Dementia and Elder Abuse

Abstract

Cognitive impairment, especially dementia, has been found to be a major risk factor for elder abuse. This paper reports a study of 54 cases of abuse and 100 non-abused people with dementia seen by the HornsbyRehabililalion & Aged Care Service in 1990-91. The aim of the study was to investigate the relationship between dementia and elder abuse considering the person with dementia as either the victim or abuser. The findings confirmed that when dementia was combined with factors such as psychiatric illness or substance abuse on the part of the carer, or pre-exivting family conflict (including domestic violence), there was a significant risk of abuse occum'ng. However, dementia did not place the sufferer at greater risk of physical andpsychological abuse, even when there was disturbed behavwur such as aggression andparanoia. Carers appeared to be at particular risk of physical abuse and psychological abuse. When abuse did occur, extra services of some types were required to maintain the person with dementia in the community, although victims were not at greater risk of institutionalisation than non-abused dementia sufferers.

Domestic violence and elderly dementia sufferers

“…Studies in Australia, 12 Canada, 13 Ireland, 14 the Netherlands, 15 Northern Ireland, 16 Studies of the characteristics of the assailants (see review of literature 1 ) include prior victimization, financial dependence on the elder victim, a history of family violence, mental illness, and substance use disorder. Some studies further cite the stresses associated with caregiving, which include physical and mental deterioration in the victim, financial issues, social isolation, no perceived resources for assistance, and lack of companionship.…”

“…While dementia sufferers may also be victimized by other patients 10 and long-term care staff, 11 there is international, published, peer-reviewed literature that empirically documents the presence of domestic violence against elder dementia sufferers. Studies in Australia, 12 Canada, 13 Ireland, 14 the Netherlands, 15 Northern Ireland, 16 and the United States [17][18][19][20][21][22] document the extent of this issue.…”

“…Some studies further cite the stresses associated with caregiving, which include physical and mental deterioration in the victim, financial issues, social isolation, no perceived resources for assistance, and lack of companionship. [12][13][14][15][16][17][18][19][20][21][22] Elders who are victimized tend to be vulnerable, socially isolated, physically or cognitively impaired, and dependent on the caregiver abuser. 1 Research on domestic violence among elderly dementia sufferers is in its early stages, and further inquiry is urgently needed into the nature of warning signs, the characteristics of assailants and victims, and effective treatment interventions.…”

Criminological Theory and Elder Abuse Research—Fruitful Relationship or Worlds Apart?

“…Looking at current elder abuse research in a context of dependency of the abused senior in the light of the aforementioned dichotomy, it must be considered to be mainly "on the strain track", looking for stressors leading caregivers into violent and neglectful behaviour-like caregiver burden (see for example Cooper et al 2008;Lee 2009;Steinmetz 1988), care recipients' aggressive and violent behaviour (Pillemer and Suitor 1992), social isolation (Compton et al 1997) or a strained precaregiving relationship (Hughes 1997;Nolan 1997;Sadler et al 1995;Saveman et al 1996). In most cases, elder abuse researchers make no reference to theories of crime and deviance, but, criminologically speaking, the basic model of thoughtlooking for burdensome factors impinging upon people and finally driving them to abuse or neglect an older person-is very much in the strain theories chain of thought.…”

Understanding elder abuse: a social rights perspective

“…However, the circumstances surrounding each individual occurrence of elder abuse can be very different. The circumstance of a person experiencing dementia and their carer (Cooney and Mortimer, 1995; Sadler et al ., 1995; Cooney et al ., 2006; Selwood et al ., 2009) is very different to that of an older person facing the continuation of family violence experienced at earlier life stages (Penhale, 1999; 2003; Lundy and Grossman, 2004). It would be a mistake, considering the complex and ambiguous nature of the care relationship, to assume that elder abuse is a consequence of dependency.…”