RCGP Safeguarding toolkit

How does adult abuse/neglect present in general practice?

Like child abuse, presentations of adult abuse and neglect in general practice are seldom clear-cut and well-defined. Adults may not recognise that what they are experiencing is abuse and individuals can experience multiple different types of abuse at the same time.

Below are some examples of how adult abuse and neglect may present in general practice. This list is not exhaustive.

• Disclosures from the adult.
• Physical signs, e.g. bruises, injuries.
• Behaviour changes e.g. more withdrawn, more angry, challenging behaviour.
• Mental health concerns, e.g. anxiety, depression, self-harm, suicidal thoughts/attempts.
• Drug and alcohol issues.
• Family/carers sharing concerns.
• Interactions between the adult and others such as family or carers that causes concern.
• The adult displays harmful behaviour towards others.
• Disclosures from a family member/carer about abuse in their own life, e.g. domestic abuse, that also indicates abuse to the adult.
• Indicators of institutional abuse/neglect in places such as care homes and residential homes.
• Information shared from other health colleagues or other agencies/professionals.
• Missed appointments – repeated patterns of adults not being brought to health appointments or missing appointments.
• Behaviour of a colleague or a Person in Position of Trust that gives concerns they may be a risk to adults with care and support needs.

It is worth noting that the signs of lots of different types of abuse can be similar. For example, an adult who presents with mental health difficulties and substance misuse issues could be experiencing any type of abuse. It is therefore important for practitioners to be able to recognise the signs that can indicate potential abuse and neglect in adults to be able to ask appropriate questions and take appropriate safeguarding action.