Disability and Abuse

By definition, abuse is something that inflicts pain or emotional distress on a vulnerable person through verbal or nonverbal acts. Abuse thrives in shame and silence. It is based on a dynamic of power and control. Studies show that people with disabilities are more likely to experience abuse. But this abuse often goes unreported.^1,2

If they are being abused, people with disabilities like spinal muscular atrophy (SMA) must advocate for themselves. But family members, doctors, and case managers should report signs of abuse and neglect if they suspect it. Reports of abuse are most common in residential care settings, but abuse also can happen at home.^1,2

Abuse often starts with verbal abuse. People with disabilities may also experience physical abuse and other forms of manipulation. Over time, this can lead those being abused to develop mental health issues like depression and anxiety.^1-5

Types of abuse

Being abused may instill fear in a person to comply with their abuser. Abusers want to gain this power and control.^1-4

Abuse can take many forms, including yelling, physical attacks, or passive-aggressive behavior. Subtle acts such as neglecting someone who asks for help or depriving them of food are also abusive. Yelling and verbal threats can cause as much damage as physical abuse. These actions often set the stage for more severe abuse.^1-5

While verbal and physical abuse are most common, other types of abuse and exploitation include:^1,2,4

• Neglect – Failure to provide proper food, shelter, healthcare, and other necessities.
  Abandonment – Leaving a disabled person alone or deserting them without regard to their health and safety.
• Sexual abuse – Forcing a vulnerable person to participate in sexual contact or witness sexual behaviors.
• Financial abuse – Pressuring a vulnerable person to withdraw money, open credit cards, or transfer assets against their will or without their knowledge.

Abuse of people with disabilities

People with physical limitations, such as those with spinal muscular atrophy, have higher rates of disability-related abuse. They rely on others for assistance with daily activities, which shifts the power dynamics to caregivers.^1-5

General examples of abuse may include:^1-4

• Name-calling or put-downs
• Verbal threats or insults
• Attempts to blame, shame, or humiliate
• Hitting, kicking, or pushing
• Confining a person to a room or at home
• Withholding food or other basic needs
• Ignoring someone who needs help
• Extreme punishment or discipline
• Limiting a person’s contact with others
• Using excessive physical restraint
• Stealing money, personal property, or a person’s identity

Examples of abuse specific to people with disabilities may include:¹

• Invalidating or minimizing their disability
• Using their disability to shame them
• Damaging or hiding their assistive devices
• Preventing them from seeing a doctor
• Threatening to harm their service animal

Warning signs of abuse and neglect

Abuse of people with disabilities can occur by a family member, friend, neighbor, or paid caregiver. Abusers usually hide their behavior in front of other people. They can appear to be caring and have a close relationship with their victim.^1-3

If you are concerned for your own safety or worried about a loved one, learn the warning signs of abuse, neglect, and exploitation.

Signs that a person is being abused may include:²

• Acting afraid or anxious
• Unexplained injuries
• Bruises or burns
• Changes in behavior or mood
• Refusing to go places
• Being withdrawn or nervous
• Isolation or depression
• Broken bones
• Overmedication or sedation

Signs of neglect may include:²

• Poor hygiene and body odor
• Lack of food or necessities in the home
• Canceled or missed doctor visits
• Being dehydrated or malnourished
• Unexplained weight loss
• Dirty clothes or hair
• Pressure sores
• Unpaid bills, overdrafts
• Unclean house

Signs of exploitation may include:²

• Forged or bounced checks
• Large monetary withdrawals
• Unpaid bills or financial problems
• New or maxed-out credit cards
• Missing items or money
• Reliance on caregivers who have mental health or substance use problems
• A new caregiver who suddenly becomes the person’s best friend
• Isolation or secrecy

Effects of abuse on people with disabilities

Abuse and trauma cause chronic stress. Aside from their physical health, abuse can affect a disabled person’s mental health and self-esteem. They may feel trapped or ashamed because they need help from others.^1-3

Hurtful words can cause emotional pain. This may lead to feeling victimized, ashamed, anxious, and afraid. Abuse of a disabled person also can contribute to behaviorial problems and diminish their cognitive or social skills.^1-3

How to get help

If you are experiencing abuse by a caregiver, it is not your fault. Talk to a trusted friend, family member, or disability advocate. Doctors, social workers, and police officers must report suspected abuse.^1-4

If you think a friend or family member is being abused, try to get as much information as you can:²

• Listen to your loved one, and reassure them that it is not their fault.
• Record your concerns in writing.
• Document physical abuse with pictures or video.
• Make a report to child or adult protective services.
• Notify your loved one’s doctors or the agency providing services.
• File a report with your loved one’s group home or nursing facility.
• Contact the police, a case manager, or an attorney.

How to prevent abuse of people with disabilities

You can help prevent abuse by being involved in your loved one’s care. If they live in a group home or nursing facility, you can make surprise visits and report any concerns. Know the warning signs of abuse, and do the following for your loved one:²

• Be vigilant and ask questions.
• Watch for odd behaviors.
• Ask about any unexplained injuries.
• Call or check in on a regular basis.
• Monitor their bank accounts and freeze their credit if needed.
• Increase their circle of support.
• Seek community resources and disabled or elder care services.
• Ask for caregiver referrals from trusted friends or social services.
• Interview potential new caregivers and agencies.
• Do a background check on any new caregivers.

People with disabilities may be reluctant to share what is happening to them. They may blame themselves or feel like they cannot escape the abuse. Be ready to listen, observe, and advocate. It may take a lot for someone to tell you they are being abused. If they do report abuse to you, do your best to confirm those claims and notify the proper authorities.^1-4