{"id":483,"date":"2026-02-25T22:25:44","date_gmt":"2026-02-26T03:25:44","guid":{"rendered":"https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/?post_type=chapter&#038;p=483"},"modified":"2026-03-10T09:50:28","modified_gmt":"2026-03-10T13:50:28","slug":"case-study-dr-tyabashe-discovers-abuse","status":"publish","type":"chapter","link":"https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/chapter\/case-study-dr-tyabashe-discovers-abuse\/","title":{"raw":"Case Study #5: Dr. Tyabashe Discovers Abuse","rendered":"Case Study #5: Dr. Tyabashe Discovers Abuse"},"content":{"raw":"<p style=\"text-align: right\"><a id=\"quick-exit-btn\" href=\"https:\/\/google.ca\" title=\"Quick Exit\">EXIT SITE<\/a><\/p>\r\n<strong>Content Warning:<\/strong> The following story depicts caregiver-directed violence, including sexual and image-based abuse. Reader discretion is advised.\r\n\r\n<hr \/>\r\n\r\nWhen Dr. Tyabashe reviews Amahle\u2019s home care records during a routine check, she notices that something is not right. Amahle is a woman with high\u2011support\u2011needs autism who is nonverbal, who resides in a care home.<strong> Entries in the caregiver app do not match the clinical notes she is reviewing.<\/strong>\r\n\r\nThe physicians' notes indicated that last week, Amahle had been feeling extremely distressed. However, when reviewing caregiver app notes provided by the agency, her main caregiver logged that Amahle was in good spirits, no issues. Dr. Tyabashe decides to investigate this discrepancy.\r\n\r\n<img src=\"https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-28-e1773102893958.png\" alt=\"\" width=\"558\" height=\"360\" class=\"wp-image-811 aligncenter\" \/>\r\n\r\nA routine check of the agency\u2019s shared folder reveals uploads from a caregiver\u2019s device during the same week. The IT lead flags unfamiliar filenames and thumbnail previews that do not match authorised documentation. Family members confirm Amahle had a difficult week and report the caregiver insisting on being alone during personal care.\r\n\r\nA caregiver\u2019s private device had been used to download a file from the agency's shared folder in the same week that Amahle\u2019s clinical notes recorded severe distress. When Dr. Tyabashe asked the agency IT lead for a routine folder review, the lead flagged several <strong>unfamiliar filenames<\/strong> and thumbnail previews that did not match any authorised documentation.\r\n\r\n[caption id=\"attachment_812\" align=\"aligncenter\" width=\"653\"]<img src=\"https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-29-e1773102864561.png\" alt=\"Downloads folder with two files, named &quot;Image-1&quot; and &quot;Image-2&quot;.\" width=\"653\" height=\"312\" class=\"wp-image-812\" \/> Several unfamiliar filenames and that do not match any authorised documentation within the app.[\/caption]\r\n\r\nA cautious preview (without opening intimate content) shows images saved under innocuous names in a personal downloads folder. Message threads in the app include an intimate, sexualised tone inconsistent with professional care, and some app entries appear edited after clinical visits.\r\n\r\nAlarmed, Dr Tyabashe preserves exports and screenshots, documents the timeline, removes the caregiver from Amahle\u2019s roster, arranges alternative care, and reports the matter to the agency and authorities. She meets Amahle and her family, and apologises for the breach of trust, and outlines immediate supports and longer\u2011term safeguards.\r\n\r\n<img src=\"https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-30-1-e1773103240190.png\" alt=\"\" width=\"532\" height=\"226\" class=\"wp-image-814 aligncenter\" \/>\r\n\r\nOnce the immediate crisis is addressed, Dr. Tyabashe turns her attention to the bigger picture. She raises the issue with agency leadership and<strong> advocates for systemic improvements.<\/strong> She recommends <strong>mandatory digital safety training for all caregivers<\/strong>, stronger <strong>documentation<\/strong> policies, regular <strong>supervision<\/strong>, and routine <strong>audits<\/strong> of the caregiver app to detect misuse early. She emphasises that technology can support care, but only when staff are trained and systems are monitored.\r\n\r\n[caption id=\"attachment_816\" align=\"aligncenter\" width=\"668\"]<img src=\"https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a.jpg\" alt=\"A new vetted caregiver replaces the previous, after a thorough criminal records check and onboarding with new anti-violence, anti-TFGBV, and safe documentation training.\" width=\"668\" height=\"376\" class=\" wp-image-816\" \/> A new vetted caregiver replaces the previous, after a thorough criminal records check and onboarding with new anti-violence, anti-TFGBV, and safe documentation training.[\/caption]\r\n\r\n<!--StartFragment -->","rendered":"<p style=\"text-align: right\"><a id=\"quick-exit-btn\" href=\"https:\/\/google.ca\" title=\"Quick Exit\">EXIT SITE<\/a><\/p>\n<p><strong>Content Warning:<\/strong> The following story depicts caregiver-directed violence, including sexual and image-based abuse. Reader discretion is advised.<\/p>\n<hr \/>\n<p>When Dr. Tyabashe reviews Amahle\u2019s home care records during a routine check, she notices that something is not right. Amahle is a woman with high\u2011support\u2011needs autism who is nonverbal, who resides in a care home.<strong> Entries in the caregiver app do not match the clinical notes she is reviewing.<\/strong><\/p>\n<p>The physicians&#8217; notes indicated that last week, Amahle had been feeling extremely distressed. However, when reviewing caregiver app notes provided by the agency, her main caregiver logged that Amahle was in good spirits, no issues. Dr. Tyabashe decides to investigate this discrepancy.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-28-e1773102893958.png\" alt=\"\" width=\"558\" height=\"360\" class=\"wp-image-811 aligncenter\" srcset=\"https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-28-e1773102893958.png 1674w, https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-28-e1773102893958-300x194.png 300w, https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-28-e1773102893958-1024x661.png 1024w, https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-28-e1773102893958-768x495.png 768w, https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-28-e1773102893958-1536x991.png 1536w, https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-28-e1773102893958-65x42.png 65w, https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-28-e1773102893958-225x145.png 225w, https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-28-e1773102893958-350x226.png 350w\" sizes=\"auto, (max-width: 558px) 100vw, 558px\" \/><\/p>\n<p>A routine check of the agency\u2019s shared folder reveals uploads from a caregiver\u2019s device during the same week. The IT lead flags unfamiliar filenames and thumbnail previews that do not match authorised documentation. Family members confirm Amahle had a difficult week and report the caregiver insisting on being alone during personal care.<\/p>\n<p>A caregiver\u2019s private device had been used to download a file from the agency&#8217;s shared folder in the same week that Amahle\u2019s clinical notes recorded severe distress. When Dr. Tyabashe asked the agency IT lead for a routine folder review, the lead flagged several <strong>unfamiliar filenames<\/strong> and thumbnail previews that did not match any authorised documentation.<\/p>\n<figure id=\"attachment_812\" aria-describedby=\"caption-attachment-812\" style=\"width: 653px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-29-e1773102864561.png\" alt=\"Downloads folder with two files, named &quot;Image-1&quot; and &quot;Image-2&quot;.\" width=\"653\" height=\"312\" class=\"wp-image-812\" srcset=\"https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-29-e1773102864561.png 1920w, https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-29-e1773102864561-300x143.png 300w, https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-29-e1773102864561-1024x490.png 1024w, https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-29-e1773102864561-768x367.png 768w, https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-29-e1773102864561-1536x734.png 1536w, https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-29-e1773102864561-65x31.png 65w, https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-29-e1773102864561-225x108.png 225w, https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-29-e1773102864561-350x167.png 350w\" sizes=\"auto, (max-width: 653px) 100vw, 653px\" \/><figcaption id=\"caption-attachment-812\" class=\"wp-caption-text\">Several unfamiliar filenames and that do not match any authorised documentation within the app.<\/figcaption><\/figure>\n<p>A cautious preview (without opening intimate content) shows images saved under innocuous names in a personal downloads folder. Message threads in the app include an intimate, sexualised tone inconsistent with professional care, and some app entries appear edited after clinical visits.<\/p>\n<p>Alarmed, Dr Tyabashe preserves exports and screenshots, documents the timeline, removes the caregiver from Amahle\u2019s roster, arranges alternative care, and reports the matter to the agency and authorities. She meets Amahle and her family, and apologises for the breach of trust, and outlines immediate supports and longer\u2011term safeguards.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-30-1-e1773103240190.png\" alt=\"\" width=\"532\" height=\"226\" class=\"wp-image-814 aligncenter\" srcset=\"https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-30-1-e1773103240190.png 1920w, https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-30-1-e1773103240190-300x128.png 300w, https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-30-1-e1773103240190-1024x435.png 1024w, https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-30-1-e1773103240190-768x326.png 768w, https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-30-1-e1773103240190-1536x653.png 1536w, https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-30-1-e1773103240190-65x28.png 65w, https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-30-1-e1773103240190-225x96.png 225w, https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-30-1-e1773103240190-350x149.png 350w\" sizes=\"auto, (max-width: 532px) 100vw, 532px\" \/><\/p>\n<p>Once the immediate crisis is addressed, Dr. Tyabashe turns her attention to the bigger picture. She raises the issue with agency leadership and<strong> advocates for systemic improvements.<\/strong> She recommends <strong>mandatory digital safety training for all caregivers<\/strong>, stronger <strong>documentation<\/strong> policies, regular <strong>supervision<\/strong>, and routine <strong>audits<\/strong> of the caregiver app to detect misuse early. She emphasises that technology can support care, but only when staff are trained and systems are monitored.<\/p>\n<figure id=\"attachment_816\" aria-describedby=\"caption-attachment-816\" style=\"width: 668px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a.jpg\" alt=\"A new vetted caregiver replaces the previous, after a thorough criminal records check and onboarding with new anti-violence, anti-TFGBV, and safe documentation training.\" width=\"668\" height=\"376\" class=\"wp-image-816\" srcset=\"https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a.jpg 1920w, https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-300x169.jpg 300w, https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-1024x576.jpg 1024w, https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-768x432.jpg 768w, https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-1536x864.jpg 1536w, https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-65x37.jpg 65w, https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-225x127.jpg 225w, https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-content\/uploads\/sites\/450\/2026\/02\/a-350x197.jpg 350w\" sizes=\"auto, (max-width: 668px) 100vw, 668px\" \/><figcaption id=\"caption-attachment-816\" class=\"wp-caption-text\">A new vetted caregiver replaces the previous, after a thorough criminal records check and onboarding with new anti-violence, anti-TFGBV, and safe documentation training.<\/figcaption><\/figure>\n<p><!--StartFragment --><\/p>\n","protected":false},"author":554,"menu_order":4,"comment_status":"open","ping_status":"closed","template":"","meta":{"pb_show_title":"","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[49],"contributor":[],"license":[],"class_list":["post-483","chapter","type-chapter","status-publish","hentry","chapter-type-numberless"],"part":26,"_links":{"self":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-json\/pressbooks\/v2\/chapters\/483","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-json\/wp\/v2\/users\/554"}],"replies":[{"embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-json\/wp\/v2\/comments?post=483"}],"version-history":[{"count":14,"href":"https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-json\/pressbooks\/v2\/chapters\/483\/revisions"}],"predecessor-version":[{"id":843,"href":"https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-json\/pressbooks\/v2\/chapters\/483\/revisions\/843"}],"part":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-json\/pressbooks\/v2\/parts\/26"}],"metadata":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-json\/pressbooks\/v2\/chapters\/483\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-json\/wp\/v2\/media?parent=483"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-json\/pressbooks\/v2\/chapter-type?post=483"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-json\/wp\/v2\/contributor?post=483"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/tfgbvsafetytraining\/wp-json\/wp\/v2\/license?post=483"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}