1. Elder Abuse and dementia
Sirkka Perttu
MSc (Health Care), RN
Daphne /WLF

2. Abused women - dementia
Progressive conditions that develop as a result of degenerative changes in the brain
Primarily affects older people and is characterised by
the loss of cognitive, social and behavioural functions that impacts a person’s mood and personality
the ability to think, speak, understand, communicate, remember
perform basic self-care functions like dressing and eating
Downes, C., Fealy, G., Phelan, A., Donnelly, N.A., Lafferty, A. (2013) Abuse of Older People with Dementia: A Review. NCPOP, University College Dublin.

3. Relationship between elder abuse and dementia
Older adults with dementia are particularly vulnerable to abuse
As the world’s population ages, the number of people with dementia is predicted to increase from 35.6 million in 2010 to million by 2050
Estimates of the prevalence of abusive behavior toward older adults with dementia who live in the community range from 5.4 percent to 62.3 percent
Abuse of older adults with dementia is underreported - older adults may be reluctant to disclose abuse because they fear retaliation or losing support

4. Relationship between elder abuse and dementia
Common physical signs of and reactions to abuse, such as withdrawal from communication or increased dependence, may be difficult to distinguish from dementia symptoms
Psychological abuse was the most common form of abuse among older adults, with estimates of its prevalence ranging from 27.9 percent to 62.3 percent.
Physical abuse was estimated to affect 3.5–23.1 percent of older adults with dementia.
Downes, C., Fealy, G., Phelan, A., Donnelly, N.A., Lafferty, A. (2013) Abuse of Older People with Dementia: A Review. NCPOP, University College Dublin.

5. Relationship between elder abuse and dementia
A study of 284 sexual abuse cases reported that 60 percent of the elderly victims suffered from cognitive impairment or dementia
35 percent of eighty-two caregivers of patients with dementia reported experiencing mutual verbal abuse with the care recipients, and 6 percent reported experiencing mutual physical abuse with them
Downes, C., Fealy, G., Phelan, A., Donnelly, N.A., Lafferty, A. (2013) Abuse of Older People with Dementia: A Review. NCPOP, University College Dublin.

6. Risk factors of elder abuse due to dementia
Victim factors:
Older adults with dementia often have psychological or behavioral symptoms such as agitation and aggression, which may intensify caregiver-recipient conflicts and result in elder abuse
older adults with dementia may experience a higher burden of chronic illness and physical impairment, which further increases their risk of abuse
Downes, C., Fealy, G., Phelan, A., Donnelly, N.A., Lafferty, A. (2013) Abuse of Older People with Dementia: A Review. NCPOP, University College Dublin.

7. Risk factors of elder abuse due to dementia
Perpetrator factors:
Caregiver burden and stress are among the most common risk factors associated with elder abus
Depression, anxiety, alcohol abuse, social isolation and poor relationships with the victim prior to the occurrence of dementia are also associated with higher risk of abuse by caregivers
In long-term care facilities, a lower level of job satisfaction and a higher level of burnout rate may lead to increased risks for abuse
Downes, C., Fealy, G., Phelan, A., Donnelly, N.A., Lafferty, A. (2013) Abuse of Older People with Dementia: A Review. NCPOP, University College Dublin.

8. Intervention models of elder abuse designed for older people with dementia
Improvement of multiagency collaboration in the management of elder abuse
Core elements:
screening tools and referral protocols
handbook for caregivers for identification of elder abuse risk factors
community resource supports and services for the caregivers
training of staff and volunteers
Anetzberger et al. 2000

9. Intervention models of elder abuse designed for older people with dementia
Reducing abusive behaviour of the demented person:
medication to help the care-recipient’s memory
written advice on understanding memory problems and what to do
more information from professionals caring for the person with dementia
Selwood et al. (2009)
Caregivers of older people with dementia need to receive adequate information and education about the clinical course of dementia and the care-recipient’s needs
(Hansberry et al. 2005).

10. Intervention models of elder abuse designed for older people with dementia
Home care and respite care services can prevent abuse (Selwood et al. 2009)
Strategies aimed at reducing caregiver isolation and enhancing social support may be effective in reducing elder abuse of people with dementia (Hansberry et al. 2005)
However, Cooper et al. (2010) suggest that outside help may be experienced as stressful for family caregivers and thus it may not result in a reduction of caregiver abuse