Domestic Violence

After you take this class, you will be able to:

  1. Detail the signs and various kinds of child, elder and spouse abuse and neglect.

  2. Discuss ways that you can prevent abuse and neglect, including reporting suspected abuse or neglect.


Our entire world has a very big problem with abuse, neglect and other kinds of violence. Children, older people, husbands, wives and other people in a family are often the victims of the violent acts done to them by other people in the home. Very often these people are very close to them. For example, a baby may be severely hit or slapped by their mother; a husband may hurt or kill a wife with a knife or a gun.

We hear about these terrible stories every day. These stories happen in every part of our country. They happen in all kinds of houses. Some of these stories tell us about very bad injuries. Others tell us about a death. We all have to work together to prevent these kinds of things from happening to other human beings.

People that are not able to take care of themselves are sometimes hurt and killed in their home by people that are caring for them just because they can not help or defend themself. These people are also hurt in hospitals and nursing homes.

When a person is hurt in a hospital or nursing home, it is usually called patient or resident abuse. When people are hurt in their own home it is called domestic violence.

Below are some of the most common types of domestic violence:

Child abuse and neglect.

When babies and children are abused it is called child abuse. When babies and children are neglected, it is called child neglect. Child neglect and abuse are both very serious problems. You MUST REPORT it if you think that a child or baby is being hurt and neglected in the hospital, nursing home or your own neighborhood.

Do NOT think that it is ”none of your business”. It is your business. Everyone should report it when they think a baby, child, adult or old person is being hurt by someone else. Healthcare workers MUST report it according to the law.

Spouse abuse and neglect (domestic violence).

It is called domestic violence or spouse abuse and neglect when a husband, wife, boyfriend or girlfriend is being hurt by the person that they love and live with.

Elder abuse and neglect.

When an old person is abused or neglected, we call it elder abuse and neglect.

All people that are at risk for abuse or neglect need our help. They need us to act. They need us to report it so that they can get help. Babies, children, helpless adults, old adults and spouses are protected against abuse with laws. They need our help too.

It is often hard to find out that these bad things are really happening. A person that is being abused may be:

1. afraid to tell others. They may think that if they tell someone that the problem will get even worse. They may also be afraid that they will have no place to go. If they have children, they may think that they and their children have no place to live if they leave or tell another person. We must help these people to get help and to find a safe place to live.

2. NOT able to get help. Some abused people may be too sick to call for or get help. Some may not be able to even speak or even walk out the door. Still others may not own a telephone or a car. These people are not able to call for help.

Healthcare workers, including nursing assistants, MUST report all abuse and neglect even if they are NOT sure it is really happening. Also, they MUST NOT ever abuse or neglect their patients or residents.


There are several kinds of abuse. Abuse can be:

  • Physical
  • Mental
  • Sexual
  • Financial

Physical abuse

A punch, slap, push or pinch is physical abuse. If a person stabs a person with a knife or shoots them with a gun, they are using physical acts of violence. These are some examples of physical abuse.

Old adults in a hospital or nursing home are physically abused when they are handled or cared for in a rough and uncaring way. Grabbing a person by their arm to get them out of bed is physical abuse.

Some of the signs of physical abuse in a person’s own home, hospitals and nursing homes are:

  • skin tears,
  • bruises, or “black and blue marks”, and
  • broken bones.

Mental abuse

This kind of abuse causes mental pain to the person who is abused. When a patient or resident is yelled at, they are being mentally abused. Other examples of mental abuse in hospitals and nursing homes can include telling a child or old person “if you do not take a bath now, you will not leave your room or have your visitors” and name calling. Calling a child a “cry baby” or an old person an “old useless bag” are examples of mental abuse.

Patients and residents that are mentally abused in their own homes, hospitals and nursing homes may:

  • cry,
  • show anger,
  • be very unhappy,
  • withdraw from other people and,
  • be very afraid of other people

Sexual abuse

Sexual contact of any kind WITHOUT the other person agreeing is sexual abuse. Most sexual abuse is also called rape.

Sexual abuse can include:

  • touching,
  • rubbing,
  • oral sex,
  • anal sex and
  • rectal sex

Most sexual abuse occurs among children and young adults, but it can also happen to old adults and younger adults who have a physical or mental problem and even with married people.

Sexual abuse also happens in nursing homes and hospitals. These acts are very illegal. People that do these things are punished according to the law. Needless to say, any healthcare provider who is guilty of any abuse or neglect will MOST likely lose their license or certification for life. They will never work in healthcare again, even after they get out of jail.

The signs of sexual abuse depend of the age of the person. For example, if an infant is touched in a bad way, few if any signs will be present. But, if an adult is raped, there may be bleeding and bruising. More signs of sexual abuse are below.

Financial abuse

When a person’s money is taken away from them by another person, it is not legal and called financial abuse. Most of us also call it stealing.

It is called financial abuse when a healthcare worker or a nursing assistant takes a person’s money to buy something for themselves or to buy something that the patient or resident does NOT want.

Nursing assistants should NEVER “borrow” money from a patient or resident. We must also NOT take any gifts from our patient or resident. These kinds of things VERY often lead to big problems, including being accused of financial abuse.


Neglect is a little different from abuse. All types of abuse involve an act that is wrong. Neglect is NOT doing something that should have been done.

For example, when an old person pays someone to clean their house, cook their meals or give them personal care and these people do NOT do these things, the older person is being physically neglected. The old person has a need to be clean. They need their meals and they need personal care. It is physical neglect if these physical needs are not met by the person who is supposed to do it.

Men, women and people of all ages can also be neglected. This neglect can happen in the home (domestic neglect), in hospitals and nursing homes.

Neglect also has several forms. Neglect can be:

  • Physical
  • Mental
  • Financial

Physical neglect

When a person’s physical needs are NOT met, it is physical neglect. When patients and residents do NOT get the physical care they deserve, the healthcare workers are physically neglecting them.

Physical neglect in hospitals and nursing homes occurs when we do NOT properly feed, clothe, and provide physical or personal care to our patients and residents.

Neglected patients and residents may be:

  • dehydrated,
  • malnourished,
  • soiled with urine,
  • soiled with feces,
  • poorly groomed, and
  • in bad health that could be much better with proper care.

Mental neglect

When a person’s mental needs are NOT met, it is mental neglect. When we turn away from a person who is asking for our help, we are neglecting the person’s mental need to be heard and respected.

Mental neglect happens in hospitals and nursing homes when we do NOT treat our patients and residents with respect and dignity. When we ignore them, leave them alone in a room without our care and attention, we are mentally neglecting them.

Patients and residents who are mentally neglected may be:

  • angry,
  • sad, and
  • withdrawn

If you would like to learn more about patient’s rights and dignity, take the course called Patient Rights and Dignity.

Financial neglect

Financial neglect is NOT letting a person use their own money to meet their physical, emotional or personal needs. For example, if an old person lives at home with their daughter and she does not let the mother use her own money to buy new glasses or a new dress that she wants, the older woman is being financially neglected.

When we do NOT let a person take money out of their account to get their hair done in the hospital or nursing home, they are also be financially neglected.


Babies and children can be abused in a physical, emotional, and/or sexual way. They can also be neglected in a physical or emotional way. All of this abuse and neglect must be reported even when we only think that it may be happening. We do NOT have to be sure. If you think it may be happening, report it.

If you think that abuse or neglect is happening in your nursing home or hospital, report it to the nurse immediately. Look in the phonebook for emergency abuse or neglect phone numbers if you think that abuse or neglect is happening in the area that you live.

Below are some of the signs of child abuse and neglect.

Physical abuse

  • scars,
  • black eyes,
  • bruises,
  • broken bones,
  • head injuries (shaken baby)
  • burns, and
  • death

Mental abuse

  • sadness,
  • withdrawal,
  • fear,
  • poor school grades, and
  • anger

Sexual abuse

  • bleeding from the rectum,
  • bleeding from the vagina,
  • bruises of the genital area, and
  • mental and emotional problems

Physical neglect

  • torn or ripped clothing,
  • lack of grooming,
  • poor physical health,
  • poor dental health,
  • lack of supervision,
  • malnutrition, and
  • lack of childhood immunizations

Mental neglect

  • shyness,
  • withdrawal,
  • poor school grades, and
  • lack of friends


A husband, wife, boyfriend, or girlfriend can also be abused in a physical, emotional, financial and/or sexual way in their own home. They can also be neglected in an emotional or financial way.

This abuse and neglect must also be reported even when we only think that it may be happening. We do NOT have to be sure. If you think it may be happening, report it.

Below are some of the signs of domestic violence.

Physical abuse

  • bruises,
  • burn marks,
  • cuts,
  • broken teeth or loose teeth,
  • broken bones,
  • head injuries, and
  • hidden internal injuries that result from punching

Mental abuse and neglect

  • eating too much or too little,
  • anger,
  • sadness,
  • withdrawal from family and friends,
  • fighting at home,
  • alcohol use and,
  • drug use

Sexual abuse

  • bruises, redness, soreness and/or bleeding of the vagina, rectum, and/or genital area,
  • unwanted pregnancy, and
  • torn, stained, or bloody under clothes

Financial abuse and neglect

  • lack of food in the house, and
  • lack of other necessary things, like electric, heat and clothes, even when the family has enough money to pay for these things

Domestic Violence: Elder/Disabled Adult Abuse & Neglect In The Home

Elders and disabled adults show the same signs of abuse and neglect as described above. These people, though, may not be able to tell other people about it. Elders and disabled adults are at risk for:

  • physical abuse,
  • physical neglect,
  • mental abuse,
  • mental neglect,
  • financial abuse,
  • financial neglect and
  • sexual abuse

Anyone can be abused or neglected. Men, women, adults, children and people of all ages can be abused. People can be abused or neglected in their own home and in hospitals or nursing homes. Infants and children can be abused or neglected in their day care program.

Nursing assistants and other health care workers must, by law in many states, immediately report all cases of elder, spouse, disabled adult, and child abuse or neglect. And, of course, we must NEVER, NEVER abuse or neglect anyone that we care for!

If you THINK that someone is abusing or neglecting a person in your hospital or nursing home, REPORT IT to the nurse. You do NOT have to be certain! Report it if you think it may be happening.

If the child, elder or disabled adult is being abused or neglected in a place where they live, call the hot line phone number or the police in your area. For example, if you live in Florida, these are the numbers to call. They will answer these numbers 24 hours a day and 7 days a week

Child Abuse, Elder Abuse & the Abuse of Disabled Adults – (800) 96A-BUSE

Domestic (Spouse) Violence- (800) 500-1119


Berman, Audrey, Shirlee Snyder, Barbara Kozier and Glenora Erb. (2010). Kozier & Erb's Fundamentals of Nursing: Concepts, Process, and Practice. 8th Edition. Pearson Prentice Hall.

Florida Coalition Against Domestic Violence. (1995). Domestic Violence Healthcare Training: A Training Manual for Trainers. Tallahassee, Fl. FCADV.

Hockenberry, Marilyn J. and David Wilson. (2010). Wong's Essentials of Pediatric Nursing. 8th Edition. Elsevier Mosby.

Nettina, Sandra M. (2009). The Lippincott Manual of Nursing Practice. 7th Ed. Lippincott, Williams and Wilkins.

Wold, Gloria Hoffmann. (2008). Basic Geriatric Nursing. Elsevier Mosby.


Copyright 2010 Alene Burke