowledge of the victim. Caregivers can sometimes pressure the victims into legally giving them their wealth (Brown, 2010). Abuse also comes in the form of neglect and the omission of essential details and aspects of life. Vulnerable adults are also entitled to things that normal adults are entitled to; they are entitled to an education, healthcare, and social care as well as suitable medication and adequate nutrition as required by their medical condition or age. Failing to provide for these needs is a form of neglect and abuse according to the law. The law provides for the prosecution of people who conduct any form of abuse to vulnerable groups in accordance with the Care Act (Cornock, 2009).
Adults with a diminishing mental capacity are at risk of being abused because they lack the ability to recognize that they are being maltreated, they also lack the capacity to stand up for themselves. Increasing age comes with a decrease in the ability to take care of oneself and dependence on others to do mundane tasks which increase the risk of abuse. Decreased physical abilities lead to physical dependence on others which leads to exposure to abuse by those trusted with taking care of the adult. Low self-esteem in adults can expose them to emotional and physical abuse by their guardian workmates and spouses (Brown, 2010). People with a history of abuse as children or at any other stage of their lives are at risk of experiencing the same or a different form of abuse as adults. They project fear and carry around an aura of victimization that abusers are able to identify and exploit. People who have had previous negative experiences after reporting a case of abuse are also at risk of being abused; they are afraid of reporting the abuses which lead them to endure the abuse over prolonged periods. The abusers are also likely to take advantage of this knowledge, they exploit and reinforce the fear through intimidation and threats. Adults that are socially isolated and without access to health and social information or services are likely to be abused by their point of external contact.
Since the victim may have difficulty reporting the abuse the caregiver and the doctors, have to look for signs of abuse. Some indicators tell if a victim is neglect abused or both. There are always signs of abuse on the victim some may be openly visible while others are subtle and have to the examined closely for one to see them. Physical and sexual abuse are evidenced by signs of bruising and scars that the victim of the caregiver cannot explain plausibly (Brown, 2010). The victim may have bruises of their genitals or signs of sexually transmitted infections. Abuse causes noticeable behavioral changes in the victims such s withdrawal, aggression the victims may become very irritable or emotionally unstable. Loss of weight and becoming unkempt and signs of poor skin care are all telltale signs of abuse that community care providers should look out for. The doctors and social workers should seek to establish the victims access to basic life essentials such as food water and the environment where they reside. If the victim is constantly seeking medical care, then there is a chance that they are being abused, in most cases abuse causes a deterioration in the health of the vulnerable adult. There is a significant relationship between sound mental health and having a strong immune system (Brown, 2010).
Vulnerable adults are at risk of being abused or falling prey to exploitation as such, they need protection and safeguards of the society and the government. Protecting vulnerable is based on six principles as prescribed by the department of health in England (Cornock, 2009).
The safeguards are designed to protect. Empowering, prevention, proportionality, partnership and accountability. The empowerment principle is based on the assumption that the adult has the capacity to make their decisions and to form coherent thoughts. It aims at giving the adult information that will help them in case they are abused. It aims at giving them tools, both physical such as phones and contact numbers to call in case they are abused and psychological, such as building their confidence and self-esteem to stand up for themselves. The protection principle aims at implementing strategies on how to deal with cases of reported abuse or neglect without further endangering the victims. Such procedures are executed by the authorities and legislators in the form of laws as well as, as policies in the care homes where the victims (Cornock, 2009).
Prevention is aimed at eliminating or reducing the risk of abuse altogether by evaluating the care homes on a regular basis and scrutinizing the characters and records of all caregivers to ensure that they do not pose any danger to their wards. The proportionality principle aims at ensuring that any form of abuse or neglect is met with the appropriate measure of response that is, the severity of the act should match its punishment and the severity of the abuse should match the treatment and care given to the victim. The partnership principle calls for the collaboration of the parties involved in the care of all victims to ensure that all the victims are treated with due care and to ensure that perpetrators of abuse are punished accordingly. Accountability between all caregivers means that they raise transparency in the provision of care for all vulnerable adults.
The care of vulnerable adults requires the cooperation of both informal and formal carers. The doctors and the social workers play the roles of formal caregivers while family members and friends form the bulk of informal carers. Professionals in community homes also fall under formal carers. All the caregivers are responsible for ensuring the wellbeing of vulnerable adults and the law provides for the accountability of both to each other and to the patient (Cornock, 2009).
Abuse may occur when the patient is either in the care of the formal or informal caregivers thus, they all have to be vigilant to identify any signs of and perpetrators of the abuse. The support of the family plays an important role in the care of a vulnerable adult as it provides the warmth senses of belonging to them. It provides the necessary emotional and psychological support needed to ensure that the vulnerable becomes as independent and functional as possible (Brown, 2010). The treatment that the adult receives from the family determines their view of the world and also determines the course of their life. The family being the primary setting for the individual gives them a perspective of how the world will treat them. Today, some programs provide support for primary informal carers. The programs equip the carers with the skills to deal with any situations arising during the care of the vulnerable adult. They also provide the necessary moral and psychological support (Cornock, 2009). Such programs also provide counseling services that help them cope with the burden of their situations. These programs provide a support system, for the carers.
In addition to providing a support system, there are government supported programs that evaluate and assess the need for finical support to informal carers as well as supplement their income to help in taking care of the clients. There are also for- profit and non-profit organizations that help offset the deficit in the revenue created when the carer has to quit their careers to take care of the clients. The government also channels funds to state governments to help in the creation of daycare and wellness centers that will care for the clients when their primary caregivers are not available. Such local government initiatives help informal caregivers maintain their jobs and at the same time offset the financial burden of having to commit the clients to full-time private community care. The government in collaboration with employers has implemented policies that provide for flexible and supportive working conditions for the informal carers (Brown, 2010).
The programs also provide forums where the informal carers can interact with social workers and doctors. These forums provided critical interactions and information sharing systems that keep carers up-to-date with the needs and wants of the vulnerable adults. The forums provide an essential connection where the doctors can inform the social workers of signs of abuse without divulging confidential patient information. Community care policies implemented have resulted in informal care being the predominant form of care for the vulnerable groups (Brown, 2010). Policy limits, the community-based services provided by health care and social work professionals to a few hours a day after an assessment which leaves the bulk of care to the family of the clients. The Community Care Act of 1990 meant to help the clients live independently in their homes or residential care centers popularized informal care; it was also intended to reduce the institutionalization of vulnerable groups (Cornock, 2009). It made provisions to ensure that the care needed by the patients was available before the clients were discharged from the hospitals. This ensured that they were well taken care of by willing and financially able family members. This determination is made by social workers who evaluate the financial wellbeing of the proposed caregiver, their ability to care for the client and the environment they propose the client should live in.
The implementation of client based care plans for vulnerable adults has made it possible to identify their individual needs and to tailor their care to these specific needs. It also helps formal carers such as doctors, social workers, and nursing practitioners create a model of care to be followed by the informal carers. Client centered care enables the formal carers to identify any signs that the client is not receiving the necessary care needed for their situation (Brown, 2010). It also helps the social workers formulate a customized review basis for each client rather than using a general evaluation for all vulnerable adults. Personalized evaluation makes it possible to determine what is missing in the care of the individual patient while at the same time eliminating unnecessary provide to the client that they may not need. A person-centered approach respects and enables the individual tastes and preferences of the client. The role of formal caregivers, in addition to assessing the nature of care provided and prescribing adjustments to the model of care used is to make referrals to local services in case of abuse or inappropriate to ensure that any issues raised by the client are taken care of.
Community care has two faucets the home care where the care is supplemented by state provided services such as day care, transportation and wellness centers and home care where the burden of care is left entirely to the family. Caring for vulnerable adults is a threefold job that involves the formal, informal carers and the societal institutions such as the government and non-governmental agencies. There are legal frameworks in the form of acts that govern the care of vulnerable groups; they guide the care and provide for the protection of the client (Cornock, 2009). Caring for vulnerable adult’s places a he burden on the informal carers, and there still needs to be improvements in the financial support provided by the government. Caring for vulnerable adults takes the cooperation of all stakeholders, including the government and the community.
References
Brown, K. (2010). Vulnerable adults and community care. Exeter: Learning Matters.
Cornock, M. (2009). Safeguarding Vulnerable Adults and the lawsafeguarding Vulnerable Adults and the Law. Nursing Standard, 23(41), pp.31-31.
