Frequent Questions

Physical abuse can instill an environment with constant fear. It does not always leave marks or cause permanent damage. Physical violence may include:

• Hitting, slapping, punching, or kicking you
• Scratching, biting, or grabbing you
• Shoving or pushing you
• Strangling or smothering you
• Destroying your property or treasured possessions
• Throwing objects to hurt or intimidate you
• Attacking or threatening to attack you with a weapon
• Any threats or actual attempts to kill you
• Hurting or threatening to hurt your children and/or pets
• Interrupting your sleep
• Denying you medical treatment
• Denying you access or neglecting your basic needs like clothing, food, and shelter

If physical abuse is present early in the relationship, it commonly gets worse over time, especially during pregnancy or when you try to leave. While physical abuse is the form of abuse that is most commonly known, it may or may not be part of an abusive relationship. There are many forms of non-physical abuse.

Emotional/psychological abuse is a behavior your partner uses to control you or damage your emotional well-being. It can be verbal or non-verbal, and it can be subtle or overt. Emotional/psychological abuse is present in all abusive relationships, in some form or another. Abuse may include:

• Name-calling or intimidating you
• Mocking you or making humiliating remarks or gestures
• Acting superior; placing little value on what you do or say
• Yelling at you or standing is a menacing way
• Threatening or making you fearful
• Manipulating your children
• Telling you what to do or where you can and cannot go
• Interrupting, changing topics, not listening or responding, and twisting your words
• Putting you down in front of other people
• Saying negative things about your friends and family
• Isolating you from your friends or relatives
• Cheating or being excessively jealous; accusing you of having affairs
• Minimizing the abuse or blaming you or others for their behavior
• Watching where you go; monitoring your phone calls, texts, car, and computer use

Economic/financial abuse happens when the abuser makes you entirely financially dependent upon them. It occurs in 98% of all cases of domestic violence. For many people, this is the reason they feel that they cannot leave an abusive relationship. Financial abuse may include:

•  Denying you access to bank accounts; hiding assets
•  Running up debt your name; ruining your credit
•  Taking your money; withholding money or giving you an allowance
•  Not letting you earn your own money
•  Jeopardizing employment by stalking or harassing you at your workplace
•  Denying access to a vehicle or damaging the vehicle, so that you cannot get to work
•  Sabotaging employment or educational opportunities

Economic/financial abuse happens when the abuser makes you entirely financially dependent upon them. It occurs in 98% of all cases of domestic violence. For many people, this is the reason they feel that they cannot leave an abusive relationship. Financial abuse may include:

•  Denying you access to bank accounts; hiding assets
•  Running up debt your name; ruining your credit
•  Taking your money; withholding money or giving you an allowance
•  Not letting you earn your own money
•  Jeopardizing employment by stalking or harassing you at your workplace
•  Denying access to a vehicle or damaging the vehicle, so that you cannot get to work
•  Sabotaging employment or educational opportunities

Sexual violence includes, but is not limited to:

• rape within marriage or dating relationships
• rape by strangers or acquaintances
• unwanted sexual advances or sexual harassment (at school, work etc.)
• systematic rape, sexual slavery and other forms of violence, which are particularly common in armed conflicts (e.g. forced impregnation)
• In addition, sexual violence may also take place when someone is not able to give consent – for instance, while intoxicated, drugged, asleep or mentally incapacitated.

• Chronic pain
• Gastrointestinal disorders
• Gynecological complications
• Migraines and other frequent headaches
• Sexually transmitted infections
• Cervical cancer
• Genital injuries

• Emotional detachment
• Sleep disturbances
• Flashbacks
• Mental replay of assault
• Shock
• Low self-esteem/self-blame
• Diminished interest/avoidance of sex
• Post-traumatic stress disorder
• Attempted or completed suicide
• Generalized anxiety
• Depression
• Symptoms of post-traumatic stress disorder
• Distrust of others
• Nervousness
• Shame or guilt
• Withdrawal
• Anxiety
• Confusion
• Fear
• Denial

• Strained relationships with family, friends, and intimate partners
• Isolation or ostracism from family or community
• Lower likelihood of marriage
• Less frequent contact with friends and relatives
• Less emotional support from friends and family

• Among female rape victims, perpetrators were reported to be intimate partners (51.1%), family members (12.5%), acquaintances (40.8%) and strangers (13.8%)
• In a nationally representative survey of adults, 37.4% of female rape victims were first raped between ages 18-24.
• Among female victims of partner violence who filed a protective order, 68% reported they were raped by their intimate partner and 20% reported a rape-related pregnancy.
• Of adults, 73% knew the attacker, 38% were friends of the attacker, 28% were an intimate partner of the attacker, and 7% were a relative of the attacker
• Perpetrators of acquaintance rape might be a date, but they could also be a classmate, a neighbor, a friend’s significant other, or any number of different roles.

The key to prevention and intervention of elder abuse is the ability to recognize the warning signs of its occurrence. Signs of elder abuse differ depending on the type of abuse the victim is suffering. Each type of abuse has distinct signs associated with it.

• Physical abuse can be detected by visible signs on the body, including bruises, scars, sprains, or broken bones. More subtle indications of physical abuse include signs of restraint, such as rope marks on the wrist, or broken eyeglasses.
• Emotional abuse often accompanies the other types of abuse and can usually be detected by changes in the personality or behavior. The elder may also exhibit behavior mimicking dementia, such as rocking or mumbling.
• Financial exploitation is a more subtle form of abuse, in comparison to other types, and may be more challenging to notice. Signs of financial exploitation include significant withdrawals from accounts, belongings or money missing from the home, unpaid bills, and unnecessary goods or services.
• Sexual abuse, like physical abuse, can be detected by visible signs on the body, especially around the breasts or genital area. Other signs include inexplicable infections, bleeding, and torn underclothing.
• Neglect is a type of abuse in that it can be inflicted either by the caregiver or oneself. Signs of neglect include malnutrition and dehydration, poor hygiene, noncompliance to a prescription medication, and unsafe living conditions.

In addition to observing signs in the elderly individual, abuse can also be detected by monitoring changes in the caregiver’s behavior. For example, the caregiver may not allow them to speak to or receive visitors, exhibit indifference or a lack of affection towards the elder, or refer to the elder as “a burden.” Caregivers who have a history of substance abuse or mental illness are more likely to commit elder abuse than other individuals.

Abuse can sometimes be subtle, and therefore difficult to detect. Regardless, awareness organizations and research advise to take any suspicion seriously and to address concerns adequately and immediately.

An abuser can be a spouse, partner, relative, a friend or neighbor, a volunteer worker, a paid worker, practitioner, solicitor, or any other individual with the intent to deprive a vulnerable person of their resources. Relatives include adult children and their spouses or partners, their offspring and other extended family members. Children and living relatives who have a history of substance abuse or have had other life troubles are of particular concern. For example, HFE abusive individuals are more likely to be a relative, chronically unemployed, and dependent on the elderly person.

The health consequences of elder abuse are serious. Elder abuse can destroy an elderly person’s quality of life in the forms of:

• Declining functional abilities
• Increased dependency
• Increased sense of helplessness
• Increased stress
• Worsening psychological decline
• Premature mortality and morbidity
• Depression and dementia
• Malnutrition
• Bed sores
• Death

The risk of death for elder abuse victims are three times higher than for non-victims.

PHYSICAL ABUSE

Physical abuse is non-accidental physical injury (ranging from minor bruises to severe fractures or death) as a result of punching, beating, kicking, biting, shaking, throwing, stabbing, choking, hitting (with a hand, stick, strap, or other object), burning, or otherwise harming a child, that is inflicted by a parent, caregiver, or other person who has responsibility for the child.

NEGLECT

Neglect is the failure of a parent, guardian, or other caregiver to provide for a child’s basic needs. Neglect may be:

• Physical (e.g., failure to provide necessary food or shelter, or lack of appropriate supervision)
• Medical (e.g., failure to provide necessary medical or mental health treatment)
• Educational (e.g., failure to educate a child or attend to special education needs)
• Emotional (e.g., inattention to a child’s emotional needs, failure to provide psychological care, or permitting the child to use alcohol or other drugs)

SEXUAL ABUSE

Sexual abuse includes sexual activities such as fondling a child’s genitals, penetration, incest, rape, sodomy, indecent exposure, and exploitation through prostitution or the production of pornographic materials. In Idaho, sexual touching of a minor under 16 is illegal.

EMOTIONAL/PSYCHOLOGICAL ABUSE

Emotional or psychological abuse is a pattern of behavior that impairs a child’s emotional development or sense of self worth. This may include constant criticism, threats, or rejection, as well as withholding love, support, or guidance. Emotional abuse is often difficult to prove, and therefore, child protective services may not be able to intervene without evidence of harm or mental injury to the child. Emotional abuse is almost always present when other types of maltreatment are identified.

ABANDONMENT

Abandonment is now defined in many states as a form of neglect. In general, a child is considered to be abandoned when the parent’s identity or whereabouts are unknown.

• Overall, any unexplained changes in a child’s body or behavior are red flags that abuse could be occurring.
• Physical Abuse: Any injury (bruise, burn, fracture, abdominal or head injury) that cannot be explained
• Sexual Abuse: Fearful behavior (nightmares, depression, unusual fears, attempts to run away), abdominal pain, bedwetting, urinary tract infection, genital pain or bleeding, sexually transmitted disease, extreme sexual behavior that seems inappropriate for the child’s age
• Emotional Abuse: Sudden change in self-confidence, headaches or stomachaches with no medical cause, abnormal fears, increased nightmares or attempts to run away
• Neglect: Failure to gain weight (especially in infants), desperately affectionate behavior, voracious appetite, and stealing food

Outcomes of child abuse can result in both short and long term injury, and even death. In most cases, children who are abused or neglected suffer greater emotional than physical damage. A child who has been abused or otherwise severely mistreated may become depressed or develop suicidal, withdrawn, or violent behavior. An older child may use drugs or alcohol, try to run away, or abuse others. The younger the child is and the closer the child’s relationship to the abuser, the more serious the emotional damage will be. As adults, they may develop marital and sexual difficulties, depression or suicidal behavior. With early intervention and treatment, these outcomes may be avoided.

Source: Child Welfare Information Gateway.

• Follow you and show up wherever you are
• Send unwanted gifts, letters, cards, or e-mails
• Damage your home, car, or other property
• Monitor your phone calls or computer use
• Use technology, like hidden cameras or global positioning systems (GPS), to track where you go
• Drive by or hang out at your home, school, or work
• Threaten to hurt you, your family, friends, or pets
• Find out about you by using public records or online search services, hiring investigators, going through your garbage,  or contacting friends, family, neighbors, or co-workers
• Posting information or spreading rumors about you on the Internet, in a public place, or by word of mouth
• Other actions that control, track, or frighten you

• A stalker can be someone you know well or not at all. Most stalkers have dated or been involved with the people they stalk. Most stalking cases involve men stalking women, but men do stalk men, women do stalk women, and women do stalk men.
• 2/3 of stalkers pursue their victims at least once per week, many daily, using more than one method.
• 78% of stalkers use more than one means of approach.
• Weapons are used to harm or threaten victims in 1 out of 5 cases.
• Almost 1/3 of stalkers have stalked before.
• Intimate partner stalkers frequently approach their targets, and their behaviors escalate quickly.

If you are being stalked, you may:

• Feel anxious, irritable, impatient, or on edge.
• Feel depressed, hopeless, overwhelmed, tearful, or angry.
• Feel stressed, including having trouble concentrating, sleeping, or remembering things.
• Have eating problems, such as appetite loss, forgetting to eat, or overeating.
• Have flashbacks, disturbing thoughts, feelings, or memories.
• The prevalence of anxiety, insomnia, social dysfunction, and severe depression is much higher among stalking victims than the general population, especially if the stalking involves being followed or having one’s property destroyed.

• Face: red or flushed, pinpoint red spots (petichiae), scratch marks
• Eyes and eyelids: petichiae to the left or right eyeball, blood shot eyes
• Nose: bloody nose, broken nose, petichiae
• Finger tips: bruises are circular and oval and often faint
• Ear: petichiae (external and/or ear canal), bleeding from ear canal
• Mouth: bruising, swollen tongue, swollen lips, cuts/ abrasions
• Under the chin: redness, scratch marks, bruise(s), abrasions
• Chest: redness, scratch marks, bruise(s), abrasions
• Shoulders: redness, scratch marks, bruise(s), abrasions
• Neck: redness, scratch marks, finger nail impressions, bruise(s), swelling, ligature mark
• Head: petichiae (on the scalp)
• Ancillary findings: hair pulled, bump(s), skull fracture, concussion

•  Voice changes: raspy voice, hoarse voice, coughing, unable to speak, complete loss of voice
• Swallowing changes: trouble swallowing, painful to swallow, neck pain, nausea/vomiting, drooling
• Breathing changes: difficulty breathing, hyperventilation, unable to breathe
• Behavioral changes: restlessness or combativeness, problems concentrating, amnesia, agitation, post-traumatic stress syndrome, hallucinations
• Involuntary urination or defecation
• Coughing / vomiting
• Loss of consciousness/ fainting
• Dizziness/ headaches

If you are pregnant, attempted strangulation can have an impact on the fetus. You should be evaluated by your doctor, immediately.

Paying attention to, and documenting, changes in your signs and symptoms can be critical to determine the nature and scope of your injuries.