Abuse in families coping with dementia - includes a related article with a case study - Special Populations: Families Coping with Dementia

Verbal abuse, bruises upon an elderly person's arms or leg from restraining, squeezing, or pinching -- this can happen when caregivers become cast downed angry, and overwhelmed in trying to provide care for a family member suffering from dementia.

Caregivers can also be upon the receiving end of verbal or physical abuse directed at them by dint of parents or spouses who are confused and angry above declining mental capacities due to blow and Alzheimer's disease. In a certain number of cases, Alzheimer's disease or other forms of dementia may cause the patient to be uncharacteristically aggressive. In other cases, verbal abuse or physical violence may have been typical of family interactions before the illness.

The following case history demonstrates by what mode an overwhelmed caregiver can become abusive. The case also raises questions about by what means resilient second marriages will be in dealing with the stres of caregiving, because the husband and wife and adult children have had sole a short period in which to exhibit natural feelings of duty and obligation.

When Jim Donnely, 70 discovered that his next to the first wife Joyce (not their real names) had Alzheimer's disease sum of two units years after their marriage, he naturally felt overwhelmed. He listed his wife in a dementia day care program three days a week where he was also able to receive counseling focused upon caregiving issues. It was during these sessions that Jim squeeze outed his constant grief over the los of his first wife, Barbara, and in what manner lonely he was feeling at the time he met Joyce He also began to expres his anger at the illness afflicting his wife, an illness that demanded of him devotion that spouses ofttimes have difficulty providing even after 40 years of marriage.

Several years passed and as Joyce's illness advanceed day care staff became regarded over her frequent reactions when her husband arrived -- "I don't want to make progress with that man," or "I'm afraid of him." Although a failure to recognize one's spouse or smooth delusions surrounding "replacement" of one's spouse through a stranger may accompany dementia, Joyce Donnely appeared to be displaying actual fear of her husband. At the same time, her attendance at day care became sporadic, and her husband's complaints of feeling overwhelmed increased.

During this period, the staff reported bruises upon Joyce's arms which were painful to the touch. When they be opposite toed Jim in a firm on the other hand not rejecting manner, he admitted that at times he became for a like reason frustrated with Joyce that he would grab her and shake her. It also became clear that as his wife's illness got worse, his anger and frustration grew farther increasing the likelihood of abuse.

With Jim's permission, Day Program staff began including other members of the Donnely family in discussions of the caregiving situation and time to come planning for Mrs. Donnely's care. Family members said they were aware of Jim's frustration with Joyce and that, at times, he did "become rough" with her. They were able to mention one by one him openly that he must not continue this abusive behavior and tendered suggestions, such as walking away when he felt frustrated or calling single of them on the phone before he reached the point where his patience might snap. These suggestions were continually reinforced during weekly sessions. Nursing residence placement for Joyce was also discussed, an option that Jim resisted. He did agree to prove a home health aide, although he later said he felt his privacy was interrupted and his stres still remained after the aide departed for the day.

Joyce continued, however, to exhibit evidence of abuse, particularly after lower extremity surgery required a prolonged stay at abode When the Day Program staff made a residence visit, bruises were observed up and down her leg Jim admitted to causing these injuries, stating that he had difficulty washing his wife and that the bruises were a follow of pinching her. Another abundant more serious injury also occurr during the same time period, although Jim at no time indicated whether or not it issueed from his actions.

Day Program staff continued to work with Jim and his family in an effort to break the pattern of stres and anger. Then, Jim became ill himself and was hospitalized. No other somebody was willing or able to care for Joyce and she was placed in a nursing abiding-place with her husband's cooperation and concurrence Once he was relieved of the day-to-day load of his wife's care, he was able to relate to her in an appropriate manner. He not seldom took Joyce out of the nursing abode on small excursions and, upon several occasions, escorted her to social circumstances held at the Day Program.

How typical is this case? by what means often do caregivers abuse relatives in their care? by what mode often do patients with Alzheimer's or other forms of dementia direct abuse at their caregivers? Although there is not still sufficient research addressing these questions, several novel studies shed light on the design and frequency of the problem

What The Studies Show

Findings from novel investigations have served to highlight the neighborhood of dementia as a risk factor for abuse.