Women Coping With a Partner's Dementia‐Related Violence: A Qualitative Study

Abstract

Purpose The aim of the present study was to differentiate between the lived experience of two groups of women caregiving for a partner with dementia. One group was coping with lifelong intimate partner violence (IPV) and dementia‐related violence (Group 1); the other group was coping with dementia‐related violence only (Group 2). Design An interpretive phenomenological analysis perspective was used. Data collection was performed through in‐depth, semistructured interviews with eight female spouses of men with dementia from each of the two above‐mentioned groups, followed by a content analysis. Findings Comparing the narratives of the aging women revealed their different experiences over several dimensions: (a) the identification of violence as a symptom of dementia; (b) the use of past couplehood memories; (c) feelings over time; (d) willingness to care for the partner with dementia; and (e) a prospective view of life. Conclusions The complexities of being old and having to cope with caregiving responsibilities for a spouse with dementia, accompanied by violent behaviors, emphasize the significance of the couple's past relationship. This notion should be taken into account in practical interventions. Clinical Relevance As part of the aging process, there is an increase in people who are engaged in dementia‐related violence. Nurses' education and practice should focus on the dynamics of dyads coping with violence and identify the particular needs of the caregiver spouse in this context.

Violence against older women: A systematic review of qualitative literature

“…Older women often experienced an escalation of IPV and controlling behaviors despite the age and/ or illness of their partner [36,40,46,61,69,77]. Changing relationship dynamics due to ageing-including a husband's retirement, children leaving the home, women wanting to engage in activities outside of the home, or diagnosis of a chronic or terminal illness-triggered escalating IPV [36,40,46,47,56,69]. Shifts in types of violence, from predominantly physical violence to predominant psychological abuse and neglect, were commonly described in studies that encompassed previous and on-going IPV [34,51].…”

“…Older women described that ageing diminished their physical and emotional capabilities to cope with experiences of violence [33,37,39,47]. This sub-theme appeared in 12 manuscripts [33,37,39,40,43,47,48,53,55,59,62,76] and was expressed in relation to various forms of violence-IPV [33,37,47], including violence perpetrated by a spouse due to dementia [40], violence in the context of a new relationship or second marriage [48,53,55,59,62], violence perpetrated by a mentally ill child [39], violence perpetrated by children-in-law [76], and elder abuse [43]. These studies primarily focused on current experiences of violence of older women, as changes in physical and emotional capacity to cope was described in relation to present victimization.…”

“…This sub-theme only emerged in three manuscripts [40,46,69], however, it is the only instance among the included studies in which older women described first or new experiences of IPV in older age. Older women who provided care for spouses with dementia reported aggressive behavior, physical violence, and verbal abuse [40,69]. In one study, a woman reported, "I don't know what's going on with my husband, he's never been like that, never hit me before.…”

“….he seems another person [46]." Another study found that women who had experienced lifelong IPV understood dementiarelated violence as a continuation of aggression, dominance and abuse, whereas women who had only been exposed to dementia-related violence took solace in a diagnosis, felt grief over the loss of their spouse as he used to be, and tried to maintain intimacy and affection in a previously caring and loving relationship [40].…”

“…In several cases, remaining in the relationship was a coping mechanism of last resort, given the multiple barriers present to women leaving the relationship, whether with an intimate partner, other family member or caregiver [48]. Women also described strong beliefs in social norms that supported staying with a sick or frail abusive partner or abusive child [33,35,40,46,57,66,76]. Many women viewed seeking help and confiding in others as embarrassing and unacceptable; one woman explained, "I was ashamed.…”