Types of abuse and neglect as defined by the Missouri Department of Mental Health are as follows:

• Physical Abuse******
• Verbal Abuse********
• Class I Neglect*******
• Class II Neglect******

Let's look at each type individually.

Physical Abuse -
An employee purposefully beating, striking, wounding or injuring any consumer.

In any manner whatsoever, an employee mistreating or maltreating a consumer in a brutal or inhumane manner.

Physical abuse includes handling a consumer with any
more force than is reasonable for a consumer’s proper control, treatment or
management; 9 CSR 10-5.200.

Examples of Physical Abuse:

• 1. Using more force than is necessary or using an improper technique to restrain a consumer.
• 2. Squirting or spraying a consumer with water for the purpose of controlling behavior.
• 3. Hitting a consumer in self-defense when the consumer is physically assaulting the direct care staff.
• 4. Forcibly shaking a consumer.
• 5. Swatting or spanking a consumer.
• 6. Pushing furniture into a consumer.

Verbal Abuse -

An employee using profanity or speaking in a demeaning, non-therapeutic, undignified, threatening or derogatory manner to a consumer or about a consumer in the presence of a consumer.

TIP:
Even if an individual does not understand what you say, profanity CANNOT be used.

Loud talking or yelling by staff members is not tolerated except in extreme emergencies.

If the individual is demonstrating an inappropriate behavior, yelling at them to stop, sit down, etc., is inappropriate. If an individual only responds to a bold, loud, authoritative voice, or has a suspected hearing loss, the use of louder than normal speech should be a team decision and written into the Personal Plan.

Examples of Verbal Abuse:

• 1. Gesturing and/or mimicking consumer‟s actions.
• 2. Calling the individual an “idiot”, “dummy”, “retarded”, “stupid” or other derogatory ******
• curse words, etc.
• 3. Yelling or shouting at a consumer.
• 4. Not only calling a consumer a name, but using profanity when speaking with the consumer.

Telling a consumer to “stop acting like a „ bi***, “he weather is a bit**” or any reference including a curse word would be considered verbal abuse.******

 
Scenarios

To reinforce what you have just learned read the scenarios below. In each scenario which type of abuse do you feel is being demonstrated? Answers are located at the bottom of the page.

• 1. A consumer pulls a staff member’s hair and staff slaps the consumer’s hand.
• 2. Staff is yelling and cursing at a consumer in a very loud tone and tells the consumer, “you are so stupid you can't do anything right!”

Answers:

• 1. This is an example of Physical Abuse
• 3. This is an example of Verbal Abuse

Abuse/Neglect Definitions

On the previous page we went over the definitions and some examples of physical, and verbal abuse. Now let's take a look at the definitions and some examples of the two types of neglect.

Class I Neglect

The failure of an employee to provide reasonable or necessary services to maintain the physical and mental health of any consumer when that failure presents either imminent danger to the health, safety or welfare of a consumer, or a substantial probability, that death or physical injury would result. 9 CSR 10-5.200

 Examples of Class I Neglect:

• 1. An individual that requires 24 hour supervision wanders out into the highway and the staff member isn‟t aware that the person is missing.
• 2. While dressing a consumer, staff forces a consumer‟s arm into the sleeve, and hear a pop. An x-ray reveals that the consumer‟s arm is broken.
• 3. Not seeking medical attention for injuries/illness in a timely manner
• 4. “Serious” medication error.

The key to determining the difference in Class I and Class II is that there is asubstantial probability, that death or physical injury would occur and harm the consumer. Anything that could result in death or injury would be considered

 Class II Neglect

The failure of an employee to provide reasonable or necessary services to a consumer according to the individualized treatment or habilitation plan, if feasible, or according to acceptable standards of care. This includes action or behavior

which may cause psychological harm to a consumer due to intimidating, causing fear or otherwise creating undue anxiety. 9 CSR 10-5.200

Examples of Class II Neglect:

• 1. Staff using intimidation, such as turning on or off a light, to keep a consumer from doing something.
• 2. Staff are found asleep while providing ISL services to an individual.
• 3. The physician and consumer‟s personal plan indicate that they are to receive a mechanical softened diet and yet staff give them food that is finely chopped.

Scenarios

To reinforce what you have just learned read the scenarios below. In each scenario which type of neglect do you feel is being demonstrated? Answers are at the bottom of the page.

• 1. When the Personal Plan states that a consumer cannot safely use chemicals (paint thinner, charcoal starter, cleaning chemicals, etc.) and the staff leave these items in an area where the consumer comes in contact with them and has to be taken to the ER.
• 2. A direct care staff takes a consumer individual swimming and does not apply sun screen resulting in a severe sunburn.
• 3. A consumer is seen wandering around a local department store without staff, it is documented in the consumer’s plan that they should be within “line of sight” of direct care staff while in the community.
• 4. Consumer’s Personal Plan states they will go to the “Y” 3 times a week but staff person doesn’t feel like taking the consumer.

Answers:

TIP:  In simple terms Class II Neglect is when a staff member fails to follow a specific procedure in the consumer’s personal plan or causes psychological harm to the consumer through the use of intimidation or fear.

 
PLEASE UNDERSTAND NOTHING JUSTIFIES ABUSE/NEGLECT!!!

 
“The measure of people’s real character is what they would do if they knew they would never be found out.”  - J.C. Macauley