Empowering caregivers with better domestic violence training

Post - Empowering caregivers with better domestic violence training

While domestic violence often goes unnoticed and unreported, home healthcare workers are positioned to be the first to spot its signs. This means your home care agency's domestic violence online training can help caregivers recognize and respond to abuse – regardless of whether your state mandates domestic abuse training.

This month is Domestic Violence Awareness Month, a critical time to focus on domestic violence online training for caregivers – with extra emphasis on recognizing elder abuse.

Elder abuse, including neglect and exploitation, is experienced by about 1 in 10 people aged 60 and older who live at home. From 2002 to 2016, more than 643,000 older adults were treated in the emergency department for nonfatal assaults and over 19,000 homicides occurred.

To recognize signs of domestic abuse and provide appropriate support, employees must receive adequate domestic violence online training. Many states require home health agencies to provide domestic violence training in addition to mandated reporting. Even in states that don’t require DV training, managed long-term care insurance companies often require that home care agencies in their plan offer elder abuse training.

How to train caregivers to screen for and address signs of elder abuse

It can be challenging to recognize the signs of domestic violence since it often happens in private. This is why it’s essential to train home health caregivers to notice potential signs of abuse, such as the following:

  • Unexplained injuries

  • Changes in mood or behavior

  • Sudden withdrawal from social activities

  • Avoidance of eye contact

  • Fearfulness around certain people

  • Isolation from friends and family members

  • Reluctance to discuss personal matters

  • Reluctance to make decisions about their own care

  • Anxiety about making phone calls or leaving the house

  • A lack of access to money or resources

  • Changes in eating habits or sleeping patterns

  • Statements indicating fear toward an intimate partner

  • Bruises in various stages on different parts of the body

While some forms of abuse are visibly apparent, more subtle signs can also indicate that a patient is a victim of domestic abuse. If you suspect your client is being abused, here are some examples of psychological signs to watch for that may indicate the relationship is abusive:

  • Refuses to leave partner alone with healthcare professionals

  • Objects to having doctors, nurses, or staff of the opposite sex

  • Heart rate increases/moves away when partner approaches

  • Watches partner for signs of approval before speaking/moving

  • Interrupts or answers healthcare questions directed to the client


Domestic violence online training on how to spot elder abuse 

Elder Abuse is the physical, sexual, psychological, emotional, or financial abuse or neglect of older people. The abusers are often adult family members (children or spouses) of the victim.

Here are some examples of what typical elder abuse looks like:

  • A woman in your care may admit to you that their partner is verbally and/or physically abusive. 
  • An elderly client of yours may show fear when a particular family member enters the room, along with a pattern of bruises in various stages of healing.

Be alert and aware of your client’s situation. Elder abuse victims do not often report the abuse, especially when it’s done by loved ones.


Ways to support victims and survivors of abuse

Domestic violence online training must include how to respond and how to report it.


Mandated reporting

Laws for mandated reporting of abuse vary for each state. They all fall under one of these four categories:

  1. States that require reporting of injuries caused by weapons

  2. States that mandate reporting of injuries caused in violation of criminal laws

  3. States that specifically mandate domestic violence reporting

  4. States that have no mandated reporting laws

Click here to find your state’s DV reporting requirements here.


Once caregivers identify and address the issue calmly and without judgment, they need to be trained to help ensure the safety of the client. 

A safety plan is a personalized, step-by-step plan to keep a person (and any children, pets, or possessions) safe while remaining in an abusive relationship while planning to leave the relationship, and/or after leaving the relationship

Here's a sample safety plan from the National Center on Domestic and Sexual Violence. Include the following:

  • Code words/phrases

  • Addresses of safe places to stay

  • Go Bag with passport, cash, cell phone and charger, clothes, medications, etc.

  • Copies of important documents like social security, immunization, driver’s license, bank account numbers, etc.  

  • Coping strategies

  • Resources for support

  • Safe place outside the house to store Go Bag

  • Phone numbers of friends and family


What actions must caregivers take if they suspect an elderly client is being abused?

Caregivers are often the first and sometimes the only witnesses to the details of an abusive situation. Because of this, it’s crucial to record and process all evidence relating to the abuse correctly.

The information you gather during a routine medical examination and/or during conversations with an abuse victim may become crucial legal evidence in a trial to convict the abuser.

Caregivers need to be trained to record and report the information your client shares about:

  • When the abuse started

  • How long it’s been going on

  • What the abuse entails


Training should include reminders to ask questions like:

  • “Do you depend on [abuser’s name] for money to pay your bills?” 

  • “Do you choose to take these medications or are you being forced to take them against your will?”

  • “Has [abuser’s name] ever threatened to physically harm you, kill you, or put you in an institution?” 

  • “How does [abuser’s name] react when you request something or disagree with them?”

  • “Have you ever been forced to sign documents against your will or without knowing what they were?”

Victims of abuse may not always respond willingly to these questions, but just knowing that someone is aware of their situation may be the first step toward getting help.

If the client admits to experiencing any kind of IPV, there are more questions you should ask to ensure the client’s safety before discharging them or leaving their home.

Before discharging a client who has disclosed abuse, ask:

  • “Do you feel safe to go home / stay at home?” 

  • “Do you need medical or psychiatric help?” 

  • “Where is the abuser at this moment?”

  • “Does the abuser have access to weapons of any kind?” 

  • “Have you ever considered killing yourself or someone else?”

  • “Are there other people in your home who may also be experiencing abuse by this person?” 

  • “Do you want access or more information about safe shelters?” 

  • “Do you have friends or family members you can go live with safely while you figure out what to do next?” 


If possible, ask to schedule a follow-up session, either at the same place, at an abuse shelter, or at another safe location.

As a home health agency, it’s likely at some point that caregivers will encounter signs of domestic violence or abuse during a routine home visit. All caregivers must be trained to screen for signs of abuse actively. 

Providing initial domestic abuse prevention online training and ongoing support from supervisors is important to ensure continued understanding and application. With effective domestic abuse online training, home health agencies can create practical training that equips caregivers with the necessary skills to recognize signs of abuse and respond appropriately.

For additional support, reach out to the National Assistance Domestic Violence Hotline: 1-800-799-SAFE (7233).

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