Elder abuse in people with dementia in Northern Ireland: Prevalence and predictors in cases referred to a psychiatry of old age service

Abstract

Objective: To establish the prevalence of elder abuse in community-dwelling patients with dementia and to test the hypothesis that there is no difference in carer and patient characteristics between the abused and non-abused populations.

Design: A cohort of consecutive referrals was formed and subdivided by the presence or absence of abuse and the two groups compared.

Setting: A rural psychiatry of old age service in N. Ireland.

Subjects: Each case had been newly referred, was 65 years old or over, lived at home, had an identifiable carer and met DSMIII-R criteria for a diagnosis of dementia. There were 49 such cases; 38 carers agreed to be interviewed.

Main outcome measures: The General Health Questionnaire 28, the Gilleard Pre-Morbid Relationship Rating Scale and Gilleard's Problem Checklist were administered to the carer and the information/orientation sub scale of the Clifton Assessment Procedure for the Elderly used to measure cognitive impairment in the patient.

Results: Abuse was elicited in 14 (37%) cases; four (10.5%) of physical and 13 (34%) of verbal abuse. No cases of abuse by neglect were detected. A poor premorbid relationship, verbal or physical abuse by the dependant, problem behaviours in the dependant, the carer's level of anxiety and a perception of not receiving help were significantly associated with abuse. Alcohol consumption of the carer, physical dependence, severity of cognitive impairment or financial or social circumstances were not associated with elder abuse.

Conclusions: Elder abuse is associated with aspects of the patient/carer relationship and should be regarded as a significant problem in patients with dementia referred to an old age service.