Types of Abuse of Elderly and those with Physical and Intellectual Disabilities Form

* Required Information

Physical Abuse

Use of physical force that may result in bodily injury, physical pain, or impairment.

Sexual Abuse

Sexual contact of any kind with an elderly person.

Emotional Abuse

Infliction of anguish, pain, or distress through verbal or non-verbal acts.

Financial/Material Exploitation:

Illegal or improper use of an elder’s funds, property, or assets.

Neglect

Refusal, or failure, to fulfill any part of a person’s obligations or duties to an elderly/IDD person.

Abandonment

Desertion of an elderly person by an individual who has physical custody of the elder or by a person who has assumed responsibility for providing care to the individual.

DO NOT Hit, slap, grab, shake or cause physical harm in any way (even if they strike you first).
DO NOT Have sex with a client (this includes kissing, hugging, caressing or touch genitial).
DO NOT Scream, belittle, call names or degrade in any way.
DO NOT Take (or Accept) money or goods from a client (even if they offer).
DO NOT Sell items or conduct financial business with a client.
DO NOT Neglect a client. It is the job of the PCA to give the client your full attention when providing care. It is our expectation that you are not on your phone, watching TV or sleeping during your time with the client.
DO NOT Leave a client alone who is not able to be left alone.

ANY INFRACTIONS AGAINST THESE RULE WILL LEAD TO NOT ONLY BEING FIRED BUT PROSCECUTION AND JAIL

I attest that I have read the above rules.

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