Dementia Care: Effects of Care Load and Couple Age on Perceptions of Abuse, Abuser, and Abused

  • Author / Creator
    Runac, Rachel E
  • Abuse is the intentional act, or failure to act, by a person that creates harm or risk of harm to another individual (Center for Disease Control and Prevention, 2019a). This issue is particularly relevant in healthcare scenarios because of older adults' increased vulnerability. The prevalence of elder abuse is much higher among those who have a diagnosis of dementia than those who are cognitively healthy (Pillemer, Burnes, Riffin, & Lachs, 2016). Showing leniency in perceptions of abuse, previous research has found that abuse of an older person with a cognitive disability is perceived differently than abuse of an older person with a physical disability, and it is rated as less severe (Matsuda, 2007). Other research has found that the abuser of an older person with dementia is perceived more leniently and the abused older person with dementia is perceived as more accepting (Runac, Kwong See, & Choy, 2017, 2018). One possible mechanism for these perceptions is sympathy for the increase in stress and burden associated with taking care of those with dementia (Etters, Goodall, & Harrison, 2008). Alternative explanations have considered the role of age and age-related stereotypes (dementia stereotypes) in perceptions of abuse (Runac et al., 2017, 2018). The present study examined perceptions of physical and psychological abuse, the abuser and abused, and the impact of self-reported quantity and quality of contact with older adults on perceptions. Using a vignette methodology, 156 undergraduate students were presented a scenario in which a husband caregiver was described as abusing a wife care recipient under varying care load conditions (no care load the wife is healthy, care load due to the wife's physical disability or care load due to the wife's cognitive disability). This was to examine the role of caregiver burden. In addition to manipulating care load, the current study varied the age of the couple; either the husband and wife were younger (32 and 29 respectively) or older (83 and 81 respectively). This was to examine the role of age and age-related stereotypes on perceptions. The study was thus a three care load by two couple age between subjects design. Results indicated that perceptions of physical abuse did not differ according to couple age and care load, and in fact, psychological abuse was rated as more abusive when there was a care load. In our study there was no leniency in perception of abuse found, however perceptions of the abused and abuser illustrated a story of leniency. Showing that care load, and by inference caregiver burden, influences perceptions of abuse, compared to the no load condition, the abuser husband is perceived as less to blame in the two care conditions, that did not differ from each other. Perceptions of his feelings showed that generally when there was a care load the husband is perceived as feeling more helpless and exhausted but experiencing less rage. Suggesting a role for age stereotyping on perceptions, in the two care load conditions the abused wife was rated as more difficult to live with when described as old compared to when she is described as young. Generally, when there was a care load, the abused wife was perceived as more happy, relaxed, calm and feeling less rage. These results show that leniency in perceptions results from a complex interplay in views of the abuser and abused. Covariate analysis with the rater’s reported contact quality and quantity with older people did not change the pattern of results. Overall, this study provides some insight on the role of care burden and age stereotypes as factors that may explain why abuse of persons with dementia is more prevalent. Theoretical and practical implications are discussed, as well as limitations and future research directions.

  • Subjects / Keywords
  • Graduation date
    Spring 2020
  • Type of Item
  • Degree
    Master of Science
  • DOI
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