Abuse is defined as “a pattern of behavior used by one person to gain and maintain power and control over another” (Reach Team 2017). Abuse can come in many forms physical, emotional, sexual, and neglect. Unfortunately, elderly and child abuse are the most common and the abused can be in danger. In some cases, a child or elder person is unable to help themselves leave an abuser because of there age or health conditions. Health care providers work hard, not only do they have to tend to the patient’s health needs but make sure a patient is not being abused. Abused victims come small and big and young and old but the signs and abuse are very similar. Some of the things that a provider can look for in a domestic violence is a sense of fear in the patient, a patient not answering questions to the fullest or ignoring them. Other ways to tell of physical abuse is to look for cuts, bruising, swelling, burns, scalds, cigarette burns, rope burns on body, bite marks, and fractures. Emotional abuse can be identified by low self-esteem, a patient feeling worthless, depression, decreased interpersonal skills, in case of a child lacks physical development and failure to thrive, and anxiety attacks. Sexual abuse can be identified by trauma to intimate body parts, difficulty walking and sitting, pain or itching in genital and or anal areas with possible bruising, bleeding, or discharge, and torn or blood-stained underwear. Neglect is another type of abuse and providers will look for poor physical health, hunger, dirty clothes or unwashed dirty body, hunger, and ill-fitting clothes. The procedure once an abuse has been identified is step 1 to call a hotline and report the particular abuse. Second step is to report to the proper management staff and if it involves children to call Department of child protection and permanency. Third step is to make sure all documentation is done and properly recorded.  

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