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Posted: February 15, 2005

Far Too Often, Caregiver Spouses Simply 'Lose It'

For some, yelling at a spouse is nothing new in the marriage. In fact, it could be a productive form of communication. However, when the caregiver is the spouse, he or she is more likely to scream at the patient than not. Frustration and anger, in turn, can lead quickly to emotional abuse.

Dr. Scott R. Beach, of the University of Pittsburgh, reported that "the stress and strain of caregiving can wear a person down to the point where the quality of care they provide is compromised."

Beach and his colleagues studied 265 elderly care recipients and their caregivers to determine factors associated with potentially harmful caregiver behavior. In general, caregivers provided unpaid help with various activities of daily living and provided primary care for an impaired family member 60 years of age or older who lived in the community.

About one in four patients said they were subjected to potentially harmful behavior some of the time. The most disturbing caregiver behavior was characterized as screaming, swearing or using a harsh tone of voice. It?s hard to know what the relationship communication styles were before the long-term illness, however.

Less commonly reported caregiver behaviors included threats to send patients to a nursing home, threats to abandon the patient, threats to use physical force and actual physical force such as hitting, shaking or other rough handling.

Seniors were at greatest risk for being subjected to such behaviors when their primary caregiver was their husband or wife, Beach and his team report in this month's Journal of the American Geriatrics Society. The likelihood that such potentially harmful behavior would be exhibited was eight times higher when the caregiver was the spouse than when he or she was not married to the patient.

"I think the simple fact that elderly spouses are together most or all of the time provides greater opportunity for such negative interaction," Beach said.

It?s also possible that the caregiver started suffering physical and cognitive losses at some point in this pattern. Further, when caregivers were at risk for clinical depression, as were 27% of those involved in the study, their patients were more than three times more likely to experience potentially harmful behavior, study findings indicated. How the study measured ?at risk for clinical depression? should be explored.

Once again we find that access to resources in one?s community can be the key to getting help before it?s too late. The original article appears here: Journal of the American Geriatrics Society, February 2005.

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