Diseases & Conditions

Abuse and Neglect

Overview, Causes, & Risk Factors

Abuse can take many forms. It may be physical, psychological, sexual, or financial. Neglect occurs when a caregiver doesn't meet the basic needs of a child, elder, or dependent adult.

What are the causes and risks of the injury?

A combination of psychological, social, and economic troubles may contribute to abuse and neglect. Financial hardship caused by drug abuse or chronic medical conditions increases the risk for abuse and neglect. The risk is highest among families with many serious problems. Children who have been abused may grow up to abuse others.

Abuse and neglect can also take place in nursing homes or other care settings. Overworked, poorly trained staff might be more likely to abuse vulnerable residents.

The long-term effects of abuse and neglect are many and varied. Emotional, psychological, and physical damage can take years to heal. In some cases, the trauma is never completely resolved. Death can even occur in extreme cases.

Symptoms & Signs

What are the signs and symptoms of the injury?

A person who has been abused or neglected may have many problems. Anxiety, sleep disorders such as insomnia, and other related conditions can be signs of stress. Injuries in various stages of healing and unexplained injuries are other signs. A neglected person may show signs of poor nutrition or hygiene. His or her medical needs, such as healthcare appointments and prescriptions for medicine, may not be getting met.

Some of the signs that a person has been abused or neglected are as follows:

  • dehydration
  • inappropriate or inadequate clothing
  • malnutrition
  • poor personal hygiene
  • unexplained bruises, cuts, head injuries, or bone fractures
  • unsafe, unsanitary, or unclean living conditions
  • untreated medical conditions

  • Diagnosis & Tests

    How is the injury recognized?

    Abuse may be suspected if signs such as those listed above, for example unexplained injuries, are noted. Neglect may be suspected if a child is often absent from school or tardy or if he or she arrives unusually early. A child might come to school inappropriately dressed for the weather. A child who is not gaining weight at an expected rate might also be a victim of neglect. Sometimes a problem can be detected just by talking to a child.

    Some state laws require professionals such as teachers and healthcare providers to report to a hotline any possible cases of child abuse or neglect. Whether or not the law requires this, a person who has reason to suspect that a child might be the victim of neglect, physical or sexual abuse, or threatened harm should report it.

    If an adult relative, friend, or neighbor appears to be suffering from abuse or neglect, it may help to talk to the person about options or call adult protective services. Bedsores and weight loss in an elderly person may be reason to suspect neglect. Financial abuse might also be present.

    Child or adult protective services will check into any suspected abuse or neglect.

    Prevention & Expectations

    What can be done to prevent the injury?

    Prevention begins with awareness. Campaigns and programs that broadcast the warning signs of abuse and neglect may help prevent these problems. Most states have a confidential hotline open 24 hours a day so cases of suspected abuse can be reported.

    Friends, neighbors, and family members can help in the following ways.

  • Ask a child or adult directly about signs of possible abuse.
  • Show concern, so that the person knows there is someone to turn to for help.
  • Talk with the person who is being abused. Getting support can make him or her feel less isolated.

  • Treatment & Monitoring

    What are the treatments for the injury?

    Treatment depends on the type of injury. The goal is to ensure the physical and emotional safety of the victim. Doctors, nurses, social workers, and other professionals may be involved in helping to meet the person's needs. Hospitalization may be needed if malnutrition or other serious physical conditions are present. Counseling services may help with emotional and psychological problems. If a person is in danger, he or she may be taken into protective custody. Treatment should include other family members and caregivers.

    What are the side effects of the treatments?

    In cases of severe abuse or neglect, the victim may need to be moved from the home or care setting. He or she may have to live with someone else, in a shelter, or in a nursing home to be safe.

    What happens after treatment for the injury?

    Child and adult protective services perform follow-up visits in cases of abuse or neglect. Medical follow-up care is important, too. This helps to ensure a person's return to good health. It is also a way to check on whether caregivers are behaving responsibly.


    Author:Gail Hendrickson, RN, BS
    Date Written:
    Editor:Crist, Gayle P., MS, BA
    Edit Date:08/17/02
    Reviewer:Barbara Mallari, RN, BSN, PHN
    Date Reviewed:08/22/01


    "About Nursing Home Abuse and Neglect", www.nursinghomeabues.com/brgil.html

    "CAN-PREVENT Child Abuse and Neglect Prevention Task Force, Inc." www.childabuseprevention.com

    Sheehy, Susan, EMERGENCY NURSING: Principles and Practice: Third edition, Mosby 1995.

    The Merck Manual of Medical Information: Home Edition 1997