Alzheimer's, Dementia & Mental Health
More Than Half of Family Caregivers Say They have
Abused Dementia Patients
Researchers found a minimal amount of significant
physical abuse
Jan.
23, 2009 - People with dementia primarily senior citizens
are abused by at least half of the family members who care for them, and
one-third of these caregivers say the abuse is at a significant level,
according to new research from UCL (University College London) published
today in the British Medical Journal (BMJ). The researchers found,
however, a minimal amount of significant physical abuse.
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"Many people think about elder abuse in terms of
"lashing out" and other similar acts, but abuse as defined by government
guidelines* can be as simple as shouting or swearing at the person being
cared for," says Dr Claudia Cooper, UCL Department of Mental Health
Sciences and lead author of the study.
The UK government is currently consulting about a
revision of their policy for safeguarding vulnerable adults. This
focuses entirely on preventing abuse by paid caregivers, but in light of
their clinical experience the authors wanted to find out how common
abusive behavior is and highlight that policy on abuse will be
ineffective unless it is realistic about the problems that family
caregivers are facing.
The researchers conducted a survey of 220 family
caregivers of people with dementia newly referred to psychiatric
services and living at home.
There were 115 (52.3%) of the caregivers who
reported some abusive behavior, such as very occasionally screaming or
yelling, and 74 (33.6%) reported significant levels of abuse, such as
more frequent insulting or swearing at the person for whom they care.
Only 1.4% reported significant physical abuse.
The measure used by the researchers in the study is
known as the Modified Conflict Tactics Scale (MCTS). Caregivers answered
questions about how often in the last three months they had acted in
five psychologically and five physically abusive ways on a scale of 0-4
(never all the time). A score of more then two on one question is
defined by this scale as 'significant' abuse.
"This is the first representative survey to ask
family caregivers about abuse. It shows that abusive behavior towards
people with dementia from family caregivers is common according to the
scale used, with a third reporting 'significant' levels of abuse, and
half some abusive behavior, said Dr. Cooper.
We found few cases of physical or frequent abuse,
although those with the most abusive behavior may have been reluctant to
report it, or take part in the study in the first place."
Co-author Professor Gill Livingston added, "Our
findings suggest that any strategy for safeguarding vulnerable adults
must be directed towards families who provide the majority of care for
older people, rather than exclusively at paid caregivers.
The UK government is currently revising its policy
in this area, but unfortunately their review is entirely focused on
preventing abuse by paid caregivers, suggesting that abuse is confined
to the formal care system whereas our research suggests this is not the
case.
"The vast majority of family caregivers do a
fantastic job under very difficult circumstances and although levels of
minor abuse seem high according to the scale used, there may need to be
a redefinition.
Healthcare professionals can be reluctant to ask
about abuse by family caregivers, but this attitude can be very
unhelpful to caregivers who are worried about their own actions and want
to talk about them and get help. Considering elder abuse as a spectrum
of behaviors rather than an "all or nothing" phenomenon could help
professionals to ask about it and therefore offer assistance."
About UCL
Founded in 1826, UCL was the first English
university established after Oxford and Cambridge, the first to admit
students regardless of race, class, religion or gender, and the first to
provide systematic teaching of law, architecture and medicine. UCL is
the seventh-ranked university in the 2008 THES-QS World University
Rankings, and the third-ranked UK university in the 2008 league table of
the top 500 world universities produced by the Shanghai Jiao Tong
University. UCL alumni include Marie Stopes, Jonathan Dimbleby, Lord
Woolf, Alexander Graham Bell, and members of the band Coldplay. UCL
currently has over 12,000 undergraduate and 8,000 postgraduate students.
Its annual income is over £600 million.
>>
Full report published today in British Medical Journal
