Physical abuse is usually associated with assault and injury, and should be reported to social services (also some injuries may have innocent explanations, such as certain medical conditions). Discretion and sensitivity should always be deployed and if there is suspicion that an adult at risk has been intentionally injured or as a result of carelessness or neglect, police and social services should be informed.
Serious attention should be given to any marks or injuries such as skin imprints; burns; bites or use of a weapon. Descriptions of colour, size, depth and shape will be important, as will any relevant clinical assessment. Information will need to be recorded and stored appropriately and body maps can help. Individuals who make allegations should be listened to and taken seriously and the adult’s explanation is crucial. This can be assisted with a simple open question e.g. ‘What happened here?’ and by the person not being near any inappropriate influences.
Where communication is not possible, enquiries with others will need to be made, to try establish a cause. Consideration needs also to be given to:
a) history of unexplained falls or minor injuries especially at different stages of healing
b) unexplained bruising in well-protected body areas e.g. inner thighs, upper arms etc.
c) burns e.g. by cigarettes; rope etc.
d) history of frequent changing of GP or reluctance for visiting a GP or seeking help
e) accumulation of prescribed medicine which is not administered
f) malnutrition, ulcers, pressure sores and being left in wet clothing or beds