Module 5 – Abuse and Neglect

Assignment

General Directions:

A. Work in a group, as assigned by your instructor.

B. Choose a group member to record the answers for the group.
C. Discuss the following scenarios and record your answers on the assignment sheets
provided.
D. One assignment will be submitted per group— each member will receive the same
mark, provided all participants contributed equally.
E. Submit your answers to your instructor at the end of the session.
F. Assignment is out of 30 marks.
G. Each group member will receive the same mark, provided all participants contribute
equally.
H. The assignment will count for 40% of your final mark in Module 5.

Name:

Date:

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 CASE #1

Mrs. Green is your client. She is 78 years old and has progressive degeneration of her
hip joints that makes it very difficult for her to get out. You have been visiting her for
three weeks, helping with the vacuuming, washing, and providing some social contact.

Although Mrs. Green seems to want you to continue coming to see her, you notice
that she is very anxious about your leaving on time. You feel that she is probably
worried about the costs of your visits and wants to make sure that she isn’t charged for
extra time.

You’re aware that Mrs. Green has a daughter and, although she doesn’t say much
about her, you get the feeling that the daughter does visit. You have never met her,
though.

At the end of your last visit, Mrs. Green’s washer backs up, spilling water all over the
basement. Mrs. Green becomes very anxious, saying to you that, “It’s alright: the
water won’t hurt the floor. You’d better go, you’ll be late.”

You can’t just leave the water on the floor and insist on cleaning it up. Somewhat
reluctantly, Mrs. Green decides to let you do this and returns upstairs.

Just as you’re finishing, you hear the door. A younger woman speaks to Mrs. Green.
You notice that her tone is harsh as she says, “You’re out of milk and bread? What did
you do with all of the food I brought last week? Feeding those damn birds again— you
don’t have enough sense to make sure that you keep food for yourself. Now I have to
get stuff because you’ve wasted what you had. Sometimes you act as though you don’t
have a brain in your head.”

Concerned, you put away the last of the cleaning supplies when you hear the younger
woman say, “Whose coat is this?” When Mrs. Green replies that it is yours, the woman
continues, “What’s the matter? You aren’t satisfied with all that I do? You have to
invite some stranger into your house? Where are you getting all the money for this?”

You go to the top of the stairs. The younger woman says to you, “Thanks for your
help, but my mother won’t be needing you anymore. I’ll make sure that you’re well
paid for today.” Mrs. Green looks miserable, but helpless. She looks down at the floor.

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 1. Describe all the feelings that you (or other PSWs) might have in this situation.
Explain how they might be helpful or unhelpful in resolving the problem. (2
marks)

2. List three behaviours of Mrs. Green’s that indicate she may be abused. (3 marks)

a.
b.
c.

3. In this situation, describe how power is being exerted over another person. (2
marks)

4. What action is appropriate for the PSW to take in this situation? Why? (3 marks

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 CASE #2

You have been assigned to assist Sarah, a new mother, care for her infant son. The
mother requires help as she has recently had a sprained ankle and wrist fractures.
Although she can get around, she cannot look after the infant and her 2-year-old
daughter. Home care was ordered by Sarah’s doctor, despite the family’s protests that
they could manage on their own. You have been visiting for two weeks.

Sarah is a quiet, painfully shy person. However, little by little, she has warmed up to
you. She smiles more often now and seems very grateful for your visits.

Today, as you hand Sarah her son after his bath, you notice a large bruise on Sarah’s
upper arm. It is purplish and about 10 cm. (4 inches) in diameter. Sarah notices that
you have seen the bruise and says, “Oh, that— I hit the freezer door last night.” You
must look doubtful, as Sarah begins to cry. She tells you that her husband grabbed her
arm and twisted it last night. She begs you not to tell anyone, saying that she would be
embarrassed if anyone knew. “He’s a good man,” she says of her husband, “I’d have
nothing if it weren’t for him.”

1. Describe all the feelings that you (or other PSWs) might have in this situation.
Explain how they might be helpful or unhelpful in resolving the problem. (1
mark)

2. Identify three signs that indicate Sarah is abused. (3 marks)

a.
b.
c.

3. Describe two ways in which Sarah is demonstrating denial. (2 marks)

a.
b.

4. What other emotion is Sarah displaying? (1 mark)

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 5. What action is appropriate for the PSW to take in this situation? Why? (3 marks)

SOLUTIONS:

In the situation with Mrs. Green, the feelings of the PSW might include concern, empathy, and frustration. The PSW may
feel concerned for Mrs. Green’s well-being and anxious about the potential abuse she seems to be experiencing. This
concern can be helpful as it motivates the PSW to take action to protect Mrs. Green. Empathy is important for
understanding her feelings of helplessness and anxiety, fostering a supportive environment. However, feelings of
frustration may arise due to the challenges in addressing the situation, which could potentially hinder effective
communication with both Mrs. Green and her daughter.
Mrs. Green exhibits several behaviors that suggest she may be experiencing abuse:
a. She appears anxious about the PSW leaving on time, indicating a fear of financial repercussions or disapproval from
her daughter.
b. Her demeanor becomes submissive and helpless in the face of her daughter’s harsh comments, suggesting a lack of
autonomy.
c. She minimizes the severity of the water situation and urges the PSW to leave, which may indicate an attempt to avoid
conflict or further anger from her daughter.
Power is being exerted over Mrs. Green by her daughter, who uses a harsh tone and belittles her mother’s choices and
abilities. This dynamic illustrates a clear imbalance of power, where the daughter’s authority and control over her
mother’s life decisions lead to Mrs. Green’s evident distress and feelings of inadequacy.
In this situation, the appropriate action for the PSW would be to ensure the safety and well-being of Mrs. Green. This
could involve speaking with her privately to express concern about her daughter’s behavior and to assess whether Mrs.
Green feels safe at home. It may also be necessary to document the observations and consider reporting the situation to
the appropriate authorities or social services for further investigation, as ensuring the safety of vulnerable individuals is
paramount.

Turning to Sarah’s situation, the feelings of the PSW may include alarm, compassion, and a sense of responsibility. Alarm
arises from witnessing possible signs of domestic abuse, while compassion drives the PSW to support Sarah in her time of
need. However, feelings of responsibility might also lead to internal conflict if the PSW fears potential repercussions for
intervening or breaking confidentiality, which could hinder the resolution of Sarah’s situation.
Signs that indicate Sarah is abused include:
a. The large bruise on her arm, which seems inconsistent with her explanation.
b. Her emotional response, particularly her crying and distress when discussing her husband’s actions.
c. Her insistence on secrecy, indicating fear of repercussions if the abuse is revealed.
Sarah demonstrates denial in two ways:
a. She downplays the abuse by rationalizing her husband’s actions, calling him a “good man.”
b. She expresses a sense of dependency on her husband, implying that she would be lost without him, which minimizes
her own needs and perspectives.
An additional emotion Sarah displays is fear, as she worries about the consequences of disclosing the abuse and feels
embarrassed about her situation.
The appropriate action for the PSW in Sarah’s situation is to gently encourage her to seek help, while respecting her
autonomy. It is crucial to provide her with resources, such as contact information for domestic violence support services,
while assuring her of confidentiality and support. This approach empowers Sarah to make informed decisions about her
safety while ensuring she knows that help is available.
In the case of the Ross family, the PSW might feel shock, concern, and helplessness upon witnessing Mrs. Ross’s violent
interaction with Ray. These feelings can be helpful in prompting the PSW to take immediate action to ensure the child’s
safety, but helplessness might also lead to inaction if the PSW feels overwhelmed by the situation.
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Possible reasons for Mrs. Ross’s angry outburst could include:
a. Stress from the demands of caring for three newborns and two older children.
b. Fatigue, which can lead to irritability and a lack of patience.
c. Possible feelings of inadequacy or frustration regarding her parenting, contributing to her aggressive behavior towards
Ray.
Behaviors in Ray that may indicate he is being abused include:
a. A decline in his physical coordination, suggesting possible neglect or emotional distress.
b. An increase in “baby-talk,” indicating regression in behavior that may stem from fear or anxiety.
The appropriate action for the PSW in this situation is to intervene immediately and ensure Ray’s safety by calmly
addressing Mrs. Ross. This could involve stepping in to separate them and speaking to Mrs. Ross in a non-confrontational
manner to understand the situation better. It may also be necessary to report the incident to child protective services to
ensure Ray receives the appropriate care and support, as the safety and well-being of the child are the primary concern.

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 CASE #3

You have been assigned to care for the Ross family. The family just had triplets: three
girls. The girls were premature, but they are now home after two months in hospital.
There are two older children in the family, Ray, age two, and Lori, age five. Although
maternal and paternal grandparents are all living, they reside 1600 km away and
cannot visit to help.

The family seems to be loving and close-knit. The parents seem very happy with the
new additions— although they admit that the birth of three was very much a surprise.

You have been with the family for two months and over that time have noticed a
change in Ray. He seems less able to run as steadily as he did before. As well, he seems
to be using more “baby-talk,” not speaking words as clearly as he once did. He also
seems to be more fearful.

Today is your day off. You find yourself in the Ross’ neighbourhood and decide to say
hello. As you go up to the door, you see Mrs. Ross violently shaking her son. She is
visibly upset and is speaking to him in a very angry voice.

1. Describe all the feelings that you (or other PSWs) might have in this situation. Explain
how they might be helpful or unhelpful in resolving the problem. (2 marks)

2. Identify the possible reasons for the angry outburst in Mrs. Ross. (3 marks)

3. Identify two behaviours in Ray that indicate that he may be abused. (2 marks)
a.
b.

4. What action is appropriate for the PSW to take in this situation? Why? (3 marks)

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