What would help me stop abusing? The family carer's perspective.

BACKGROUND

A third of family members caring for people with dementia report acting abusively towards them, but there are currently no evidence-based interventions to reduce or prevent such behavior. Family carers who act abusively have not previously been consulted about what may help to reduce abuse.

METHOD

We prospectively recruited a consecutive sample of 220 family carers of people with dementia referred to secondary psychiatric services. We asked carers who reported any abusive behavior in the previous three months to select from a list of services and potential interventions those that they thought might help to reduce or prevent this abusive behavior. Carers were also asked to suggest other interventions that might help prevent abuse.

RESULTS

113/115 carers who reported any abusive behavior answered questions about possible interventions. The three most frequently endorsed interventions were: medication to help the care recipient's memory (n = 54; 48.2%); written advice on understanding memory problems and what to do (n = 48; 42.9%) and more information from professionals caring for the person with dementia (n = 45; 40.2%). When asked which interventions were most important, medication to help memory (n = 21; 18.6%), home care (n = 17; 15.0%), residential respite and sitting services (both n = 12; 10.6%) were most frequently endorsed.

CONCLUSION

To prevent abuse, family carers prioritized medication for memory, good communication from professionals, written advice on memory problems, home care, residential respite and sitting services. As no interventions to reduce abuse by family carers have yet been formally evaluated, a good starting point may be the expressed wishes of family carers.