Harm can take a wide range of forms. It can be intentional - often called abuse. However, harm is often unintentional - and can happen through accident, lack of knowledge, skill or understanding.

Harm can be caused through what is done, or not done - so, where care and support are not provided when they are needed, it can cause harm.

Physical harm

Slapping, punching, biting, hitting, shaking and kicking are all forms of physical harm, as are poor medications management, and concerns regarding falls and frailty.

Psychological/Emotional harm

Psychological harm includes being humiliated, intimidated, shouted at, threatened, bullied or constantly criticised. It can also mean being controlled by someone, ignored or left alone. Psychological harm is often an outcome where an adult is at risk of other types of harm. The psychological impact of harm can last longer than the physical or financial impact.

Neglect

Neglect involves denying medical or physical care, access to a doctor or other services. It could be denying someone medication, food or heating, privacy or dignity. It can also mean self-neglect. Sometimes carers struggle to maintain a level of care that results in unintentional neglect.

Possible signs of harm

Physical harm

• unexplained or unusual injuries
• a delay in seeking treatment for injuries or illness
• a sudden increase in confusion
• unexplained deterioration of health or appearance

Psychological harm

• people being anxious or afraid
• misuse of medication, that is, not giving medicines properly
• unexplained changes of behaviour, becoming anxious or withdrawn, fear of another person
• pressure by family or professionals to have someone moved into, or taken out of, care
• hostile or unkind behaviour by a person

Financial harm

• unexplained debt, not paying bills for services
• another person using the adult's possessions, bank account or property without his or her informed consent

Neglect

• not having their basic needs met, such as adequate food or heating
• not being provided with adequate information about their rights or entitlements, or being misinformed
• the adult at risk not receiving appropriate care, which would protect them from harm

Sexual harm

• prejudicial actions or remarks to the adult at risk about age, gender, disability, race, colour, sexual or religious orientation
• unexplained changes of behaviour, becoming anxious or withdrawn, fear of another person. 

Because harm can often be linked to someone’s care needs and not being able to protect themselves, harm often happens in a place where a person should feel safest.

Harm can happen anywhere including the family home, a hospital ward, care home, day centre, work or a public place.

Anyone can cause an adult to be at risk of harm. Because of the nature of harm, it is not unusual for this to be someone an adult knows well. 

This includes:

• someone who the adult works with
• a relative or friend
• someone supporting the adult, either as a paid or unpaid carer or support
• the adult themselves