Elder Abuse Can Be Reduced By Training Caregivers About Dementia

Jacqueline Marcell Health Guide
  • Elder Abuse is an expanding serious problem affecting hundreds of thousands of elderly people in the United States. And since the abuse is oftentimes at the hand of a family member or friend, the issue remains largely hidden by the families, causing gross under-reporting of the crisis.


    It is estimated that only 1 out of 14 incidents come to the attention of authorities. And criminal prosecution rarely occurs, because by the time law enforcement gets involved the incident has long passed and the family doesn't want to bring attention to their disgraceful family secret.



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    Statistically families (and many doctors who are not dementia specialists) ignore the early warning signs of dementia because they incorrectly believe that the intermittently odd behaviors are just a normal part of aging and untreatable senility. Most say that the behaviors just "aren't that bad yet"-which is a costly mistake in every regard. Since one out of every eight persons by the age of 65 gets some form of dementia (Alzheimer's makes up 65%), and nearly one out of every two by the age of 85 is afflicted (the fastest growing segment of population), dementia adds an enormous burden on families who are already ill-prepared for the strain of caring for an aging loved one.



    Overburdened caregivers ride a roller coaster of emotions - feeling overwhelmed, out of control, sad, angry, guilty, and obligated to be in constant demand. They lose touch with friends who don't understand, their careers suffer when they must take time off or quit work, they suffer sleep deprivation, and they rarely get adequate nutrition or exercise. They feel overwhelming frustration and grief that they are not able to make their loved one better - and they experience ominous thoughts of impending death.


    The National Center for Elder Abuse (NCEA) reports that the rate of depression for caregivers of non-demented patients is 35.2%, which is twice the public average. Among dementia caregivers, the rate is a whopping 43-46%. And caregivers who experience the greatest levels of ongoing stress were 63% more likely to die within the next 4 years than their non-caregiving peers.



    When a patient becomes very difficult to manage, the caregiver experiences yet another level of frustration. Since there are 5 million people with Alzheimer's in the US, and agitation occurs in 40-60% with 7 out of 10 being cared for at home, is there any surprise that elder abuse can occur when an overstressed caregiver reaches their limit with a challenging elder? People who would have never dreamed of crossing the line are finding themselves lashing out in a moment of utter frustration. Of course, overwhelming guilt and hopelessness is the outcome.


    NCEA reports that 20% of caregivers live in fear they will become violent-and this rate increases to 57% among caregivers who have previously experienced violence from those they now care for. Researchers conclude that previous violence by the care receiver appears to move persons who are fearful of becoming violent to actually commit violent acts.



    Misunderstood is the fact that Mild Cognitive Impairment (MCI) precedes Alzheimer's and can last five to ten years. Not all of those people, but a large percentage, will progress to Stage One Alzheimer's which typically lasts 2-4 years - yet is still mild. But then there is often some type of crisis when the family realizes that full-time care is now essential. This usually signals the beginning of Stage Two, which can last 2-10 years as the family tries to care for their loved one at home. And then the illness gets worse, Stage Three, which lasts 1-3 years and when many people are placed in a nursing home.

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    Seeking help early from the right doctor, a neurologist specialized in dementia, can save families so much heartache and money-and save our society the burden of caring for so many elders who decline sooner than need be. What everyone needs to know is that with proper care and medication (Aricept, Exelon, Razadyne or Namenda), in most people dementia symptoms can be masked/slowed down-keeping the patient independent and in milder MCI and Stage One longer. Instead, healthcare professionals don't get the call until the patient has progressed to Stage Two, but there is no going back-even with medication.



    Elder abuse is an issue that needs to be examined as closely as domestic violence, which has fortunately been deterred by abundant public service announcements and radio and television discussions. Also, the availability of battered women shelters and counseling has made a huge difference in the awareness of the issue. The same is needed for elder abuse. Through public awareness and education another taboo can be brought out in the open so offenders will think twice before they lash out. Ideally, they will know to seek the help of a mental health professional way before they cross the line.


    The bottom line is that when families have fewer frustrations and difficult behaviors to cope with (because their loved one's dementia was diagnosed and treated early); and caregivers know how to obtain coping resources sooner-elder abuse can be drastically reduced.



    * Doctors and healthcare professionals (who are not dementia specialists) need to understand the early warning signs of dementia and be open to referring their patients to specialists for an early and accurate diagnosis and treatment.


    * With national education and extensive media awareness and community support, the over 50 million American caregivers can learn how to better cope with the challenges of caregiving.


    * Family doctors and therapists should routinely screen their patients for caregiver burnout-so stress, frustration and depression can be addressed immediately.


    * Eldercare workers in the home or in professional settings should be required to undergo extensive criminal background checks.


    * Anyone who suspects any type of elder abuse must be encouraged to report it immediately.


    * Support groups (in person and online) can help caregivers cope and feel less alone.


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    * Stressed out caregivers should be encouraged to seek alternate care for their patient, so they get a break (respite) and recharge before caregiver stress erupts into any level of abuse.


    * Caregivers and healthcare professionals need to know about The National Center for Elder Abuse (http://www.ncea.aoa.gov/), which provides resources to find assistance, publications, data and answers to elder abuse questions.


    * Everyone should know the Ten Warning Signs of Alzheimer's
    (Reprinted With Permission of The Alzheimer's Association)

    1. Memory loss
    2. Difficulty performing familiar tasks
    3. Problems with language
    4. Disorientation of time and place
    5. Poor or decreased judgment
    6. Problems with abstract thinking
    7. Misplacing things
    8. Changes in mood or behavior
    9. Changes in personality
    10. Loss of initiative

    Expanded Descriptions: http://www.elderrage.com/alzheimers.asp


    You can learn more about Jacqueline and find information about her book at ElderRage.com

Published On: March 12, 2008