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A vulnerable adult is an adult who, due to mental or bodily disability, cannot take care of themselves without help from others. [1] [2]
Adults usually become vulnerable by cognitive impairment such as Down syndrome. Aging can cause or worsen a person's vulnerability, by physical decrepitude and/or lack of money. [3] [4] [5]
Many vulnerable adults have suffered abuse, [6] the long-term effects of which may aggravate their vulnerability.
A vulnerable adult's daily living activities may be affected by impairments such as illiteracy, communication difficulties, learning disabilities and other practical deficits. International initiatives (such as the UN's Sustainable Development Goal 4) try to fix this by giving them a fair chance to learn. [7]
Vulnerable adults' cognitive impairment puts them at greater-than-usual risk of abuse (domestic or institutional) and exploitation. [8] [9] [10] Vulnerable adults are also at risk of self-neglect if they do not receive sufficient support. [11]
Vulnerable adults often live in assisted living facilities or council estates, depending on the degree of their vulnerability and the accessibility of such facilities. Adults who are vulnerable as a result of trauma may be offered trauma counselling. [12]
A vulnerable person's legal status depends on the extent of their impairment. This can be difficult to assess. Some vulnerable people may not qualify for long-term care despite being generally unable to live independently.
Vulnerable adults sometimes have guardians - these are individuals with a legal right to make decisions on their behalf, such as those related to medical care and housing. [13] Guardians may be family or friends, [13] or they may be professionals who make decisions on behalf of many vulnerable people in exchange for their money. [13]
NB The definition of a vulnerable adult in Section 59 of the 2006 Act is modified by the Safeguarding Vulnerable Groups Act 2006 (Miscellaneous Provisions) Order 2009, which excludes disabilities which don't make an adult vulnerable.
In the law of England and Wales 'vulnerable adult' is loosely defined. Section 59 of the Safeguarding Vulnerable Groups Act 2006 says: [14]
1) A person is a vulnerable adult if he has attained the age of 18 and—
(a) he is in residential accommodation,
(b) he is in sheltered housing,
(c) he receives domiciliary care,
(d) he receives any form of health care,
(e) he is detained in lawful custody,
(f) he is by virtue of an order of a court under supervision by a person exercising functions for the purposes of Part 1 of the Criminal Justice and Court Services Act 2000 (c. 43),
(g) he receives a welfare service of a prescribed description,
(h) he receives any service or participates in any activity provided specifically for persons who fall within subsection (9),
(i) payments are made to him (or to another on his behalf) in pursuance of arrangements under section 57 of the Health and Social Care Act 2001 (c. 15), or
(j) he requires assistance in the conduct of his own affairs. [15]
In most parts of the world, the last section, (j), is what defines a vulnerable adult. [14]
People are starting to say 'adult at risk' or 'adult at risk of harm' [16] instead of 'vulnerable adult'. [17]
In Singapore, the Vulnerable Adults Act ("the Act") was signed on 19 December 2018. [18] The Act defines that a vulnerable adult includes anyone over 18 years old whose mental or physical disabilities leave them helpless against abuse, neglect, and self-neglect, which terms are defined in s.2. [19] [20]
The United States uses the term "incapacitated adult" interchangeably with the term "vulnerable adult". The Department of Justice defines this as "an adult who is unable to receive and evaluate information or make or communicate informed decisions to such an extent that the adult lacks the ability to meet essential requirements for physical health, safety or self-care, even with reasonably available appropriate technological assistance" (Civil Financial Exploitation 22 M.R.S. § 3472 (2020) [21] ).
In 2012, Governor Mark Dayton of Minnesota signed a bipartisan bill for vulnerable adults which made abuse and neglect into felony offenses. The bill also increased the penalties for those who use restraints to harm children. [22]
Lawmakers worked with health care workers and the nurses union to craft the law. The Minnesota Nurses Association said: [23]
The compromise was an effort between all parties to protect the rights of workers in cases of understaffing, while giving the county attorney the right to charge someone who intends to neglect a vulnerable adult with a felony as opposed to a gross misdemeanor.
Before this law, the most severe charges were gross misdemeanors with no prison time. This law means that bodily injury carries a penalty of up to 10 years in prison or up to $10,000 fine or both. On the other hand, partial or considerable bodily harm could bring up to five years in prison and/or up to $5,000 in fines. [24]
An estimated 12% of Latin America and the Caribbean has a disability. This amounts to 66 million people. The ECLAC has allocated resources to examine what can be done for housing for disabled people as well programs for education and employment. [25]
Elder abuse is "a single, or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person." This definition has been adopted by the World Health Organization (WHO) from a definition put forward by Hourglass in the UK. Laws protecting the elderly from abuse are similar to and related to laws protecting dependent adults from abuse.
An assisted living residence or assisted living facility (ALF) is a housing facility for people with disabilities or for adults who cannot or who choose not to live independently. The term is popular in the United States. Still, the setting is similar to a retirement home, in the sense that facilities provide a group living environment and typically cater to an older adult population. There is also Caribbean assisted living, which offers a similar service in a resort-like environment.
A form of child abuse, child neglect is an act of caregivers that results in depriving a child of their basic needs, such as the failure to provide adequate supervision, health care, clothing, or housing, as well as other physical, emotional, social, educational, and safety needs. All societies have established that there are necessary behaviours a caregiver must provide for a child to develop physically, socially, and emotionally. Causes of neglect may result from several parenting problems including mental disorders, unplanned pregnancy, substance use disorder, unemployment, over employment, domestic violence, and, in special cases, poverty.
The Lanterman–Petris–Short (LPS) Act regulates involuntary civil commitment to a mental health institution in the state of California. The act set the precedent for modern mental health commitment procedures in the United States. The bipartisan bill was co-authored by California State Assemblyman Frank D. Lanterman (R) and California State Senators Nicholas C. Petris (D) and Alan Short (D), and signed into law in 1967 by Governor Ronald Reagan. The Act went into full effect on July 1, 1972. It cited seven articles of intent:
The Individuals with Disabilities Education Act (IDEA) is a piece of American legislation that ensures students with a disability are provided with a Free Appropriate Public Education (FAPE) that is tailored to their individual needs. IDEA was previously known as the Education for All Handicapped Children Act (EHA) from 1975 to 1990. In 1990, the United States Congress reauthorized EHA and changed the title to IDEA. Overall, the goal of IDEA is to provide children with disabilities the same opportunity for education as those students who do not have a disability.
Child abuse is physical, sexual, emotional and/or psychological maltreatment or neglect of a child, especially by a parent or a caregiver. Child abuse may include any act or failure to act by a parent or a caregiver that results in actual or potential wrongful harm to a child and can occur in a child's home, or in organizations, schools, or communities the child interacts with.
Child protection refers to the safeguarding of children from violence, exploitation, abuse, and neglect. It involves identifying signs of potential harm. This includes responding to allegations or suspicions of abuse, providing support and services to protect children, and holding those who have harmed them accountable.
The precise definitions of and punishments for aggravated sexual assault and aggravated rape vary by country and by legislature within a country.
In the United States, Adult Protective Services (APS) are social services provided to abused, neglected, or exploited older adults and adults with significant disabilities. APS is typically administered by local or state health, aging, or regulatory departments and includes a multidisciplinary approach to helping older adults, and younger adults with disabilities, who are victims. Services range from the initial investigation of mistreatment, to health and supportive services and legal interventions, up to and including the appointment of surrogate decision-makers such as legal guardians.
Child protective services (CPS) is the name of an agency in many states of the United States responsible for providing child protection, which includes responding to reports of child abuse or neglect. Some states use other names, often attempting to reflect more family-centered practices, such as department of children and family services (DCFS). CPS is also sometimes known by the name of department of social services, though these terms more often have a broader meaning.
In English law, an appropriate adult is a parent, guardian or social worker; or if no person matching this is available, any responsible person over 18. The term was introduced as part of the policing reforms in the Police and Criminal Evidence Act 1984 and applies in England and Wales.
The Mental Capacity Act 2005 is an act of the Parliament of the United Kingdom applying to England and Wales. Its primary purpose is to provide a legal framework for acting and making decisions on behalf of adults who lack the capacity to make particular decisions for themselves.
Safeguarding is a term used in the United Kingdom, Ireland and Australia to denote measures to protect the health, well-being and human rights of individuals, which allow people—especially children, young people and vulnerable adults—to live free from abuse, harm and neglect.
Research published from 2000 to 2020 illustrates increased prevalence rates of sexual violence against people with intellectual disabilities, compared to the general population.:61 The World Health Organization (WHO) funded a study which concluded that 15% of the adult population worldwide in 2012 had a disability, putting them at increased risk of physical, sexual, and intimate partner violence. Of that 15%, 6.1% had intellectual disability with 5.5% experiencing sexual violence. In another 2012 report, the WHO found that worldwide, children with intellectual disabilities experienced a 4.6 times greater risk of sexual violence than those without disability.
Disability abuse is when a person with a disability is abused physically, financially, sexually and/or psychologically due to the person having a disability. This type of abuse has also been considered a hate crime. The abuse is not limited to those who are visibly disabled or physically deformed, but also includes those with learning, intellectual and developmental disabilities or mental illnesses.
Institutional abuse is the maltreatment of a person from a system of power. This can range from acts similar to home-based child abuse, such as neglect, physical and sexual abuse, and hunger, to the effects of assistance programs working below acceptable service standards, or relying on harsh or unfair ways to modify behavior. Institutional abuse occurs within emergency care facilities such as foster homes, group homes, kinship care homes, and pre-adoptive homes. Children who are placed in this type of out of home care are typically in the custody of the state. The maltreatment is usually caused by an employee of the facility.
Disability hate crime is a form of hate crime involving the use of violence against people with disabilities. This is not only violence in a physical sense, but also includes other hostile acts, such as the repeated blocking of disabled access and verbal abuse. These hate crimes are associated with prejudice against a disability, or a denial of equal rights for disabled people. It is viewed politically as an extreme form of ableism, or disablism. This phenomenon can take many forms, from verbal abuse and intimidatory behaviour to vandalism, assault, or even murder. Although data are limited studies appear to show that verbal abuse and harassment are the most common. Disability hate crimes may take the form of one-off incidents, or may represent systematic abuse which continues over periods of weeks, months, or even years. Disabled parking places, wheelchair access areas and other facilities are frequently a locus for disability hate. Instead of seeing access areas as essential for equity, they are seen instead as 'special treatment', unjustifiable by status, and so a 'reason' for acting aggressively. Denial of access thus demonstrates a prejudice against equal rights for disabled people; such actions risk actual bodily harm as well as limiting personal freedom.
Patient abuse or patient neglect is any action or failure to act which causes unreasonable suffering, misery or harm to the patient. Elder abuse is classified as patient abuse of those older than 60 and forms a large proportion of patient abuse.
Elder rights are the rights of older adults, who in various countries are not recognized as a constitutionally protected class, yet face discrimination across many aspects of society due to their age.
Individuals with disabilities are more susceptible to contracting COVID-19 and have higher mortality rates compared to those without disabilities. This is particularly true for people with intellectual and developmental disabilities, those residing in care facilities, and women with disabilities. Individuals with disabilities face heightened risks of mental health issues related to the pandemic, such as increased feelings of loneliness and isolation. They were also more likely to face domestic violence and abuse during the pandemic. People with disabilities are more likely to experience unemployment as a result of the pandemic and may require changes to the types of accommodations they require for work. Children with disabilities experience complications in their educational programming. Remote learning poses a host of challenges for children with disabilities, including disruptions to physical and occupational therapies and access to assistive technologies.
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