Detecting abuse against women in the home.

Assault is the single major cause of injury to women. Between 1.8 and 4.0 million American women are abused in their homes each year. The perpetrator of domestic violence is usually male (95%), the victim usually female. Most domestic violence is a result of the learning and reinforcement of a power imbalance between partners. Home care providers are in a prime position to detect actual or potential abuse against women, but the dynamics of abuse often produce an artificial home atmosphere, with the occupants ill at ease with the home care provider. This makes detection more difficult. Although a direct inquiry about abuse is usually the best approach, both distinct and subtle signs of abuse can be detected by informed providers. Once physical abuse is detected, it is of paramount importance to select the most appropriate referrals, resources, and strategies to assist the woman in freeing herself of abuse. Emergency departments are recommended for immediate physical treatment, shelters for therapeutic and rehabilitative services.