Finex House

Some common reactions to abuse include substance abuse, difficulty remembering things, difficulty making decisions, confusion and distortion of time. Other reactions include many thoughts coming at once, flash backs; replaying what happened often; feeling numb; feeling hyperactive; feeling overwhelmed; nightmares; fatigue, stomach aches, bowel problems, dizziness, chest pains, startled reactions, loss of faith and despair. Many battered women have alienated their friends because the batterer would not allow them to visit. Batterers want victims to feel incompetent so that they can exert more power over them. Sometimes all a victim needs to do to make symptoms disappear is to escape from the batterer. Sometimes the symptoms disappear once the survivor feels safer. Other times, the escapee may need extra help with their recovery like therapy. If the symptoms continue for any length of time, the symptoms could turn into a form of mental illness. “Mental illness is not a crime and there are now strict mental health law requirements which must be met before a person may be involuntarily hospitalized. Mental illness is legally defined as, “a substantial disorder of thought and mood perception, attention or memory which grossly impairs judgment, behavior, the capacity to recognize reality to meet normal demands of life but it is not to include alcoholism. See the Massachusetts Code 30 1(a).” 1. Down and Out. A Manual on Basic Rights and Benefits for Homeless People in Massachusetts 1997, p. 29 A publication of the Massachusetts Coalition for the Homeless

Service providers, especially medical workers, may be the only outsiders to have contact with a battered woman who has a disability. Therefore, when providing services for women with disabilities, it is important to know what a woman’s disability is and what physical symptoms might be related to it. Sometimes people assume that a physical problem stems from a disability when in fact battering causes it. “If a woman with a disability has bruises on her, tell whoever is with her that you need privacy with your patient and ask the patient if the cause is from being hit.” SUSAN ROBINSON MD AUTHOR OF HAVING A BABY WITHOUT A MAN

Domestic violence is often seen as solely physical violence. However, physical violence is just one of the tactics used by batterers to control their partners and, therefore, it is just one of the risks battered women and their children face. A batterer’s controlling behavior may also cause risks to the children, psychological harm, loss of housing, health care, employment, or current standard of living. In addition, some battered women may not consider the physical violence to be their greatest risk. A battered woman will face one set of risks if she stays in the relationship and a different set if she leaves. Battered women are at the highest risk for death when they plan to leave. This is why a secret safety plan is so important. There are many similar types of abuse that all battered women deal with. However, women with disabilities face additional risks. “For instance, taking a person in a wheelchair somewhere that they don’t want to go can be likened to kidnapping. Removing the battery from an electric wheel chair can be like locking someone in a closet. Removing the portable ramp from their home can be like locking them/us in the house. If the victim is deaf, taking or breaking her TDD is like tearing out the phone.” 1 Another difference in the abuse between people who have disabilities and people who do not is that those that are not disabled have more types of people who may be the perpetrators of the abuse. For instance, certain personal care attendants have committed terrible acts of abuse against those who are disabled. Professionals, who work with persons with disabilities, are mandated to report all incidents of suspected abuse of persons with disabilities to the Disabled Person’s Protection Commission. 1 Sexuality and Disability Vol. 9 No.3 “Escaping from Abuse: Unique Issues for Women with Disabilities” p. 276 Chris Womendez sad Karen Schneiderman

Chapter 19A sections 14-26 of Massachusetts Law defines elder abuse as acts or omissions resulting in serious physical, sexual or emotional injury, or financial loss to an elder. Therefore, elder abuse includes: physical abuse, sexual abuse, emotional abuse, caretaker neglect, and financial exploitation. Signs of physical abuse against people who are elderly are similar to those who are disabled. The signs of abuse include, but are not limited to, bruises, black eyes, welts, missing teeth, lacerations and rope marks; physical signs of being subjected to punishment or restraint; a caregiver’s refusal to allow others to visit an elder alone and laboratory findings of over or under medicating. 1 Abuse must be reported to the Elder Affairs 1-800-922-2275. If it is substantiated, the protective services caseworker will offer the elder a choice of services designed to alleviate or end the abuse. The elder’s rights and wishes are always respected if they are competent. OTHER INDICATORS OF ELDER ABUSE ARE: Bruises, missing teeth, punctures, gag marks, imprint injuries, burns, bilateral bruising on forearms suggesting shaking, bite marks, bleeding, injury near the genitals, spots from hair pulling, unusual activity in bank account, missing pensions, stocks etc., new acquaintances expressing affection, and fear of loved ones. Pattern of injury such as elbow bruising can result from a fall. Does the explanation match the injury? Are the injuries frequent? Abusers may be any one or more of the following five types: I.) well intended 2.) incompetent 3.) narcissistic 4.) abusive 5.) sadistic 1 Recognizing and Responding to s Maltreatment Holly Ramsay Kiawanik PHD

If the Personal Care Assistant (the “PCA”) is not the abuser, you can ask the PCA for help to escape from the abuser. Perhaps he or she can call the police or call one of the accessible resources at the beginning of the resource list. There are many knowledgeable and good PCAs who assist people who have difficulty with their fine motor skills such as buttoning or feeding. However, others in this field have been very abusive. Therefore, it is important to check references and to do criminal background checks for PCA’s at the time of hire. These PCA’s may be well meaning but have no empathy and actually break the bones of the person who is being served by these perpetrators. If the abuser is the PCA, or pays the PCA, or is overly friendly with the PCA, don’t tell the PCA anything. An abusive PCA may be characterized by falling into one of the following types: I. inadequate 2. egocentric 3. molesting 4. vicious with intent to cause damage People with disabilities have the right to the best quality of life. This includes safety, privacy, and security. This also means freedom to communicate and conduct all like activities freely, without fear of restriction, coercion, or physical, sexual or emotional abuse. November 1 997 Informational form prepared by Disabled Persona Protection Commission (DP PC) and the Boston Center for Independent Living (BCIL)

When domestic violence happens within same sex relationships there may be additional problems that one can encounter. For instance, the police officer that is called may not know whom to hold accountable for the abuse. Sometimes the judge cannot decide who is at fault and may give a mutual order to both individuals. It may become more difficult for both the provider and the victim if the abused person is larger in stature than the perpetrator and/or when both have chronic illnesses or disabilities. Eiesha and her spouse did not know they were in the third stage of lime disease until their son was diagnosed positive with congenital lime disease too. More of Eisha’s memory disappeared and at times she was so weak that she could not open the refrigerator to feed the family. Eisha’s lesbian spouse was increasingly cruel to her, as they both became more vulnerable. When the neighbors heard Eiesha crying, they called the police. They both claimed to be abused. Eiesha and her son are safe now, and both are receiving needed medical attention. They have moved into a subsidized apartment near the medical specialists who are treating the lime disease through medication. * * * * Michelle had diabetes and lost both legs as well as two of her fingers. She also had several chronic illnesses including a herniated disc and asthma. When she got out of the hospital from the amputations, she went right back to her batterer because she thought there was no place else for her to go. Michelle’s spouse treated her more cruelly than she had done before. She was fed sparingly. Michelle was severely dehydrated and malnourished so her batterer did not bother to lock the door any longer. This time Michelle got away and she wheeled out into the street to flag a car down. She was picked up and rushed to an Emergency Medical Service that did not give her real name out to anyone. She remained in the hospital for five months until she had fully recovered. Instead of going back to the batterer she called 411 for a battered women’s shelter. The 411 information operator referred her to Finex House. She attends support groups, and self-esteem meetings. At one support group in Finex House Michelle met a former battered woman who has successfully reestablished her life in corporate America and has chosen to be a mentor for Michelle and assist her in obtaining work.

Domestic violence happens in teenage relationships and other dating relationships. Disabled teenagers are even more at risk and have lower self esteem - the seeds necessary for abuse to continue. One out of three women and girls experience violence in their intimate relationships. This statistic is higher among disabled teenagers but such attacks are underreported. The most likely perpetrator of child sexual abuse is the biological father or another known adult male in the family. Paying attention to the relationships of childhood and early adolescence is so important because the perpetrators may be unlikely family members. In addition, every year there are too many deaths that can be attributed to teen dating violence in Massachusetts when the victims decide to end their relationship. “The Massachusetts Society for the Prevention of Cruelty to Children offers sexual abuse prevention programs through grade 12.” May 25, 2000 article in the Boston Globe

You may want to know the following answers. Was she engaged in sex against her will? Was she not conscious enough to make a decision? Was she out on a date and doesn’t want to have sex but he does it anyway? What is “date rape”? Is she capable of saying “No!” because her disability may not allow her to move or talk? If a woman is accompanied by a man who is overly solicitous and never leaves her side, that in itself is a diagnostic clue that abuse might be going on. When speech or hearing difficulties impede communication, service providers should take the extra initiative to learn directly from the woman what has happened.

According to Nora J. Balderian and Barbara Faye Waxman, who co-authored Rape Treatment Recommendations for Disabled People, persons who have a disability are especially vulnerable to sexual attack. They are perceived as easy prey and as unable to fight back. Remember, many sexual assaults are committed in the home by persons known to the victim. This does not make the assault any less criminal. A person who is being raped must use her/his own judgment as to how to get away. Fighting back may be an effective strategy in avoiding rape. Sometimes it is more advantageous to remain calm. Date rape may occur when the perpetrator ignores the victim saying, “No”. It is not easy to escape from the rapist if he/she is determined to rape you. Disabled people have a harder time getting away. “We may be more apt to have sex with someone who is abusive or to have sex when we don’t want it just to be considered normal.” “Sexuality for us as disabled women is often confusing.” stated D.A.W.N. (Toronto, Canada). “Yet, many of us have been sexually abused, molested, and raped...” Like battering, the closer the relationship between the victim and the rapist, the less likely she will be to tell the authorities what happened. Even though there are special “sexual assault units” in Boston and other cities that could be contacted for the initial complaints when a woman is raped, it is still difficult to get help. Only 39% of those raped reported the crime to the police. It is difficult to explain the assault when the woman knows the rapist and this is usually the case. Stranger rape is the most frequently prosecuted. For a woman with a disability, the typical inhibitions about reporting rape by a member of the household may be compounded by mobility or communication difficulties and/or dependence upon the abuser for assistance. It is important to be prepared. Self-defense techniques can be adapted for women with disabilities. For example, a woman in a wheelchair may learn to use her chair as a weapon against an attacker. If you have a disability and are interested in assistance in obtaining a temporary restraining order or finding resources for accessible self-defense classes contact the Boston Self-Help 617-277-0080.

The idea of “preserving family unity” has been used to continue the denial of woman battering. Under the misguided notion that preservation of the family unit is the best outcome, those who might have helped have too often failed to take action. The data is chilling. Their male partners kill one half of all women murdered in Massachusetts. If a woman tells you she is being battered, believe her, It’s hard enough for her to admit to herself and others that she is being beaten, and it’s even harder when those she confides in doubt her. If you are a service provider, be aware of the signs of abuse and the resources available to aid battered women to escape.

Personal Care Attendants have also been known to over medicate people with disabilities or elderly individuals that they are serving. Also, some people who have disabilities have been raped while under the effects of drugs. The problem of using drugs as a tool to commit sexual assault is not a new phenomenon for disabled people. Substance-related sexual assault is an issue for all women. “Attention has been on benzodiazepine misuse and particular on Rohpnol, a strong sedative, which is not legal for use in the USA. These drugs have been slipped into victim’s drinks by individuals who later assault them. Because the drug’s effects make it difficult for the person who has been assaulted to remember what occurred, he or she may have a confused story to tell to others.”