Abuse of individuals with disabilities webinar

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  • Reasons why this population is at higher risk in general any limitation to one’s ability to tend to daily activities of living (ADLs) severely increases the risk for abuse and neglect
  • If a person is isolated abuse continues without outside knowledge and intervention
  • This population of individuals is at risk by the sheer number of people they are in contact with on a daily basis – doctors, nurses, ambulate drivers, etc Intimate partner - most commonly identified perpetrator of abuse are husbands, live in partners and men
  • The nature of the relationship creates an environment that may support and even encourage abuse - many hours of contact, often isolated, can be encouraged to become dependent even beyond what is necessary, the intimate nature of that contact – (bathing, toileting) Health care workers, pas, etc may become overly parental in their interactions, may over step bounds, friendship and a work relationships may become confused Individual may not understand that boundaries are being broken – may have been groomed through learned helplessness and childhood experiences with others


  • 2. OVERVIEW Prevalence Types of abuse Risk factors Screening
  • 3. PREVALENCE Individuals with disabilities experience abuse at similar or increased rates Life time rates of abuse 62% for both individuals with disabilities and general population (Young, et al. , 1997) In a study of physical and sexual abuse, physical rates were equal and sexual abuse was 4 times higher for individuals with disabilities (Martin, et al, 2006) In a study of over 1000 women in family practice clinics, those who reported experiencing abuse were 2 times more likely to report having a disabilities Studies also suggest that women with disabilities experience abuse for longer periods of time and by more perpetrators
  • 4. PREVALENCE The research does not truly estimate the prevalence due to lack of: Screening Outreach Accessible services  Noattempt to seek services since little to none are available
  • 5. TYPES OF ABUSE Individuals with disabilities suffer from multiple forms of abuse Physical, sexual, emotional, economic Also experience disability related abuse  Denying access to mobility devices  Preventing them from accessing medical care  Neglecting personal care  Withholding medications
  • 6. EXAMPLES OF DISABILITY RELATEDABUSE Refusal to aid in toileting Over or under-medication Breaking communication and mobility devices  Wheelchair, TTY, pager, prosthetic limb Moving furniture in a home of a visually impaired person Taking away a prosthetic limb Mistreating service animals
  • 7. EXAMPLES OF DISABILITY RELATED ABUSE Force the person to allow them to become the representative payee Threatening to report them to DYFS  Historically courts have ruled against women with disabilities Threatening to institutionalize them
  • 8. RISK FACTORS Some suggest having a disability in this world immediately places that person at risk Research has suggested some specific risk factors
  • 9. ISOLATION Isolation creates a barrier to support and services Individuals who are less mobile, and more socially isolated have a higher likelihood of experienced abuse (Nosek et al, 2006) Isolation can be a result of  Lack of accessibility  Lack of mobility  Social isolation  Lack of transportation
  • 10. PERPETRATORS Individuals with disabilities are exposed to multiple potential abusers This population is at risk by the sheer number of people they come into contact with  Intimate partners  Family members  Health care providers  PAS workers  Ambulance drivers
  • 11. PERPETRATORSo Intimate partners are the most commonly identified perpetrators of domestic violence including husbands and live in partnerso Perpetrators of sexual violence are most often people they come into daily contact with but not people they live with Most often men are identified as the perpetrator
  • 12. PERPETRATORS IN RELATIONSHIPS Certain predatory individuals may view a romantic relationship with a person with a disability as an opportunity for exploitation, mistreatment and abuse An individual may specifically target individuals they believe to be vulnerable and intentionally seek out individuals they believe they can exploit, mistreat and abuse The expectation may be that the woman will not be believed if she reports abuse  Which is often the case Less likely to resist or fight back
  • 13. PERPETRATORS – FAMILY Family members – parents and siblings who have limited patience or regard for the individual may become abusive Some parental relationships become strained due to the additional needs of a child with a disability – the child is then blamed for the break down in the marriage and in turn abused or neglected Siblings may become jealous due to the added attention the child receives as a result of the disability and may act out towards the child
  • 14. PERPETRATORS – SERVICEPROVIDERS(PAS, HEALTHCARE WORKERS, GROUP HOMEWORKER) The nature of the relationship between individual and worker is viewed as a risk factor Ongoing contact (many hours in the home, time spent in day treatment programs, etc) Intimate nature of contact (bathing, toileting) Blurring of boundaries (worker vs. friend/partner) Perpetrators may enter the field in order to specifically target this population  Perceived vulnerabilities and opportunities
  • 15. DEPENDENCY• Perpetrators may have the role of both partner and primary caregiver • Physical, emotional and financial dependency may increase the risk of abuse and limit one’s ability to leave • This creates a dichotomous and confusing relationship of abuser and caregiver An abused individual will be fearful of losing their source of daily care As a result the abused individual may feel he or she needs to compromise or accept the abuse to continue to receive the benefits of the relationship (Hassouneth – Phillips, 2005)
  • 16. LACK OF IDENTIFICATION Abuse against individuals with disabilities often goes unrecognized Due to nature of abuse which often targets the person’s disability These behaviors are often not defined as abuse by state laws The person often does not realize the behavior is abusive
  • 17. LACK OF IDENTIFICATION May not tell others for fear of disbelief  People don’t want to believe this occurs so will dismiss it  The person accused is viewed as an upstanding citizen, may be a person of authority  People with disabilities are historically not seen as reliable sources of information Lack of knowledge about victimization Do not know who to contact  There are not many places to go for help
  • 18. SYSTEM AND CULTURAL BARRIERS Lack of accessible resources  Lack of accessibility  Limited physical access  No interpreters  Attitudinal barriers • Disability organizations in general have lack of information and resources on abuse • Lack of capacity to address issue (screening, resources, referral) • Historically attempts at seeking help has been met with insensitivity • Lack of coordinated response – disability and DV or SA
  • 19. SYSTEM AND CULTURAL BARRIERS Oppression and devaluation of women with disabilities Ableist and sexist view points Negative valuations of individuals with disabilities  Seen as less than (not the ideal female form)
  • 20. SYSTEM AND CULTURAL BARRIERS Discrimination and oppression become internalized Creates self devaluation and poor self esteem Women with disabilities report overall high rates of low self esteem (Gilson, DePoy, & Cramer, 2001)  Thistranslates in a fear of being alone  Doubts another partner would want to be with them  Lack of worthiness around being in a relationship  May blame themselves for the abuse
  • 21. TIPS FOR SERVING SURVIVORSWITH DISABILITIES Screening  Always screen for abuse  There remains a lack of screening across disciplines
  • 22. SCREENING You can begin to screen all clients who you encounter Has anyone ever hit, slapped, kicked, pushed, shoved, or otherwise physical hurt by someone? Has anyone ever forced you to engage in sexual activities? Has anyone ever threatened, intimidated, coerced or manipulated you to do things you did not wish to do, done or said anything to make you feel fearful, or humiliated, overly criticized, or bullied you? * it is important to ask about lifetime history and current history (i.e. within the last year or 6 months)
  • 23. SCREENING Then ask disability related abuse questions  Has anyone prevented you from using a wheelchair, cane, respirator, or other assistive devices?  Has anyone you depend on refused to help you with an important personal need, such as taking your medicine, getting to the bathroom, getting out of bed, getting dressed, or getting food or drink?  Within the last year, did someone take your SSI or SSD check, a paycheck, or financial aid check without your permission, refuse to allow you to access your bank account, or restrict your use of money, a debit or credit card?