Module 5 – Abuse and Neglect

Assignment

Submitted By:
Anita Thapa
Kevin Maloba Ngube
Parneet kaur
Rupinderjit kaur
Sukhpreet Kaur

Date of submission:
11th May 2025

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.
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)

I may experience sadness, helplessness, anger, frustration, and concern as a Personal

Support Worker. I could be worried for Mrs. Green's safety and well-being and feel
protective of her. These emotions can be useful since they motivate me to act, report the
issue, and support Mrs. Green. They could, however, be harmful if they make me respond
emotionally or approach the daughter in the wrong manner, which might worsen the
situation.

Additionally, I might feel conflicted or anxious about overstepping boundaries or making

assumptions. It’s important to manage these feelings professionally by staying calm,
objective, and focused on Mrs. Green’s best interests. I will explain to her daughter that
Mrs. Green needs physical, psychological, and emotional support as she is elderly and
 experiencing age-related challenges. At the same time, I will report my observations to my
supervisor and the appropriate social protection service to ensure that steps are taken to
protect Mrs. Green and provide her with the care she deserves. Channeling emotions into
appropriate action is essential for effectively resolving the situation and safeguarding the
client’s well-being.

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

a. Mrs. Green worries a lot about the PSW leaving on time, either because of fear she will
be blamed or that she will upset her daughter.
b. She ignores the importance of the flooded basement by saying "It's alright," which may
indicate an ability to minimize problems to stay out of trouble.
c. She shows emotional pain and a lack of control over her own life when her daughter
insults her and orders the PSW not to come back, making her look sad and helpless.

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

By insulting Mrs. Green, doubting her intelligence, and limiting her access to services and
even her cash, the daughter maintains control and authority over her. Mrs. Green is made
to feel helpless and dependent by the daughter's criticism and her choice to fire the PSW,
which shows psychological and emotional abuse.

The daughter uses her position of trust and proximity to manipulate and intimidate Mrs.
Green, asserting dominance through harsh language and financial control. This creates a
power imbalance where Mrs. Green is unable to advocate for herself, leaving her
vulnerable to ongoing mistreatment and isolation.

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

The PSW have an ethical and legal duty to take care of elderly patients, so they should
notify the proper supervisor or authority of the suspected elder abuse. Proof of emotional
and possibly financial abuse is evident, and Mrs. Green might be too scared or unable to
speak up for herself. Ensuring Mrs. Green's safety and wellbeing requires careful record-
keeping of the incident and attention to the workplace's abuse reporting procedure.

In addition, the PSW should remain calm and, if it is safe to do so, explain to Mrs. Green’s
daughter that Mrs. Green is experiencing physical and emotional challenges related to
agerelated degeneration, and that she requires appropriate support. However, the PSW
must prioritize reporting the incident to their supervisor and the appropriate social
protection services so that proper steps can be taken to ensure Mrs. Green receives holistic
 and respectful care in a safe environment. Taking timely action can help prevent further
abuse and ensure that Mrs. Green's rights and dignity are protected.

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)

As a PSW, when I saw the bruise on Sarah’s arm and heard her quietly admit that her
husband had twisted her arm, I felt a mix of concern, sadness, and a strong sense of
responsibility. I was deeply concerned for her safety and the well-being of her children. I
also felt sadness knowing that someone so vulnerable was suffering in silence. At the
same time, I felt unsure and conflicted about what to do next—especially after she
begged me not to tell anyone.

These emotions can be helpful because they reflect my compassion and commitment to
protecting the client. Feeling concern pushes me to take the situation seriously and act
in Sarah’s best interest. However, these feelings can also be unhelpful if I let fear or
uncertainty stop me from following proper reporting procedures. For example, if I allow
my sympathy to stop me from informing the supervisor because Sarah asked me not to
tell anyone, I could unintentionally be enabling further harm.

As a PSW, I must manage my emotions professionally and always prioritize client safety,
ethical duty, and legal obligations, even when it’s emotionally difficult.
2. Identify three signs that indicate Sarah is abused. (3 marks)

a. Physical evidence of injury

I observed a large, purplish bruise on Sarah’s upper arm, approximately 10 cm in

diameter. This kind of injury, especially on the upper arm, is consistent with being
grabbed or handled forcefully. After I noticed the bruise, Sarah initially tried to cover it
up by saying she hit the freezer door. Later, she admitted that her husband had twisted
her arm. This type of injury, coupled with the initial attempt to hide it, is a strong
physical sign of abuse.

b. Emotional distress and fear of disclosure

When Sarah realized that I had noticed the bruise, she became visibly upset, started
crying, and pleaded with me not to tell anyone. This reaction showed emotional distress
and a deep fear of what might happen if others find out. Such behavior is common
among abuse victims who may feel trapped, afraid of retaliation, ashamed, or worried
about losing their family stability. Her reaction signals that the abuse is likely ongoing
and affecting her emotionally.

c. Isolation and fear of losing support

Sarah said, “I’d have nothing if it weren’t for him,” which shows a deep sense of
dependence on her husband—not just emotionally, but possibly financially or socially.
This suggests she may feel isolated and believe that leaving him would mean she would
have no support. This level of dependence and fear of losing her home or family unit is
often a result of manipulation or control in abusive relationships, making it another
warning sign of ongoing abuse.

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

a. Making excuses for the injury

When I first asked about the bruise, Sarah said she had hit the freezer door. This is a
common example of denial, where a person tries to cover up abuse by offering a more
acceptable or less threatening explanation. Her attempt to explain the injury away
indicates she may not be ready to face the reality of the abuse, or she might be trying to
protect herself or her family from further harm or shame.

b. Rationalizing the abuser's behavior

Even after admitting that her husband twisted her arm, Sarah immediately said, “He’s a
good man.” This is a classic form of denial where the victim tries to justify the abuser’s
 actions by focusing on their positive qualities. It shows that she is struggling to reconcile
the person who harmed her with the person she depends on. By defending him, she is
minimizing the abuse and avoiding confronting how serious and dangerous the situation
really is.

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

Sarah is displaying fear and emotional dependency. When she noticed that I saw the
bruise and began to cry, it showed that she is afraid—not just of the physical abuse, but
also of what might happen if someone finds out. Her reaction and the way she tried to
justify her husband’s actions by saying, “He’s a good man” and “I’d have nothing if it
weren’t for him,” suggest that she feels dependent on him emotionally and financially.
She also seemed ashamed and embarrassed, which are common emotions in situations
of abuse. These signs indicate that Sarah may be in a vulnerable situation and needs
support beyond physical care.

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

As a PSW, the appropriate action for me to take is to report the suspected abuse to my
supervisor or the appropriate authority immediately, following my workplace policies
and procedures. Although Sarah asked me not to tell anyone, I have a professional and
legal responsibility to report any signs of abuse or neglect. This includes unexplained
injuries and emotional distress, especially when the client confides that harm was
caused by another person. It is important to report the situation because Sarah may be
at risk of further harm, and her children could also be in danger. Reporting can help
connect her with the resources and support she needs to stay safe. I would continue to
support Sarah with compassion, listen without judgment, and reassure her that my goal
is to ensure her and her children’s well-being
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)

In this situation as a PSW I would feel astonished and disturbed seeing a parent
furiously shacking around a minor child in this awful way. Witnessing such an event
can evoke a wide range of emotions such as grief, confusion, fear, anger and feelings
of powerlessness.
Being in this situation my first instinct would be to immediately intervene to ensure
the child’s safety and well-being is in good hands and out of harms way. However,
doing so could cause the situation to escalate even further instead of de-escalating. Is
important as a PSW to manage these emotions and to act professionally and
effectively, focusing on the child’s immediate well-being and safety. Reaching out to
child support programs and police would be highly recommended in these cases.

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

1. Lack of support, taking up additional responsibilities:

Maternal and paternal grandparents are all living, however they reside 1600 km away
and cannot visit to help Mrs. Ross. The lack of support from family and friends can
significantly impact Mrs. Ross, leading to increased stress, isolation, and challenges in

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 ©NACC2017V.4 Section IV. Module 5. Abuse and Neglect

raising children. Mrs. Ross is feeling overwhelmed and leaving her feeling
unsupported.

2. Stress and Exhaustion:

Mrs. Ross is feeling overwhelmed with multiple responsibilities and household tasks
can trigger angry outbursts. Although Mrs. Ross is happy with the new addition, the
birth of three was very much a surprise for her and her husband. Daily demands of
parenting can create a sense of being stressed.

3. Managing Children’s Behavior:

Mrs. Ross could be dealing with her children’s tantrums, disobedience, and other
behavioral issues. Providing her children with support during difficult times can be
emotionally demanding especially with 3 new-borns and 2 children. Mrs. Ross could
be managing conflicts between the siblings which can cause stress and frustration for
her.

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

a. Behavioral Changes

Ray’s behavior is a visible representation of inner stability and security such as

increased use of more “baby-talk,” not speaking words as clearly as he once did. Ray
displays sudden change in behavior, changes that seem like regression as loosing skills
they once had. Ray seems to be more fearful and frightened which could lead to the
child being emotional distressed related to being psychologically abused by the
parent.

b. Physical Symptoms

Trauma can also manifest physically, leading to chronic pain or other physical health
issues such as Ray being less able to run as steadily as he did before. It clearly displays
that Ray is being purposely physically injured and being put in risk of being harmed by
the parent. Any intentional harm or mistreatment to a child such as Ray under the age
of 18 years old is considered child abuse.

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

I believe the appropriate action for the PSW to take in this situation would be to focus
on safety and immediately reporting to the local children’s aid society and or police if
immediate danger is present. This would include staying very calm and listening to the
child without interruption and reassuring the child is in safe custody. If possible,
remove the child from the immediate environment if it is unsafe. Keep detailed
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records of the incident, including date, time, location and what was observed or
reported. If the situation is under control, as a PSW I would suggest the family to seek
counselling

©NACC2017V.4 Section IV. Module 5. Abuse and Neglect

or joining parental support programs and monitoring the well-being of Ray to ensure
he is receiving the necessary support and guidance from his family.

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©NACC2017V.4 Section IV. Module 5. Abuse and Neglect

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