When an elder is the abuser

Characteristics of domestic violence perpetrators with dementia from police records using text mining

“…They found that, in general, older victims (aged 55 and over) were less likely to call for assistance if the POI was a spouse compared to younger victims, possibly because of greater dependency on the spouse ( 42 ). Similarly, victims of people with dementia in a domestic setting may be less inclined to involve police due to a belief that the POIs behavior is influenced by their dementia or because they have already endured years of abuse ( 17 , 43 ). We were unable to identify any studies into the impetus (or failure) to involve police in cases where the perpetrator suffered from dementia, thus further research is required in this area.…”

“…This field is hampered by a lack of a cohesive conceptual framework for violence in dementia; that is, not all violence is offending but the perception often depends on whether the behavior is regarded as arising from the dementia or manifesting from characterological traits ( 13 , 17 ). Research in this area has also predominantly focused on victims of intimate partner violence or elder abuse ( 48 ), with knowledge about perpetrators of violence mostly gleaned from the victim’s report of the type of abuses and characteristics of the perpetrator ( 16 , 49 , 50 ).…”

“…A complicating factor is the difference in terminology that can be applied to violence committed by older people with dementia, particularly if the victim is similarly older and frail and/or cognitively impaired. In practice, the violence can be construed as DV, its subset, elder abuse (defined as “acts of omission or commission that result in psychological, physical, financial or sexual harm to a person” perpetrated by a person in a position of trust) ( 17 ) or as neuropsychiatric symptoms of dementia (“a heterogenous group of non-cognitive symptoms that are almost ubiquitous in dementia”) ( 17 , 18 ) with important implications for interventions for the perpetrator and the victim. If the violence is viewed as a symptom of dementia, the perpetrator can be managed by the medical system.…”

Homicide and Dementia: A Systematic Review

“…Education of primary care is essential as the majority of older people with dementia receive their healthcare from general practitioners rather than specialist services. In relation to family violence, for example, a lack of training for screening regarding specific issues faced by older adult victims has been identified in healthcare professionals [57, 58]. Any clinicians caring for people with dementia with the risk factors highlighted by this review must consider the safety of potential high-risk victims such as co-residents in aged care facilities and spouses, especially where there has been intimate partner violence [58].…”

“…In relation to family violence, for example, a lack of training for screening regarding specific issues faced by older adult victims has been identified in healthcare professionals [57, 58]. Any clinicians caring for people with dementia with the risk factors highlighted by this review must consider the safety of potential high-risk victims such as co-residents in aged care facilities and spouses, especially where there has been intimate partner violence [58]. Counselling spouses and carers regarding the particular risks and circumstances where aggression may arise and strategies to avoid, defuse, or escape dangerous situations may save lives [57].…”