1
Q
what is defined as a vulnerable person? (3)
A
- specific definitions according to each relevant law
- generally, someone dependent on others
- at risk of harm due to the choices & actions of the people on whom they depend for care care and necessities
2
Q
what is included as a vulnerable person (3)
A
- children (under 18)
- people living w a disability (mental & physical)
- people in need of assistance to meet daily needs (ex. older adults)
3
Q
what are 5 common types of abuse
A
- physical
- sexual
- psychological/emotional
- financial
- honor based violence
4
Q
define abuse
A
- broad term meaning an act or failure to act constituing mistreatment that causes lasting damage, physical injury, emotional disability, or sexual exploitation
5
Q
define physical abuse, what are examples
A
- unwanted contact or the threat of contact that is harmful, painful, or injurious
ex. slapping, pinching, punching, pushing, kicking, hair-pulling, burning, biting, cutting
6
Q
define sexual abuse, provide examples
A
- any unwanted sexual contact or forced exposure to anything that is explicity sexual
ex. sexual touching, forced sex, forced humilitating acts, offensive sexual comments, control of birth control, being forced to watch or take part in sexual acts w a third party
7
Q
define psychological/emotional abuse, what are examples
A
- acts or omissions that cause lasting psychological harm
- being forced by another person, to watch or take part in behavior that is psychologically/emotionally harmful
ex. threats, humilitation, put-downs, name-calling, actions that induce fear or mental illness
8
Q
define financial abuse
A
- use of financial info or other resources (ex. property, possessions) to control and cause harm to another person
- exploitation of another person’s financial or other resources to exert control or deprive a person of their property or money
9
Q
define “honor” based violence
A
- form of domestic violence where someone in a position of power commits or threatens to commit acts of violence against another in order to control their choices or force them to behave in certain ways
10
Q
what are examples of “honor” based violence (5)
A
- fear of or actual forced marriage
- controlling sexual activity
- false imprisonment
- forced abortion
- death
11
Q
what is neglect
A
- failure of a caregiver to provide adequate food, clothing, shelter, supervision, and/or medical care
12
Q
what is child neglect
A
- an act of omission by a parent or guardian, resulting in (or likely to result in) harm or imminent risk of harm to a child,
13
Q
signs of neglect reflect…
A
- the lack of basic necessities –> hunger, thirst, weight loss, poor hygiene
14
Q
what are some physical indicators of neglect (8)
A
- underweight
- failure to thrive
- constant hunger
- poor hygeine
- inappropruate dress
- consistent lack of supervision
- unmet healthcare care
- hoarding food
15
Q
what are some behavioral indicators of neglect (6)
A
- inactive babies, no vocalization
- hyper-vigiliant facial appearance
- stealing or hoarding food
- extended stays at school
- constant fatigue, listlessness
- assuming adult roles & responsibilites at home
16
Q
define child abuse
A
an act or omission of a parent/guardian or person in whose care a child is in results in:
- physical injury to the child
- emotional disability of a permanent nature
- sexual axploitation of the child with or without the child’s consent, pornography
- shaken baby syndrome
- munchausen syndrome by proxy (rare situation where a parent deliberately makes a child sick in order to get attention from HCP)
17
Q
what are 3 main types of child abuse
A
- physical
- sexual
- emotional
18
Q
what are some physical indicators of physical abuse (3)
A
- unexplained bruises, welts, lacerations or abrasions –> various stages of healing
- unexplained burns
- unexpected fractures or dislocations
19
Q
what are some behavioral indicators of physical abuse (5)
A
- does not seek comfort when injured, stoicism
- indiscriminately seeks affection
- behavior extremes: aggressive or withdrawn
- fear of a particular person or place, irrational and particular fears
- role reversal: tries to care for parent, disproportionate concern or care of a parent
20
Q
what are some physical indicators of sexual abuse (8)
A
- bruises, bleeding, or lacerations in the genital area
- torn, stained, bloody underwear
- pain, swelling, itching in genital area
- difficulty walking or sitting
- vaginal or penile discharge
- repeated UTIs
- physical injury of throat
- pregnancy
21
Q
what are some behavioral indicators of sexual abuse (8)
A
- regressive behavior (ex. bedwetting)
- running away from home
- problematic substance use
- change in school performance
- age-inappropriate sexual play
- provocative drawings of sexual nature
- overtly seductive behavior w adults
- running away
22
Q
what are some indicators of emotional abuse
A
- extreme lack of self-confidence –> “cannot win”
- states that no one cares about him/her
- lags in physical, mental, emotional development
- habit disorders: sucking, biting, rocking
- suicide threats or attempts
- one of the most difficult forms of abuse to define & recognize*
23
Q
in manitoba, to constitue child abuse, what is required?
A
- there needs to be evidence that the impact of the emotional abuse on the child is of a potentially permanent naturen
24
Q
define: a child in need of protection (6)
A
- one where the life, health, or emotional wellbeing of the child is endangered by the act or omission of a person responsible for their care
- where a child:
- -> is without adequate care, supervision, or control
- -> is in the care, custody, control or charge of a person who does not provide adequate care, endangers the child’s life, or who fails to obtain medical treatment for the child
- -> is abused or in danger of being abused
- -> is beyond the control of a person who has the care, custody, control, or charge of the child
- -> is likely to suffer harm or injury due to the behavior, condition, domestic enviro, or associations
- -> being under the age of 12 years, if left unattended & without reasonable supervision
25
what is the age of consent in manitoba and across canada
- 16 years
26
what are some close-in-age exceptions noted in the criminal code r/t sexual activity
- people who are 14 or 15 can consent to sexual activity w someone who is less than 5 years older than them
- a 12 or 13 year older individual can consent to sexual activity w someone who is less than 2 years older than them AS LONG AS the older person is not in a position of authority or trust
27
describe the legal responsibility of duty to report (2)
- anyone suspecting that a child is need of protection is obligated to report the situation to CFS or the police if there is imminent danger to the child, based on info that leads to a reasonable belief that the child needs protection
- where a person has info that leads the person reasonably to believe that a child is or might be in need of protection, the person shall report the info to an agent, or to a parent or guardian of the child
28
describe Failure to Report (3)
- where a person fails to report, the person commits a punishable offence
- punishable by prison and fines as well as professional sanctions such as professional censure and suspension
- not fulfilling this duty may lead to: continued abuse, professional & legal sanctions
29
the duty to report applies even if..
- the info is learned thru professional activities such as care or assessment, when otherwise privacy laws might apply
30
describe Disclosure Without Individual's Consent
- PHIA allows for the sharing of personal health info without the consent of the person to facilitate a child protection investigation
- it is not necessary to have the consent of the child to report
31
describe reporting in good faith (4)
- anyone who reports suspected abuse or neglect in good faith, that is not maliciously or without grounds, is protected from lawsuits and prosecution
- informants protected
- the identity of the reporting person is not disclosed to the family
- no legal action lies against a person for reporting in good faith
32
describe the WRHA reporting policy (4)
- governs responsibilities of WRHA staff
- defines abuse
- policy that outlines the process for reporting a child in need of protection
- will be consistent with the ACT
33
what are some nursing values that promote protection of vulnerable persons (5)
- promoting health & well-being
- promoting and respecting informed decision making
- honouring dignity
- promoting justice
- being accountable
34
what is the intent of the Vulnerable Persons Living with a Mental Disability Act (3)
- to support people to be as independent as possible
- promote and respect the rights of adults living w a mental disability and ensure they are free from abuse, neglect, and exploitation
- encourages people to make the choices they are capable of making, and invoke a support network to help w choices about things they are not able to manage on their own
35
who is included under the Vulnerable Persons Living with a Mental Disability Act
- significantly impaired intellectual functioning and impaired adaptive behavior, manifested prior to the age of 18 years
- excludes a mental disability due exclusively to a mental disorder as defined in the mental health act
36
what is The Protection for Persons in Care Act
- a law intended to protect persons in hospital, personal care homes, or other health facilities from possible abuse and neglect
37
what does the protection for persons in care act outline
- mistreatment = physical, sexual, mental, or financial --> an offence under MB law
- concerned citizens and staff have a duty to report suspected abuse
- once reported, inquiry process done
- PPCO will proceed to investigation if reasonable grounds to believe pt abused or neglected
- criminal wrongoding to police; allegations of professional misconduct to professional body
38
describe duty to report r/t the protection for persons in care act (4)
- mandatory to report
- investigator has access to personal health info
- report to protection for persons in care office
- when necessary, incident referred to professional body for review of professional status or discipline
39
elder abuse can be.. (4)
- physical
- emotional
- sexual
- financial
40
where can elder abuse occur?
- at home
| - in PCH settings
41
what difficulty is associated w elder abuse
- difficult to interrupt the cycle of abuse if the person is competent & capable and unwilling to leave the situation
- we can provide info on supports available or connect the person w someone who can help them access help
42
what is financial abuse
- exploitation or theft, often of older adults, who are cognitively impaired or otherwise dependent on their abuser for resources, love, or companionship
- occurs whenever someone takes money, proprty, or assets without consent
- can include taking control of bank accounts or real estate, pressuring, forcing, or tricking someone into: lending or giving away money, property, or possessions, selling a home or moving, making or changing a will, working for little or no money, providing food & shelter to others without being paid
43
who often commits financial abuse
- relative or friend
44
family/domestic violence can include: (6)
- physical violence
- emotional violence
- threats
- control
- isolation
- possessiveness
45
describe the cycle of abuse r/t domestic violence (3)
- very difficult to break, the abuser may promise after each instance of violence that it will be the last
- people often feel they cannot leave bc of children, pets, financial dependency, or other reasons
- if they don't fall under the CFS act, PPC act, or vulnerable persons act, they cannot be forced to leave --> but can provide info & resources on supports that can help a person escape an unsafe situation
46
what is the role of nurse r/t the protection & prevention of harm to vulnerable persons
- identify & recognize abusive situations
- reporting: knowledge of legal responsibility & carrying it out
- early intervention: knowledge of available resources & skills to intervene
- prevention: ex. promote healthy parenting
*do NOT investiagte allegations of abuse & neglect*
47
describe what should be included in documentation of suspected abuse/neglect (4)
- description of person, injuries, including accurate & objective detail on any signs of abuse noted
- specific dates & times of disclosure, in person's own words "what happened"
- concerns abt immediate safety
- height & weight
* in general needs to be non-judgemental, objective, ASAP after suspicion*
48
for children, what else should be included in documentation of suspected abuse/neglect
- accurate recording of child's developmental stage
| - child's behavior w & without parent or guardian
