Abuse in Families Coping with Dementia

Care giving can stir up angry and conflicted feelings as well as bring out the most loving and unselfish side of a full time caregiver.  Verbal abuse, bruises on an elderly person’s arms or legs from restraining, squeezing, or pinching can happen when caregivers are depressed, angry, or overwhelmed with having toprovide care for a family member with dementia. Investigations have found that dementia is a definite risk factor for abuse caregiver stress, combined with unrealistic expectations of a person suffering from dementia, can lead to abuse or neglect by caregivers.

Assessing the Needs of Overwhelmed Caregivers

1.       How much rest are caregivers getting?

2.      What personal sacrifices are caregivers making in order to serve the person’s needs?

3.        Are caregivers neglecting their own health?

4.        Is constant surveillance required as part of care tasks?

5.       Have caregivers turned to alcohol or drug abuse in their distress?  Has
 substance abuse been lifelong?

6.       How drastically has the older person’s personality changed in response to
 illness?

7.       Are caregivers receiving verbal or physical abuse from the person in their
 care?

8.        Is the primary caregiver overwhelmed by demands from several
dependent people at once?

9.        Are financial constraints interfering with the caregiver’s ability to follow
 medical advice?

10.    Are problems from the family history resurfacing and contributing to
 abuse or neglect?

 Warning Signs of Stress and Depression

 Sleep disturbance:  difficulty falling asleep or remaining asleep; waking up early in the morning feeling anxious or irritable; unable to stop worrying or ruminating.

 Appetite changes:  unusual over-eating or loss of appetite; significant weight gain or loss.

 Increased medication or alcohol usage:  Overuse of sleeping pills, painkillers, alcohol, or caffeine.

 Mood changes:  uncharacteristic short-temperedness, crying, or agitation; expressionless face or flat tone of voice; recurrent thoughts of death or suicide.

 Physical problems:  decreased resistance to illness; delay or neglect of vital physical needs; poor nutrition.

 Chronic fatigue:  loss of energy; decreased motivation, concentration, and attention; unending sense of tiredness.

 Rough handling:  marked impatience when giving care; hitting, pushing, or yelling when frustrated or angered; neglecting vital care tasks.

                               Taking Care of Aging Family Members
 Lustbader and Hooyman

 Factors to Consider When Siblings Share the Care

 1.    Are worries about the inheritance straining arrangements for care?  
      Are these strains unspoken or out in the open?

2.      How geographically spread out are the siblings?  Does only one live locally, or are the majority nearby?

3.       Does a large financial disparity exist between siblings?  Does one have far greater resources than the other(s).

4.     What has been the nature of siblings’ adult relationship with each other?  Have they had minimal contact or active friendships with each other?

5.      How obviously do the parents have a favorite or a scapegoat among the siblings?  Have these feelings been carried over into adult life?

6.       Is there a natural leader among the siblings?  Has one mediated conflicts or consistently helped the others?

7.      Is there a health care professional among the siblings?  Do the others view this person as the one who should provide the care or make the decisions?

8.      Is there a split in the family between those who want to take care of the parent at home and those who prefer to seek nursing home placement?

9.      Does the family expect daughters to be caregivers in preference to the sons?  Do the women accept this role?

10.  What are the other obligations pressuring each sibling?  Do some have 
young children or other relatives for whom they are already providing care?