MyRACentral and several other HealthCentral communities are marking Domestic Violence Awareness Month with posts about the issue and how it relates to chronic illness and disability. Check out our special Domestic Violence Awareness Month page for links to the other posts and resources.

"Ow."

"Ease up a little, please."

"Not so hard."

Almost every time this attendant was scheduled, she'd used too much force when assisting me in the shower, dressing or other personal tasks. Almost every time, I'd have to ask her to be more gentle. I told management about it, but not in a formal complaint - I was afraid of reprisals from her or her coworkers. Then one day, as she was washing my hair, she pressed harder and harder and harder on the back of my neck, causing a severe injury. Finally, management made it safe for me to complain. They asked me if I'd told her to stop that day in my shower and I hadn''t. I had been incapable of speech, in shock that someone would deliberately hurt me, just breathing through the assault, waiting for it to stop. And it finally did. I never saw that particular attendant again. But every day, chronic whiplash-like symptoms serve as a reminder of what she did to me.

When you live with chronic illness, you live with the possibility of needing help from others. Sometimes, it's temporary and sometimes, it's for the rest of your life. In either case, it also leaves you more vulnerable to being abused.

What, How Much and Challenges in Getting Out

Rates of abuse of people with disabilities are higher, sometimes much higher, than amo0ng the able-bodied. It is estimated that "women with disabilities have an 83% chance of being sexually assaulted in their lifetime." This number includes women with developmental disabilities who are victims of sexual assault at a horrifying rate. Over 90% of both women and men with intellectual disabilities will experience sexual abuse at some time in their life. If you ask women with physical disabilities, 62 percent of them have reported being victims of physical, sexual or emotional abuse. Men with disabilities are more likely to be abused, as well.

When people with disabilities are abused, it is most often by their caregivers, people who are trusted to assist them to live more independently. Some who help do choose this kind of work because they genuinely want to help others. Many choose to care for loved ones without pay and do so with kindness and generosity. However, the ugly underbelly of caregiving is that some of those who provide it find ways to exert power and control over the people they are supposed to help.

Abuse can take many forms. Physical like hitting, slapping or being rough when providing personal care. Sexual abuse includes rape and being forced to engage in unwanted sexual activity, even when it is by a partner or spouse. Verbal or emotional  abuse happens when someone threatens to put you in an institution, calls you names or controls you by saying they won't provide care for you if you don't behave in a certain way. When someone controls your money without your consent, it's financial abuse. And then there is neglect, a sometimes more subtle way of exerting power and control. Leaving you too long on the toilet, not assisting you with changing out of dirty clothes, not ensuring you have food and drink before leaving the house are all examples of neglect.