ANCHORS FOR ADULT - MALTREATMENT
EXTREME - 4
1. Death due to abuse or neglect
2. Physical assaults resulting in life threatening injuries
3. Injuries to head, face or genitals
4. Home environment presents life threatening risk to the adult
5. Battering during pregnancy
6. Stalking
7. Use of weapons and/or objects
8. Burns
9. Internal Injuries
10. Dehydration and/or malnutrition due to neglect that is life threatening
11. Hypothermia that is life threatening (due to neglect)
12. Strangulation
13. Killing pets
14. Threatening suicide, homicide or both as a means of control
15. Hostage taking
16. Broken bones
17. Sexual abuse (including individuals lacking capacity to consent)
18. Sexually transmitted diseases (STD's) in persons who lack the capacity to consent
19. Rape
20. Knowingly infects with a sexually transmitted or communicable disease
21. Sexual Exploitation
22. Lives in a constant state of fear
23. Acute depression (diagnosed by a mental health professional)
24. Lack of food, shelter, supervision, or medical care which presents life threatening risk to the adult
25. Bone exposed due to bed sores
26. Immersion in extremely hot or cold water
27. Urine burns
28. Locked in/out of residence by caretaker
29. Abandonment or desertion
30. Financial exploitation (totally depletes financial resources)
31. All threats to harm a child witness to domestic violence
32. Unable to protect self due to mental, physical or intellectual functioning
33. Any other situation the FSOS considers extreme risk to the adult
SEVERE - 3
1. Physical assault resulting in injuries (sprains, dislocations, significant bruising to torso or extremities)
2. Lack of food, shelter, utilities, supervision or medical care which presents significant risk to the adult
3. Psychological battering
4. Surveillance (related to domestic violence or stalking)
5. Threats of violence toward alleged victim and/or other family members
6. Threatens with or access to weapons
7. Controlling activities (sleeping, eating, access to money, travel, transportation, etc.)
8. Physical restraints or chemical restraints (using medication to control adult's behavior)
9. Cutting, burning, destroying clothes, destroying car/tires, heirlooms, family photos, or furniture.
10. Isolation
11. Force feeding
12. Forced to perform degrading acts
13. Injuries that are inconsistent with explanation
14. Family member/caretaker forces adult from adult's home
15. Deliberate over-medication(overdose) or under medication
16. Unable to manage medication as prescribed or indicated
17. Skin breakdown, bed sores
18. Dehydration and/or malnutrition due to neglect that is not life threatening
19. Hypothermia
20. Wandering
21. Parasite infestation in/on the adult's body
22. Theft of funds, property, and resources by caretaker/family member
23. Individual lacks capacity to understand document(s) to be signed (POA's wills, contracts, etc.)
24. Any other situation the FSOS considers severe risk to the adult
MODERATE - 2
1. Name calling and other verbal abuse
2. Repetitive falls
3. Controlling access to friends, family, employment, and/or education
4. Using male privilege/sex role stereotypes (playing mind games)
5. Deprives spouse of medical or support services
6. Physical assaults with minor injuries (bruises)
7. Prior history of abusive/neglectful behavior
8. Inappropriate treatment during caretaking/rough transfers (moving adult from bed to wheelchair, etc.)
9. Unexplained genital infections.
10. Poor personal or oral hygiene creating health problems for the adult
11. Lack of utilities or disconnection of utilities
12. “Doctor Shopping” (multiple health care providers)
13. Unsanitary home environment presents health risk to adult
14. Lack of necessary aides (walker, cane, eyeglasses)
15. Caregiver unstable or exhibits antisocial behavior
16. Contractures
17. Fails to follow medical, therapy, or safety recommendations.
18. Misuse of funds, property, and/or resources by caretaker or family member
19. Excessive charges for food, shelter, care or services
20. Caretaker/family member threatens to place adult out of home
21. Inappropriate food, clothing or shelter
22. Any other situation the FSOS considers moderate risk to the adult
MILD - 1
1. Lack of respect for adult's autonomy (ignoring, silent treatment, treating adult like a child, etc)
2. Broken assistive devices
3. Locking self in/out of residence depending on climate
4. Incorrect positioning by caretaker
5. Attempts to isolate the adult from support system
6. Adult or caretaker/family member neglecting financial obligations
7. Any other situation the FSOS considers mild risk to the adult
NONE - 0
1. There is no indication of adult abuse, neglect, and/or exploitation
ANCHORS FOR ADULT - FAMILY DEVELOPMENTAL STAGES AND TASKS
EXTREME - 4
1. Constant state of chaos
2. Controls activities of family through violent means
3. Adult is afraid for their safety and the safety of others
4. Controls all aspects of family life
5. Doesn’t allow the adult to have relationships with extended family/community resources
6. Total isolation of the adult
7. Threatens to harm self or others
8. Doesn’t allow privacy for family members
9. Intimidates family members
10. Chooses to use violence toward others
11. Abuses self
SEVERE - 3
1. Doesn’t respect adult's right to self determination and privacy
2. Unrealistic expectations of adult's abilities (i.e. MR/DD, physical dysfunction)
3. Denial of health problems (mental and/or physical)
4. Ashamed to admit that a problem or situation exists
5. Refuses assistance on behalf of an adult although the adult’s needs are not being met
6. Controls activities of the family through nonviolent means
7. History of unresolved conflicts that lead to abuse or neglect
8. Manipulative use of affection to control others
9. Withholding affection or use of guilt to control others
10. Encourages dependence
MODERATE - 2
1. Family members not able to effectively communicate their needs
2. Total dependence on another family member to meet their emotional needs
3. Lowered self esteem/self worth (fear of rejection or loss)
4. No established routine or schedule leading to a neglectful situation
5. Wants to assist but is incapable of doing so
6. Unable to define family roles
7. Recognizes that the adult has a problem but doesn’t know how to seek assistance
8. Difficulty in meeting basic needs
MILD - 1
1. Adult usually able to function
2. Inconsistent roles and expectations
3. Can usually communicate needs but has difficulty discussing subjects such as chronic health problems, impairment, aging, and lifestyle changes
NONE - 0
1. Family roles and expectation discussed and acceptable to all family members
2. Capable of communicating needs
3. Family affection expressed appropriately
4. Supportive of each other during changes in life
5. Able to resolve conflicts without violence
6. Accepts and adjusts to changes (i.e. out of home placement, need for assistance with ADL's)
7. Stable home environment
8. Recognizes and seeks assistance when needed
ANCHORS FOR ADULT - EDUCATION, EMPLOYMENT, TRAINING (Victim/Perp Screen)
EXTREME - 4
Adult has no education, employment, or training necessary for self sufficiency.
SEVERE - 3
Adult has limited education, employment, or training necessary for self sufficiency.
MODERATE - 2
Adult has some education, employment, or training necessary for self sufficiency.
MILD - 1
Adult has few needs regarding education, employment, or training necessary for self sufficiency.
NONE - 0
Adult has no needs regarding education, employment, or training necessary for self sufficiency.
ANCHORS FOR ADULT - HISTORY OF ABUSE
(Victim/Perp Screen)
NO RATING ANCHORS
ANCHORS FOR ADULT - LEVEL OF FUNCTIONING (Victim/Perp Screen)
EXTREME - 4
1. Adult often demonstrates behavior that results in potential harm to self or others
2. Pattern of high-risk behavior is escalating
3. Criminal history of violence
4. Perpetrator believes that there should be no consequences for violent behavior
5. Adult abuses drugs(including prescription drugs) or alcohol resulting in total incapacity
6. Adult has an untreated mental illness or indicators of mental illness resulting in high risk behavior or incapacity
7. Adult victim/perpetrator is acutely depressed(i.e. longing for death)
8. Unable to protect self
9. Unable to effectively learn coping skills
10. Unable to communicate needs
11. Unable to carry out any activities of daily living
12. Lacks the capacity to consent for services
13. Non-ambulatory
14. Multiple physical and/or mental impairments
15. Lives in an abusive or dangerous situation
16. History of substantiated abuse allegations
17. Becomes physically or verbally aggressive on a consistent basis
18. Consistently blames others for problems or actions
19. Adult victim/perpetrator suffers from Post Traumatic Stress Disorder
20. Adult victim or perpetrator's behavior interferes with access to services
SEVERE - 3
1. Adult does not always recognize danger to self
2. Perpetrator makes unreasonable demands of others
3. Adult abuses drugs(including prescription drugs) or alcohol resulting in substantial incapacity
4. Adult minimizes, denies problems and refuses services
5. Unable to carry out numerous activities of daily living
6. Needs assistance with mobility and transferring (moving from wheelchair to bed, etc.)
7. Demonstrates marked disorientation and confusion
8. Reluctant to provide care for adult
9. Employment problems and unhealthy dependency
MODERATE - 2
1. Adult is able to recognize some dangerous situations
2. Infrequently takes action to protect self
3. Unrealistic expectations of self or others
4. Able to carry out several activities of daily living
5. Mobile non-ambulatory
6. Some difficulty in establishing and maintaining relationships
MILD - 1
1. High risk behaviors rarely occur
2. Inconsistent in decision making, but does not present a danger to self or others
3. Adult has limited mobility
4. Able to carry out most activities of daily living
5. Behavior usually appropriate to situation
6. Adult demonstrates ability to plan for their own safety
7. Often takes actions to protect self
NONE - 0
1. Adult is able to resolve conflict in a healthy manner
2. Consistently able to protect self and/or provide for own needs
3. Communicates needs and feelings appropriately
4. Has consistent social support
5. Able to carry out all activities of daily living
6. Demonstrates independence through employment or other means
ANCHORS FOR ADULT - NATUR OF ABUSE (Victim/Perp Screen)
NO RATING ANCHORS
ANCHORS FOR ADULT - SAFETY PLAN (Victim/Perp Screen)
NO RATING ANCHORS
ANCHORS FOR ADULT - SYSTEMS OF SUPPORT
EXTREME - 4
1. Family/friends encourage adult to remain in a dangerous situation
2. Total isolation
3. Community agency withdraws services without notice
4. Family/friends discourage adult from seeking agency assistance
5. Community agency does not provide adequate or appropriately trained staff
SEVERE - 3
1. No family or extended family
2. No contact with extended family
3. Resources available, but adult cannot access services due to extensive waiting list
4. Unable to access any community resources
5. Family/friends lack sufficient knowledge or abilities to meet the adult's needs
6. No formal support from clubs, churches or other community partners
7. Community agency contracts to provide services which they are unable to deliver
8. Community agency threatens to withdraw services without adequate notice
MODERATE - 2
1. Family/friends are not supportive of adult making decisions
2. Adult has contact with extended family, but refuses their assistance
3. Community agency has no funds available for services
4. Limited support from clubs, churches or other community partners
5. Family/friends have a conflict with the adult that prohibits needed support
6. Community agency did not respond to request for services
MILD - 1
1. Family/friends do not respect adult's lifestyle
2. Community agency does not coordinate well with other community partners
3. Family/friends threaten to withdraw support or assistance
NONE - 0
1. Community agency coordinates well with other community partners
2. Family/friends willing to support and assist adult
3. Adult is supported by a network of clubs, churches or other community partners
ANCHORS FOR ADULT - SEQUENCE OF EVENTS
EXTREME - 4
1. Multiple incidents of maltreatment with a pattern of escalation
2. Public display of violence toward the victim
3. Escalation of batterer's risk taking behavior
4. Maltreatment is justified by the perpetrator
5. Use of a weapon
6. Total incapacitation due to drug (including prescription drug) or alcohol abuse
7. Revenge or retaliation
8. Trauma to the genitals, breast and/or rectum
9. Danger to self or others
10. Total dependence for personal care
11. Total depletion of assets or resources
12. Perpetrator has no recognition of high risk triggers
13. Unable to pay for food, shelter, utilities, medication or medical care
14. Failure of caretaker/adult to seek medical treatment resulting in a life threatening situation
15. Mentally/physically incapable of providing for self
16. Fantasies of homicide/suicide
17. Medical treatment required as a result of maltreatment
18. Multiple life threatening health problems
19. Excessive fear in the presence of the perpetrator
20. Perpetrator has total access to property or finances which leads to maltreatment
SEVERE - 3
1. Abusing drugs (including prescription drugs) or alcohol that contributes to the maltreatment
2. Needs to control and dominate victim/family
3. Blames the victim
4. Forced by circumstances to provide care for the adult
5. Perpetrator believes the victim is property
6. Violent behavior outside the home
7. History of violence in family of origin
8. History of criminal charges or civil protective orders (EPO/DVO)
9. Serious unmet mental health needs
10. Physically and/or mentally unable /unwilling to provide for personal/financial needs
11. Lack of support system
12. Caretaker/adult delays seeking medical attention resulting in a serious medical situation
13. Perpetrator has minimal recognition of high risk triggers, but does not respond
14. Isolation
15. Impaired communication
16. Adult victim/perpetrator's prior history of violent relationships
17. History of domestic violence offender treatment
18. Extremely upset when bathed, changed or examined
19. Bruises in different stages of healing