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Types of abuse, identification and reporting

Abuse and use of restraint

The following types of abuse are highlighted in the legislation or National Standards:

  • Belgium (Flanders): there is a particular focus on sexual and financial abuse.
  • —Ireland: (following the Council of Europe’s definition) all types of abuse, including physical abuse, sexual abuse and exploitation, psychological threats and harm, interventions which violate the integrity of the person, financial abuse, neglect, abandonment and deprivation (whether physical or emotional) and institutional violence with regard to the place, the level of hygiene, the space, the rigidity of the system, the programme, the visits, the holidays.
  • Malta: physical, verbal, financial, psychological or sexual abuse, neglect, discriminatory abuse or self- harm, inhuman or degrading treatment, whether through deliberate intent, negligence or ignorance.
  • Romania: any type of abusive, negligent or degrading treatment of a resident. Residents should be protected against abuse, neglect, discrimination, degrading or inhuman treatment.
  • —UK (England): any behaviour towards a service user that is an offence under the Sexual Offences Act 2003(a); ill-treatment (whether of a physical or psychological nature) of a service user; theft, misuse or misappropriation of money or property belonging to a service user; neglect of a service user.
  • UK (Northern Ireland): all forms of abuse, neglect, exploitation, and serious harm – including online.
  • —UK (Wales): physical, financial or material, psychological or sexual abuse, neglect, discriminatory abuse or self-harm, inhuman or degrading treatment, through deliberate intent, negligence or ignorance.
  • UK (Scotland): the Adult Support and Protection (Scotland) Act makes provisions to protect adults at who may be at risk of “harm”. Harm is any type of harm and includes financial, physical, psychological, sexual, neglect, as well as self-harm or neglect.

In all the above mentioned countries the requirements include that the residential care facility shall ensure that all residents are safeguarded from abuse and, in the majority of cases, neglect or ill-treatment are also mentioned. Overall, in the majority of the cases, financial abuse is well addressed in the National Standards or legislation. As an example, in the UK (Northern Ireland and Wales) the National Standards go into great detail about the procedures and practices for ensuring that residents retain their independence in dealing with their own money and finances, they receive support if needed for handling it and eventually, about how staff could become involved with a resident’s finances. In Belgium (Flanders), residential care facilities are required to develop a “frame of reference” for inappropriate sexual behaviour toward residents.

In Ireland, Malta and the UK, robust policies and procedures should be in place to support the residents’ right to protection from any type of abuse. Likewise, in the three countries, residents should be supported and enabled to safely report any concerns and/or allegations of abuse to staff or in the case of Malta and the UK, to the Regulator or relevant Authority. All suspected, alleged or actual incidents of abuse or of improper treatment should be fully investigated and acted on promptly.

Interestingly in Ireland, it is stated, that residents should be assisted and supported to identify and recognise abusive and neglectful behaviour and to develop the knowledge, self-awareness, understanding and skills needed for their own self-care and protection. Likewise in the UK (Northern Ireland), residents and their relatives should be informed and know how to make a complaint or allegation of abuse, neglect or exploitation. In Romania, residential care facilities must encourage and support residents to identify any form of abuse, neglect, or degrading treatment that they are subjected to by staff in the facility, family members or any other person they are in contact with. Abuse should be reported in writing and addressed to the director of the facility (or management).

There are references in the National Standards in Ireland to abuse in the case of residents with dementia or cognitive impairment, and it is stated that staff should be aware of the difficulties that residents with a cognitive impairment may have in communicating an allegation of abuse and/ or neglect. The service should have arrangements in place to address any communication difficulties to facilitate residents to report such concerns.

The National Standards or legislation make reference to training on abuse in Ireland, Romania and the UK (North- ern Ireland and Wales). In particular in Northern Ireland (both in the National Standards for residential care and the ones for nursing homes), within their probationary period of employment, staff should complete training on and be able to demonstrate knowledge of protection from abuse, indicators of abuse and responding to suspected, alleged or actual abuse. A refresher training on the protection of vulnerable adults should be provided for staff at least every three years.






Last Updated: Friday 31 January 2020


  • Acknowledgements

    This Dementia in Europe Yearbook received funding under an operating grant from the European Union’s Health Programme (2014-2020). The content of the Yearbook represents the views of the author only and is his/her sole responsibility; it cannot be considered to reflect the views of the European Commission and/or the Consumers, Health, Agriculture and Food Executive Agency or any other body of the European Union. The European Commission and the Agency do not accept any responsibility for use that may be made of the information it contains.
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