Worried about an adult

A vulnerable or at risk adult is a person aged 18 years or over who -

  • has needs for care and support whether or not the local authority is meeting any of those needs
  • is experiencing or is at risk of abuse or neglect
  • as a result of those care and support needs is unable to protect themselves. This is from either the risk of or the experience of abuse or neglect

An adult with care and support needs may be someone who -

  • has a physical or learning disability or a sensory impairment
  • is elderly
  • has mental health needs, such as dementia or a personality disorder
  • misuses substances or alcohol. They misuse it to the extent that it affects their ability to manage day to day living
  • has a long term health condition
  • is providing unpaid care to a family member or friend

Vulnerable people are at risk of abuse which can take many forms.


Injuries are not always caused with intent or by neglect or abuse. It can often be the case that there is no real explanation, so it is important not to jump to conclusions. The following may be possible indicators of abuse -

  • history of unexplained falls
  • unexplained bruising. In well protected areas or soft parts of the body or in different stages of healing
  • unexplained burns, fractures or marks on the body possibly shaped like an object
  • untreated medical problems
  • weight loss due to malnutrition or dehydration


Sexual abuse is the involvement of vulnerable adults in sexual activities, which -

  • they do not fully understand so are unable to give consent to
  • they object to
  • may cause them harm

The following list may be indicators of sexual abuse. They may also be indicator to many other problems. Some of the indicators could be as - 

  • sudden change in behaviour, confusion or withdrawal
  • incontinence
  • overt sexual behaviour and language by the vulnerable adult
  • self-inflicted injury
  • disturbed sleep pattern and poor concentration
  • difficulty in walking
  • torn, stained underwear
  • love bites
  • pain or itching, bruising or bleeding in the genital area
  • sexually transmitted disease, urinary tract and vaginal infection
  • bruising to upper thighs and arms
  • frequent infection
  • severe upset or agitation when being bathed, for example
  • pregnancy in a person unable to consent


Financial or material abuse can take the form of -

  • fraud
  • theft
  • using of the vulnerable adults property without their permission
  • this could involve -
    • large sums of money
    • small amounts from a pension or allowance each week

It is important not to jump to the wrong conclusions too quickly. The following is a list of possible indicators of financial abuse -

  • sudden inability to pay bills
  • sudden withdrawal of money from an account or the buying of items that the individual does not need or use. This is as well as unreasonable and inappropriate gifts
  • person lacks belongings that they can clearly afford
  • unwillingness to accept unnecessary expenditure by the person's relatives
  • power of attorney obtained when the person is unable to understand what they are signing
  • extraordinary interest by family members in the vulnerable adult's assets
  • recent change of deeds to the house
  • the person managing the finances is evasive and uncooperative
  • reluctance to accept care services
  • personal items going missing

Emotional or psychological

This can include -

  • intimidation or humiliation
  • shouting or swearing
  • emotional blackmail
  • denial of basic human rights
  • using racist language
  • preventing someone from enjoying activities or meeting friends

The following may be indicators of many different problems. It is important not to jump to the wrong conclusions too quickly.

  • ambivalence about carer
  • fearfulness, avoiding eye contact, flinching on approach
  • deference
  • insomnia or need for excessive sleep
  • change in appetite leading to unusual weight loss or gain
  • tearfulness
  • unexplained paranoia
  • low self esteem
  • confusion, agitation
  • coercion
  • distress caused by being locked in a home or car
  • isolation - no visitors or phone calls allowed
  • inappropriate clothing
  • sensory deprivation
  • restricted access to hygiene facilities
  • lack of personal respect
  • carer does not offer personal hygiene, medical care, regular food and drinks

Neglect or self-neglect

A person can suffer because their physical and psychological needs are being neglected by a carer. This could include failure to keep someone warm, clean and well nourished or neglecting to give prescribed medication. The following may be evidence of neglect -

  • inadequate heating and lighting
  • poor physical condition of the vulnerable adult
  • persons clothing is ill fitting, unclean and in poor condition
  • malnutrition
  • failure to give prescribed medication properly
  • failure to provide appropriate privacy and dignity
  • inconsistent or reluctant contact with health and social care agencies
  • isolation - denying access to callers or visitors

Self-neglect can be, but is not limited to, neglecting to care for –

  • personal hygiene
  • health
  • surroundings

and includes behaviour such as hoarding.


Discriminatory abuse is often on the grounds of -

  • age
  • gender
  • race
  • culture
  • religion
  • sexuality
  • disability
  • hate crime
  • mate crime. Mate crime occurs when vulnerable adults are 'befriended' with the intention to abuse

Discriminatory abuse can be -

  • derogatory comments
  • harassment
  • being made to move to a different resource and service based on age
  • being denied medical treatment on grounds of age or mental health
  • not providing access


Organisational abuse includes neglect and poor care practice in an institution or care setting. This could be in a hospital or care home, for example, or in relation to care provided in one’s own home. This may range from one off incidents to ongoing ill-treatment. It can be through neglect or poor professional practice as a result of the -

  • structure
  • policies
  • processes
  • practices

within an organisation.

The following list may be possible indicators of institutional abuse -

  • no flexibility in bedtime routine and deliberate waking
  • people left on the commode or toilet for long periods of time
  • inappropriate care of possessions, clothing and living area
  • lack of personal clothes and belongings
  • un-homely or stark living environments
  • deprived environmental conditions and lack of stimulation
  • inappropriate use of medical procedures, for example, enemas, catheterisation
  • 'batch care' - lack of individual care programmes
  • illegal confinement or restrictions
  • inappropriate use of power or control
  • people referred to, or spoken to with disrespect
  • inflexible services. They convenient to the provider rather than the person receiving services
  • inappropriate physical intervention
  • service user removed from the home or establishment. This is without discussion with other appropriate people or agencies. It could be because staff are unable to manage the behaviours

Reporting a concern

If you have concerns that someone you know may be at risk of abuse or is being abused, it is very important to let us know.