Abuse can happen anywhere, to anybody and by anyone. But it is more likely to happen somewhere it can be kept hidden, against people who are vulnerable, dependent or isolated and by someone they trust. It could be a one-off incident or it could happen regularly over a long period. Abuse can sometimes be unintentional, but in many cases the abuser means to cause harm.
You may be concerned that the person you care for is being abused or neglected by others. Or you could be the one who is facing abusive behaviour, perhaps from the person you care for.
If you are concerned about someone else or are experiencing abuse yourself, then it is very important that you speak out. Abuse in any form is unacceptable. Everyone should have the basic right to live safely and without fear of harm.
Below we explain what the terms ‘abuse’ and ‘neglect’ mean and discuss some of the different types of abuse you could have witnessed or experienced. We also highlight some warning signs that might help you spot whether someone is being abused or neglected. We then explain what you should do if you think that either you or the person you care for are being abused and provide details of some of the support services available.
Understanding what ‘abuse’ and ‘neglect’ mean
Below we explain the meaning of the terms ‘abuse’ and ‘neglect’. This could be helpful if you suspect that something you have witnessed or experienced is wrong, but you are not sure whether it counts as abuse or neglect.
Abuse is when someone is treated with cruelty, causing them harm, hurt or distress. It often involves the misuse of power and control. It is usually deliberate, but even if it is unintentional it can still count as abuse. See below for further details about some of the different types of abuse you might come across.
Unlike abuse, where something is actively done to somebody, neglect is where something is not done but it still results in harm being caused. Usually it means someone is not adequately taken care of. Examples of neglect include:
- Not being provided with any food or drink, or not enough of it or not of the right type.
- Not having wet or dirty clothes changed, not being washed or not being helped to go to the toilet, especially if the person cannot do these things themselves.
- Not making sure someone is warm or limiting their access to heating.
- Ignoring someone’s emotional needs.
- Not assisting someone to go to the doctor when they need to.
- Not making sure they have all the medications that they need.
- Not intervening in a situation that is dangerous, especially when the person cannot adequately judge risk themselves.
What are the different types of abuse?
Abuse can come in a number of different forms. Some of these relate to the harm that is caused, and others to who carries out the abuse and where they do it. We explain some of the types that you may come across below. It is important to be aware that somebody could be affected by just one of these, or by more than one at the same time.
This is anything that causes physical harm. It could include:
- Being hit, slapped, punched, pushed, kicked, burnt or otherwise physically assaulted.
- Being restrained inappropriately, unnecessarily or without authorisation.
- Being force-fed.
- Being locked in a room.
- Having your medication misused.
Sexual abuse is any unwanted act that is of a sexual nature. This could include:
- Sexual harassment.
- Sexual assault.
- Rape.
- Indecent exposure.
- Online sexual abuse.
- Inappropriate or unwanted looking or touching.
- Sexual teasing, inappropriate jokes or innuendo.
- Sexual photography, including being shown photos of a sexual nature or having naked photos shared online without your consent.
- Being forced to watch pornography or witness sexual acts against your will.
- Being forced or pressured to take part in sexual acts you do not consent to.
Being coerced into a sexual relationship by somebody who is in a position of power could also potentially count as sexual abuse.
This is the inflicting of any type of psychological or emotional harm. It includes denying people choice, privacy and dignity. It can be harder to spot than other types of abuse, because it can be more subtle and it rarely leaves physical signs behind.
Examples of psychological abuse include:
- Being humiliated, controlled, harassed, rejected, coerced or intimidated.
- Being threatened with physical abuse, or someone threatening to hurt themselves or others.
- Being threatened with abandonment.
- Being stopped from seeing other people, leading to a lack of human contact and isolation.
- Being verbally abused, such as being shouted at or sworn at.
- Being bullied on social media or by text.
- Unreasonably or unjustifiably withdrawing services, support and information, or threatening to do so.
- Making someone feel they are to blame for the abuse they are experiencing.
This is when someone’s actions cause you financial harm. It is sometimes also called material abuse. It includes:
- Having your money or other valuables stolen.
- Having your money, property or possessions misused by someone who has been tasked with looking after them.
- Being coerced into spending your money in a way you don’t want to, including in your Will.
- Restricting your access to money, property or employment opportunities.
- Pressuring you to establish a Lasting Power of Attorney (LPA) against your will.
Common examples of financial abuse are doorstep, post, phone, internet, or email scams.
This is when harm is caused by being treated unequally because of what is known as a ‘protected characteristic’. These are particular identity traits, as defined by the Equality Act 2010. They include:
- Age
- Disability
- Gender reassignment.
- Marriage and civil partnership.
- Pregnancy and maternity.
- Race.
- Religion or belief.
- Sex.
- Sexual orientation.
Discriminatory abuse includes, for example, any actions, comments, name-calling, slurs or jokes that are racist, sexist, ageist or homophobic. It could also happen in combination with one of the other types of abuse above, for instance if you are physically abused because of your race.
Domestic abuse is when one or more of the above types of abuse is carried out by a current or former intimate partner or a family member (including in-laws and step-family). Despite the name, domestic abuse does not need to be carried out in the home. It is one of the most common types of abuse.
Organisational abuse is when harm is done to someone by an organisation providing them with health or social care. This abuse could be physical, sexual, psychological, financial or discriminatory. It is often caused by inadequate structures, policies and practices. Examples of organisations that could carry out this abuse include:
- Care homes.
- Day care services.
- Companies providing care to someone in their own home.
Spotting the signs of abuse or neglect
It is important to take the time to learn the warning signs that might indicate someone is being abused or neglected. You are more likely to spot when abuse or neglect are happening if you know what to look out for. Some of these may be big changes, others may be small. Some may happen suddenly, and others over a longer period of time.
Some tell-tale signs include:
- Cuts, bruises, wounds, fractures or other injuries, particularly ones that are untreated or unexplained. Look out especially for the same injuries happening multiple times.
- Looking unkempt or like they have lost weight, wearing dirty clothing or seeming hungry or dehydrated.
- Having an unusually cold, dirty or untidy home.
- Becoming increasingly isolated.
- Seeming to have less money than you would expect them to have, not wearing their usual jewellery or things seeming to be missing from their home.
- Behavioural changes including being nervous, quiet, withdrawn or lacking in confidence. Alternatively, they may become aggressive and angry without an obvious cause.
- Talking about feeling unsafe or seeming scared to be left by themselves or with a particular person.
- Legal or financial documents unexpectedly arriving or others suddenly disappearing.
This list is not exhaustive; there may be other changes you have noticed which you suspect indicate abuse or neglect. Go with your gut instinct and take action.
Bear in mind though that, even if you are aware of the signs, abuse and neglect can still be difficult to spot. People who abuse others often go to a great deal of effort to hide what they are doing and its impact. And many people who are being abused are in denial about what is happening, are not in a position to talk about it or try to hide it too. So do not blame yourself if you later discover someone has been abused or neglected and you didn’t spot it. What is important is the action you take when you do become aware of it.
What should I do if I think the person I care for is being abused or neglected?
It is important to act quickly if you suspect the person you care for might be being abused or neglected, even if you are not completely certain. Don’t wait in the hope of finding further evidence to confirm your suspicions. The longer you ignore it, the longer they may be being harmed, and it could even escalate further. It is always a good idea to be certain that they are safe.
If you think someone is in immediate danger or suffering a medical emergency, then you should contact the emergency services by calling 999.
If it is not an emergency, you could try and speak to the person you care for in private, if it is appropriate. Tell them what you are concerned about and ask if they are ok. Give them a chance to speak as much as they want to, listen to what they tell you and try and stay composed even if what they say is upsetting. Don’t promise that you will keep what they tell you a secret, as you may need to break this promise to get them the help they need.
Bear in mind that they may not be willing to admit what is happening or not want to talk about it for fear of consequences. Or they may take a little while to come round to the idea of opening up about it.
If they do disclose that they are being abused or neglected, you should make it clear to them that what is happening is wrong and that they have the right to feel safe. Ask them what they would like you to do to help. You could tell them about the different people and organisations who can support them, as discussed below, and offer to contact some of them on their behalf if they don’t feel able to do so themselves.
If it is not appropriate to speak to the person you care for directly, or they are not willing to discuss the topic with you yet, you could try talking to other people who know them. Tell them about what you have witnessed and see whether they share your concerns.
Alongside these options, it is also important to raise your suspicions straight away with a professional who can help. You may worry that they won’t be interested or will think you are fussing about nothing, but it is likely that they will take your concerns seriously and act upon them.
A good starting point is to contact adult social services at the local authority where the person you care for lives. Ask to speak to the adult safeguarding team, which is sometimes known instead as the adult protection team. They will put you in touch with a social worker who deals with abuse and neglect cases.
Where somebody is vulnerable, the Care Act 2014 makes it the local authority’s duty to protect them. That means if they think someone may potentially be being abused or neglected, they are required to conduct an investigation and find out whether they need to take any action.
They might also arrange for an independent advocate to help represent the person you care for’s wishes during this investigation. Take a look at our guide ‘Getting an independent advocate’ for more information about this process.
If you don’t know which local authority the person you care for comes under, you can find out on the GOV.UK website.
If you are unhappy with how the local authority has handled the case, for instance if you think they haven’t investigated it fully or quickly enough, then you can make a complaint. Take a look at our guide ‘Making a complaint about the local authority’.
You could also talk to the person you care for’s GP, if you know who they are. Share your worries with them and any concerns you might have for the person’s health. You should explicitly tell them that you have a safeguarding concern, so they know they need to follow their safeguarding policy.
If you think that the abuse that the person has suffered is potentially a crime, you could also talk to the police by calling their non-emergency line on 101.
If after contacting these organisations, you are still worried about the person’s situation, you could consider contacting a community care solicitor. They can help support you throughout the process of any investigations. However, if you do not qualify for legal aid, this service can be expensive.
If you are worried about a service provided by a professional care agency or organisation then you could consider reporting your concerns to the Care Quality Commission (CQC). You can do this either by calling 03000 616161, writing them a letter or through their website. Although they don’t generally deal with individual complaints, you can still let them know your concerns so that when they next inspect that service they can bear it in mind.
There are also a range of other support services available, which can provide you and the person you care for with specialist help and advice depending on their particular situation. Some of these are listed below.
What should I do if I am being abused by the person I care for?
If you have been subjected to abuse by the person you care for, then it is very important that you come forward and talk to someone.
This might seem very difficult to do. You may be scared that it will make the abuse worse. You may worry about what will happen to you or the person you care for if you raise your concerns. You may feel embarrassed or ashamed about what has happened. You may think that the person you care for is not to blame for their actions because their condition means they are in pain, scared, resentful or upset. You may think that you will not be taken seriously or believed.
But you do need to speak out. Abuse is never acceptable, regardless of what the other person may themselves be dealing with. You deserve to live a life that is safe and free from the fear of being harmed. Your concerns will be taken seriously, and action will be taken to protect you and stop the abuse.
The best way to stop it from happening anymore is to talk to someone who can help. We discuss some of the people and organisations you can turn to below.
If you feel like you are in immediate danger or it is a medical emergency, you should call 999.
If you are unable to safely make this phone call, you could use the ‘Ask for ANI’ service through a local pharmacy to get emergency help instead. See below for further details.
If you are not in immediate danger, you could start by speaking to someone you trust, such as a friend, relative or colleague. Try to pick someone you think will be understanding of your situation and will act on what you are saying quickly and decisively.
You should also, if you can, speak to a professional about what is happening. A good place to start is your GP. Tell them what has been going on, and any impact it may have had on your health. Ask for their help to make it stop. They will be trained in how to deal with situations like this, and will take the concerns you raise seriously.
You could also contact adult social services at your local authority. Ask to speak to the adult safeguarding team, which is sometimes known instead as the adult protection team. They will put you in touch with a social worker who deals with abuse and neglect cases. If they think someone is potentially being abused or neglected, they have a duty to look into it. They will most likely conduct an investigation and find out whether they need to take any action to stop the abuse or neglect. They will keep you involved in this process to make sure that you feel in control of the outcome and that you are kept safe throughout.
They might also arrange for an independent advocate to help represent your wishes. Take a look at our guide ‘Getting an independent advocate’ for more information about this process.
If you don’t know which local authority you come under, you can find out on the GOV.UK website.
If you are suffering from domestic abuse, and don’t feel you can approach your GP or social services safely, then you might find it easier to get support using the ‘Ask for ANI’ scheme at your local pharmacy. This is a Home Office initiative to provide an easy and discreet way for people who are subject to domestic abuse to get help. Just go into your local pharmacy and ask for ANI (pronounced Annie). This is a code word standing for Assistance Needed Immediately, which will signal to the pharmacist that you are being abused and need help. They will then ask you to come with them to a private consultation room. There, they will ask whether you need emergency support from the police, and if so will offer you the use of a phone to call 999 or make the call for you. If you don’t need emergency help, but would like other support, they can help you to contact a domestic abuse helpline or local support service.
If you think that a crime has been committed, then you could also talk to the police by calling 101, their non-emergency number.
You could also consider contacting a community care solicitor, who can support you through the process. If you do not qualify for legal aid, however, this can be quite an expensive option.
There are also a range of other support services available, which can provide you with specialist help and advice depending on your situation. Some of these are listed below.
What other support services are available?
Alongside the options discussed above, there are also a range of supplementary support services that can provide help to people who are being abused or neglected, or to anyone who suspects it is happening.
The services that you can access will depend on the situation. We have broken down the different circumstances below to help you find the services that best suit your needs.
If you think that a crime is currently being committed and that it is an emergency, call 999. Otherwise, you could contact the police on 101 to report what you think has happened.
If you would prefer to stay anonymous when reporting your suspicions about someone else, you can contact Crimestoppers who guarantee 100% anonymity. You can call them on 0800 555 111 or contact them online. They may pass this information on to a local police force who can investigate further and try and support the person you think is being abused.
If you suspect that the activity you are concerned about is a crime, which abuse or neglect can be, then you could contact the charity Victim Support. They help anybody affected by any type of crime. They have a free Supportline, open 24 hours a day. Just call 08 08 16 89 111 or start a live chat on their website.
If the person experiencing domestic abuse is a woman, then they could call the free 24-hour National Domestic Abuse Helpline on 0808 2000 247. This service is run by the charity Refuge, and staffed by a team of highly-trained female advisers.
If the person affected by domestic abuse is a man, then they can use the Men’s Advice Line, run by the charity Respect. It is for men experiencing domestic abuse in any of their relationships. Just call 0808 801 0327 between 9am and 8pm, Monday to Friday or email info@mensadviceline.org.uk.
If it is an LGBT+ person who has been affected by domestic abuse, they could call the Galop helpline on 0800 999 5428 or email help@galop.org.uk. The helpline is open Monday to Friday from 10am until 5pm, and until 8pm on Wednesdays and Thursdays. They will connect you with an LGBT+ person who has training and experience in working with LGBT+ people who have been subject to domestic abuse.
You could also consider contacting the charity Victim Support. They have a free Supportline, open 24 hours a day. Just call 08 08 16 89 111 or start a live chat on their website. They can help people currently experiencing abuse, but also support people who have suffered in the past. They support both women and men. They have Independent Domestic Violence Advocates (IDVA) and local outreach services across the country.
Alongside the services discussed above, those people who have been subject to sexual abuse could also consider getting in touch with Rape Crisis. They have a free helpline for women and girls who have experienced rape or sexual violence and can connect you with their network of local Rape Crisis Centres across the country. Their helpline is open between 12pm and 2.30pm or 7pm and 9.30pm, 365 days of the year. Just call 0808 802 9999.
If you are concerned about someone who is older or if you are yourself older and are being abused, you could use a free confidential helpline provided by the charity Hourglass. Just call 0808 808 8141, text 078 6005 2 906 or email helpline@wearehourglass.org, Monday to Friday 9am to 5pm.
You could also call the Age UK Advice Line, a free national helpline for older people and their friends, family and carers. It is open 365 days of the year, including bank holidays and weekends, between 8am and 7pm. Just call 0800 678 1602.
Or you may want to get in touch with The Silver Line instead. This is a general helpline for people aged over 55, open 24 hours a day, 7 days a week. It is free and confidential. They can be contacted on 0800 4 70 80 90.
If you or the person you are concerned about is aged 25 or under, then you could contact The Mix. This is a charity that runs a crisis text service which is open 24 hours a day, and a telephone helpline which is open between 3pm and midnight daily. Just call 0808 808 4994 or text THEMIX to 85258.
Or you could talk to Childline either online or by calling 0800 1111. They are open 24 hours a day, 7 days a week. They can help to support you through the crisis.
If you or someone you are concerned about has a learning disability, you can call Mencap’s Learning Disability Helpline for free between 10am and 3pm, Monday to Friday on 0808 808 1111 or email helpline@mencap.org.uk.
If you or someone you care for is struggling as a result of being abused or neglected and would benefit from talking to someone, they could call the Samaritans on 116 123. The Samaritans are open 24 hours a day, 7 days a week and their service is free. They specialise in listening to anyone who is in distress without making any judgments or telling someone what to do. Or if they would prefer to write down how they are feeling rather than talking to someone on the phone, they could send the Samaritans an email instead by contacting jo@samaritans.org or write them a letter to Freepost SAMARITANS LETTERS.
Alternatively, they could text SHOUT to 85258 to access a free, confidential anonymous text support service for people experiencing a crisis who are unable to cope and need some support.
Or if the person you are worried about is a man, they may prefer to contact CALM (Campaign Against Living Miserably), a service aimed specifically at men. They have a webchat service and a phone helpline, and they are open between 5pm and midnight every day. Their number is 0800 58 58 58.
Online Help and Advice
Visit our online support section where we have provided advice and guidance on a range of relevant topics to help you in your caring role.