The researchers found that the risk of abuse increased when caregivers were married to the care recipients, especially when the caregivers were at risk for clinical depression, were cognitively impaired, had reported physical symptoms in the previous week, or were taking care of more needy recipients. In those situations, care recipients were more likely to report that their caregivers screamed and yelled at them, used a harsh tone of voice, insulted them, called them names, or swore at them.
However, when caregivers were nonspousal family members, such as adult children, they did not show the same treatment toward the care recipient, even if the pair lived together.
Beach speculated that the reason for the especially harsh spousal treatment was "marital relationships--some of this could have been going on before caregiving began.
"There's more opportunity for spouses to be abusive," he added. "If an adult daughter is living with her mother or father, the adult daughter is more than likely working, so she's not there eight hours a day." He also pointed out that adult children are less likely to have cognitive deficits, physical problems, or depression than elderly caregivers.
The findings from this study could provide useful tools to doctors, who can help identify caregivers at risk for providing poor-quality care. They may particularly target depressed, older spousal caregivers for screening and intervention efforts.
"Clinicians should focus not only on treating the depression, but also on providing these caregivers with alternatives that might ease the burden of caregiving, such as support group referral or arranging for other family members, friends, or formal service providers to perform respite care," wrote the researchers.
While other studies on caregiving have typically interviewed only one person in the relationship, the Pitt researchers spoke with both caregivers and ca
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Contact: Karen Hoffmann
klh52@pitt.edu
412-624-4356
University of Pittsburgh Medical Center
8-Feb-2005