When dealing with members of the public on a day-to-day basis, there will inevitably be times when you come into contact with vulnerable individuals of one kind or another. Although your interactions may be limited, you can have the capability to make a positive difference to that individual’s experience in your practice, and beyond.
How do we define vulnerability?
Although being “vulnerable” can mean different things to different people, an individual may be considered to be vulnerable if they are less able to look after themselves or to protect themselves from harm.
A person could be temporarily vulnerable, for example following a bereavement or job loss. In other cases, a person’s age, mental health or physical health could cause them to be vulnerable
Vulnerability can be caused by a variety of different factors, both internal and external. A person could be temporarily vulnerable, for example following a bereavement or job loss. In other cases, a person’s age, mental health or physical health could cause them to be vulnerable.
In some cases, a factor causing vulnerability may be visible, but it is not always easy to spot in cases where clients have a brain injury, dementia or mental health issues. Having a better awareness and looking out for signs of vulnerability could make all the difference to a vulnerable person in need of help and support more generally.
Case study
Mrs M was well educated and a teacher before she retired early in her fifties. She lived alone with her dog and two cats in a large house following a separation from her husband. She lived independently and unsupported with no immediate family members to check in on her.
One day, Mrs M attended her local veterinary clinic with some medication. She appeared confused and had attended to ask whether the medication she had been taking was for her or the dog. The veterinary staff were right to be concerned about Mrs M’s well-being and raised a safeguarding referral with the local authority.
The local authority found that Mrs M had a complex form of mixed dementia which impacted her cognition and severely impacted her communication, speech and language skills. Despite this, Mrs M had been living alone with this condition for an unknown period of time. The local authority ultimately found that Mrs M had not been living well or looking after herself (or her animals) at home and she was at risk of self-neglect.
Without the referral, Mrs M would have continued to put herself at risk of harm as she was not on the radar for social services. The safeguarding referral allowed Mrs M to be properly assessed by social services and to obtain the care and support she needed to live safely.
There is an important balance to be struck between spotting potential warning signs to prompt a safeguarding concern and ensuring that individuals are not treated differently simply because of their age, behaviour or appearance
Spotting the signs of vulnerability
There is an important balance to be struck between spotting potential warning signs to prompt a safeguarding concern and ensuring that individuals are not treated differently simply because of their age, behaviour or appearance. This is not an exclusive list, but here are just a few things you can observe which may give cause for concern about a person’s vulnerability and well-being:
- Appearance: do they have any bruises or marks; do they look unwell or unclean? How are they dressed – is it appropriate for the weather? Are they wearing their clothes correctly or are they at risk of accidentally exposing themselves?
- Behaviour: is the individual’s behaviour appropriate to the situation? Does their behaviour fit the circumstances? Are they acting unusually or sheepishly in the presence of a particular person?
- Communication: are there any obvious communication difficulties? Do their responses make sense for the questions asked? Are they struggling to find the right words to fit?
- Cognition: are there any signs of confusion or disorientation? Do they know who they are and where they are? Do they know what day it is?
- Changes: for familiar clients, you may notice a change in behaviour or appearance which causes concern
What can I do?
Safeguarding is everybody’s business. You may be the only person the individual sees that week. If you suspect that a person may be putting themselves at risk of harm, or if you have concerns that they could be the victim of physical, financial, emotional or sexual abuse you can make a difference.
In cases of serious concern, when a person is in imminent danger of being harmed or abused, you can contact the police. In other cases, a safeguarding referral can be made to your local authority anonymously by phone or by using an online form.
Consider training staff and having procedures in place to deal with these issues to ensure vulnerable individuals living in the community can feel supported when accessing your services
Of course, not all vulnerabilities will require local authority involvement or support. Sometimes, just handling an enquiry with patience, sensitivity and empathy can go a long way. Consider training staff and having procedures in place to deal with these issues to ensure vulnerable individuals living in the community can feel supported when accessing your services.
Just like with Mrs M, you could be the person that makes the difference to a person receiving the help they desperately need.
Professional obligations
Your first professional obligation under the RCVS Codes of Conduct for Veterinary Surgeons and Nurses is to make animal health and welfare your first consideration when attending to animals. It may be the case that where you identify safeguarding concerns about animal owners, you may also want to consider whether the owner has the ability to properly look after their animals.
Where you identify safeguarding concerns about animal owners, you may also want to consider whether the owner has the ability to properly look after their animals
Although their animals may be a source of comfort to an owner, you must also be aware that the welfare of the animals may be at risk. You may (if appropriate) ask directly about how they look after their animals and ask questions which may lead to the disclosure of warning signs relating to the animal’s welfare. If you do have any specific causes for concern, you can raise these with your client to see if they can be addressed. If concerns remain, it may be necessary to raise the matter with the RSPCA, who has expertise in dealing with such situations. Although you do have a duty of confidentiality towards clients and their animals, this can be overridden where animal welfare may be compromised.
