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Am J Psychiatry 1993; 150:643-646
Copyright © 1993 by American Psychiatric Association
The relationship between dementia and elder abuse
AC Coyne, WE Reichman and LJ Berbig
COPSA Institute for Alzheimer's Disease and Related Disorders, UMDNJ- CMHC, Piscataway 08855-1392.
OBJECTIVE: Alzheimer's disease and other dementias may be associated with
greater risk for physical abuse than other illnesses of the elderly. The
authors examined the relationship between dementia and abusive behavior in
a group of demented patients and their caregivers. METHOD: An anonymous
questionnaire was distributed to 1,000 caregivers who called a telephone
help line specializing in dementia. Demographic characteristics of patients
and caregivers were assessed, the occurrence of abuse was examined, and
caregivers completed the Zarit Burden Interview and the Zung Self-Rating
Depression Scale. RESULTS: Questionnaires were completed by 342 caregivers.
The mean age of caregivers was 56.1 years; 163 (54.5%) were adult children
caring for parents, 111 (37.1%) cared for spouses, and 25 (8.4%) cared for
other relatives. Thirty-three caregivers (11.9%) reported that they had
directed physically abusive behavior (e.g., pinching, shoving, biting,
kicking, striking) toward the dementia patient in their care. These
caregivers had been providing care for more years, cared for patients
functioning at a lower level, displayed higher burden scores, and displayed
higher depression scores than caregivers who reported no abuse. In
addition, 92 caregivers (33.1%) reported that the patient directed abuse
toward them during the course of providing care. Caregivers who had been
abused by patients, in comparison to those who had not, were more likely to
direct abusive behavior back toward the patient in their care. CONCLUSIONS:
These results support the hypothesis that abuse involving cognitively
impaired older adults and their caregivers may be associated with the
relatively high psychological and physical demands placed on family members
who care for relatives with dementia.
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