Introduction		Signs of Physical Abuse
	Domestic Violence		Signs of Neglect
	Lasting Effects of Domestic Violence		How to Get Help
	Child Abuse and Child Protective Services		Safe Home Environment
	How Social Workers Help		Additional Safety Precautions
	Caregiver Abuse and Neglect

Introduction

Warning: perils ahead. That's life: lightning strikes, fires, accidents and injuries, family crises, food poisoning and falls, cancer and heart attacks. Risk is inherent in life, and we learn to protect ourselves and control what we can.

When tragedy strikes and we fall victim to forces outside of our control or from lifestyle choices, we can find comfort from the support of others. Social workers are specifically trained to help people regain their equilibrium following an illness, family challenges, and accidents.

Keeping yourself and your family safe and healthy should be a high priority. And when disaster happens, seeking help just makes good sense.

Domestic Violence

Violence in the home touches the lives of people from all races, educational backgrounds, and socioeconomic groups, often causing devastating consequences for women, children, and families. Domestic violence, also known interpersonal partner violence or family violence, is the single largest cause of injury to women between the ages of 15 and 44, more than muggings, car accidents, and rapes combined.

As many as 4 million women are abused and 2,000 die from their injuries every year, according to the American College of Emergency Physicians.

Studies have found that batterers are most commonly males who use violence to control a wife or girlfriend. They may use physical violence, such as punching, kicking, slapping, or strangulation, or sexual violence. Another form of abuse is psychological; the abuser may threaten to hurt other family members or pets, may use insults, criticism and name-calling, and intimidation. Domestic violence also includes abuse against older adults (elder abuse), and dating violence against teenagers.

The Lasting Effects of Domestic Violence on Women and Children

The damaging effects of violence in the home can be far-reaching and long-term. Women with a history of domestic violence have higher rates of all health problems than other women, according to the Centers for Disease Control and Prevention (CDC). They also report long-lasting health conditions, such as chronic pain and gastrointestinal disorders. Abused women are often depressed and anxious.

Growing up in a violent home can be traumatic for children, even if they are not the victims. Children who witness their parents' domestic violence are more likely than their peers to experience depression and anxiety, to abuse drugs and alcohol, run away from home, commit sexual assault crimes, and attempt suicide.

Children exposed to domestic violence are more likely to exhibit increased levels of aggression and anti-social behavior, unhealthy peer relationships, and poor school performance.

Victims of domestic abuse often fear their partner's retribution if they try to get help. Still, community services are available to protect women and children from abuse. Social workers can refer clients to residential shelters, support groups, assertiveness classes, and services that provide legal assistance. The National Domestic Violence Hotline (800-799-7233) provides crisis intervention and is available 24 hours a day.

Child Abuse and Child Protective Services

Like domestic abuse, child abuse can be a dangerous family secret that is underreported to authorities. In 2002, 906,000 U.S. children had been abused, according to child protective service agencies. Of these, 61 percent had been neglected, 19 percent were physically abused, 10 percent were sexually abused, and 5 percent were psychologically abused. An estimated 1,500 children died from abuse that year, according to CDC.

The effects of child maltreatment can last a lifetime. The stress of chronic abuse in infancy or early childhood can slow or alter brain development, leading to sleep disturbances, panic disorder, attention-deficit disorder, and other problems later in life. Child abuse has also been linked to long-term health problems, such as heart disease, cancer, and lung and liver disease.

Children who have been abused by a parent often do not form an emotional bond with them, which can later lead to difficulties in forming attachments with other adults and with peers. Abused teenagers have a higher risk of experiencing teen pregnancy, low academic achievement, and mental health problems.

How Social Workers Help in the Child Protective Services Arena

Social workers play an active role in protecting children through the child welfare system and they are in a position to provide early intervention. The child welfare system is comprised of many community organizations that collaborate to promote child safety. These organizations include public agencies, such as departments of social services, and private child welfare agencies and organizations. They often collaborate with the schools, health and mental health agencies, and other community-based organizations to meet the needs of children and families.

This network investigates reports of possible child abuse, provides services to families to assist with protecting children, and arranges for foster care or permanent adoptive homes for children who are not safe at home. Child protective service workers follow up on child abuse reports if the report meets the state's legal definition of abuse or neglect.

After talking with the parents, teachers, childcare providers, and others, child protective service workers may move a child who is believed to be in immediate danger to a shelter, foster care home, or to the home of a relative. In some states, when the risk to a child appears to be minimal, the child protective service worker may identify family problems and offer needed services. For example, he or she might counsel the family. The parents' attendance at a mental health or alcohol abuse treatment program may be recommended. The child protective service worker can also make regular visits to the family where there is a risk of child abuse or neglect.

In abuse cases that meet the state's definition of child abuse or neglect, child protective service workers will offer voluntary, in-home services to help the family resolve the conflicts that led to the abuse. If services are refused, court intervention may be necessary.

The child welfare system provides an array of prevention and intervention services to children and families; particularly to children who have been or are at risk of abuse or neglect.

This system's role is to promote the safety and well being of children. Part of this role is to teach adults parenting skills and offer services that will help to minimize future risk to children.

Caregiver Abuse and Neglect

Caring for another person is a rewarding and challenging job. Often caregivers take care of others while neglecting themselves. Stress can build leading to actions that would not normally occur.

Abuse refers to any willful act or omission of a caregiver or any other person which results in physical injury, mental anguish, unreasonable confinement, sexual abuse or exploitation, or financial exploitation to or of a vulnerable adult.

Signs of Physical Abuse:

• Multiple bruising, not consistent with a fall
• Black eyes, slap marks, kick marks, grasp marks, finger tip bruising and other bruises
• Burns such as cigarette burns, dunking burns (hands/feet being immersed in boiling hot water)
• Fractures not consistent with falls
• Stench of urine or feces
• Indications of malnutrition or over-feeding
• Administration of inappropriate drugs

Neglect is failure of a caregiver to provide essential services necessary to maintain the physical and/or mental health of a vulnerable adult.

Signs of Neglect:

• Lack of basic care
• Abandonment
• Not providing proper food or fluids
• Failure to provide proper health care
• Lack of personal care
• Not dressing someone (for example, from the waist down because the person is incontinent
• Not dressing someone appropriately (such as wearing thin clothes in the winter)
• Refusing to buy new clothes for someone who has gained or lost weight
• Being left to sit in urine/feces
• Absence of mobility aids so the person's movements are restricted
• Absence of necessary medication
• Improperly fitting or damaged dentures
• Nonfunctioning hearing aids, including lack of batteries
• Isolation (for example, the person may be locked in a room or confined space with only basic necessities
• No social contact or stimulation

How to Get Help

Highly trained social workers are available to help you identify options to alleviate elder abuse. Social workers can identify state and local human service centers that offer mental health services. These services are often available on a sliding fee scale that is affordable to everyone. Also, social workers can refer you to crisis centers, private counselors, and others who can help.

Safe Home Environment

Home may be where the heart is, but there are also potential hazards that threaten the safety and welfare of children. Unintentional injuries are the leading cause of death among children ages 14 and under in the United States. Each year, more than 4.5 million children are treated in hospital emergency centers for injuries incurred specifically in the home, according to the National Safe Kids Campaign.

Children most at risk are those age 4 and under, males, minorities, and children living in poverty. Low-income families often must live in a hazardous environment where there is overcrowded housing, inadequate supervision, and a lack of safe play areas for children.

Parents can't protect children from every hazard, but they can consider safety an important issue and take precautions. An estimated 90 percent of unintentional injuries can be prevented. Never leave your toddler unattended.

Preventing Drownings, Falls, and Lead Poisoning

• Drowning is the leading cause of injury-related death among children ages 1 to 4. Prevention is a matter of carefully watching children while they are in the bathtub and around swimming pools and ponds. Flotation devices in swimming pools should not be a substitute for supervision. Empty large buckets when they are not in use. Also, learn child first aid and CPR. In many places, the local Red Cross will offer CPR training sessions.
• Falls can be prevented by keeping young children away from heights, such as high porches or balconies; strapping children into high chairs and strollers; securing rugs with double-sided tape or a rubber pad; using a rubber mat in the bathtub; and keeping windows closed and locked when children are around. Insect screens are not sturdy enough to protect children from falling out of windows.
• Lead poisoning can cause irreversible brain damage and may impair mental functioning. Infants and young children are especially vulnerable to the effects of lead. Homes built before 1960 may contain lead-based paint that can be either removed or covered. Take advantage of community lead screening programs to have children tested for lead poisoning.

Additional Safety Precautions

• Safety proof your home.
• Store medicines and cleaning products on high shelves.
• Make sure toys are age appropriate to avoid choking.
• Make sure your child's car safety seat is age and weight appropriate.

For more safety information, contact local health agencies and social services organizations. Discuss health, safety, and family issues with helping professionals in your community.

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