Elder Abuse Caregiver Caregiver Caregiver Caregiver Stress

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To learn more about preventing abuse by                     Family Caregiver Alliance                                 To learn more about elder abuse and
caregivers:                                                                                                           how to report it:
                                                            www.caregiver.org
     A Model Intervention for Elder Abuse and                 A national information center and pioneer in the
Dementia. This curriculum was designed for workers                                                                    www.elderabusecenter.org
                                                              development of caregiver services. FCA’s website          The National Center on Elder Abuse
in the field of adult protective services and Alzheimer’s
                                                              provides a wealth of information and online services      1225 I Street NW, Ste. 725
Association personnel. It contains referral protocols to      for caregivers.
improve communication and promote cooperation                                                                           Washington, DC 20005
among organizations that provide services to caregivers
and those that provide protective services. It also
                                                               690 Market Street, Ste. 600
                                                               San Francisco, CA 94104
                                                                                                                        Phone: (202) 898-2586
                                                                                                                        Email: NCEA@nasua.org
                                                                                                                                                                                           A Fact Sheet On
includes assessment guidelines to help professionals           Phone: (415) 434-3388
identify individuals and families at risk. For more
information contact:
     Office of Geriatric Medicine/Gerontology
     Northeastern Ohio Universities
                                                               Email: info@caregiver.org

                                                            Alzheimer’s Association
                                                            www.alz.org
                                                                                                                      National Committee for the Prevention of Elder
                                                                                                                      Abuse
                                                                                                                      www.preventelderabuse.org
                                                                                                                        1101 Vermont Ave. NW, Ste. 1000
                                                                                                                                                                                          Caregiver
                                                                                                                                                                                              Stress
     College of Medicine                                      The largest national voluntary health organization        Washington, DC 20005
     P.O. Box 95                                              committed to finding a cure for Alzheimer’s disease       Phone: (202) 682-4140
     Rootstown, OH 44272                                      and helping those affected by it. State and local         Fax: (202) 682-3984
     (330) 325-6359                                           chapters provide services to people with the              Email: ncpea@erols.com
     Fax: (330) 325-5907                                      disease’s, their families and caregivers, and health
     Email: brp@neoucom.edu                                   care professionals. The Alzheimer’s Association’s       To find out about services in your community:
                                                              website contains a section for caregivers, that

                                                                                                                                                                                                     and
Preventing Stress from Becoming Harmful: A Guide                                                                      Area Agencies on Aging (AAA) provide or coordinate
                                                              includes resource directories, instructions in
for Individuals Who Care for Persons with Dementia.                                                                   services for the elderly and their families. They also
                                                              behavior management, and information about the          provide information on a variety of issues of concern to
This handbook, available from the Office of Geriatric         disease and its treatment.
Medicine/Gerontology (see above), is a self-assessment                                                                the elderly and caregivers, and help seniors and their
guide to help caregivers identify their own risk of            919 North Michigan Ave., Ste. 1100                     families gain access to services. Look in the city or
becoming abusive and offers suggestions for lowering           Chicago, IL 60611-1676                                 county government section of the telephone directory
                                                               Phone (800) 272-3900                                   under “Aging Services” or “Social Services.” You can


                                                                                                                                                                                          Elder
risk. The handbook is available in English and Spanish
versions.                                                                                                             also get the number from the Eldercare Locator at
                                                            National Aging Information Resource Center                (800) 677-1116.
To learn more about dementia and caregiving:                www.aoa.gov/NAIC/Notes/caregiverresource.html
AARP                                                          Operated by the Administration on Aging of the U.S.
                                                              Department of Health and Human Services, this site                  Equal Opportunity Employer/Program



                                                                                                                                                                                             Abuse
www.aarp.org/statepages/az.html                               includes information on government-sponsored            Under the Americans with Disabilities Act (ADA), the
  The nation’s leading organization for people over           resources, national caregiver organizations, articles   Department must make a reasonable accommodation to allow
  the age of 50. The organization has produced a              and links to other sites.                               a person with a disability to take part in a program, service, or
  variety of publications on caregiving, many of which                                                                activity. For example, this means that if necessary, the



                                                                          STOP
  are available on its website, including A Caregiver                                                                 Department must provide sign language interpreters for people
  Guide of Information and Resources (Document #                                                                      who are deaf, a wheelchair accessible location, or enlarged
  D16697):                                                                                                            print materials. It also means that the Department will take
                                                                                                                      any other reasonable action that allows you to take part in and
                                                                                                                      understand a program or activity, including making reasonable
   Arizona State Office                                                                                               changes to an activity. If you believe that you will not be able
   302 North 1st Ave., Ste. 410                                    ADULT ABUSE, NEGLECT                               to understand or take part in a program or activity because of
   Phoenix, AZ 85003
   (602) 256-2277                                                    AND EXPLOITATION                                 your disability, please let us know of your disability needs in
                                                                                                                      advance if at all possible. This document is available in
   Fax: (602) 256-2928                                                                                                alternative formats by contacting 602-542-4446. Disponible
                                                                                  CALL                                en español en la oficina local.
   Tucson Information Center
   5055 E. Broadway, Ste. B-105                               1-877-SOS-ADULT
   Tucson, AZ 85711
   (520) 571-9884
                                                                        1-877-767-2385
   Fax: (520) 571-9832                                                TDD 1-877-815-8390                                                   AAA-1040APAMNA (10-02)                          Aging -If it’s not your issue...
                                                                                                                                                                                                     it will be.
M
          ost people who need help with daily activities         caregiver is at greater risk for infections and disease.            Experiences emotional and mental “burnout,”               assistance with most daily activities. Caregivers
          as a result of a disabling condition or illness        Some experts believe that stress causes hypertension,               anxiety or severe depression                              who cannot afford to hire helpers may qualify for
          get the care they need from family members             coronary disease or even premature death.                           Feels “caught in the middle” by providing care to         public assistance.
or friends. Some receive help from paid caregivers who                                                                               children and elderly family members at the same           Plan for the future. Careful planning can relieve
work for agencies or independently. Despite the                  Do all caregivers experience stress?                                time                                                      stress by reducing uncertainty, preserving
significant physical and emotional demands of providing                                                                                                                                        resources and preventing crises. A variety of
care, the overwhelming majority of caregivers are                      Some stress is normal. In the past, it was believed           Has “old anger” toward the care receiver that can
                                                                 that the more care a person provided the more likely he             be traced to their relationship in the past               instruments exist to help plan for the future
meeting the challenge; many are doing an excellent job.                                                                                                                                        including powers of attorney, advanced directives
But reports of abuse by caregivers are not uncommon              or she was to experience stress. Now it is known that
                                                                 not all caregivers are created equal. Some, who provide                                                                       for health care, trusts and wills.
and appear to be on the rise. This fact sheet responds                                                                         The care receiver:
to frequently asked questions about caregiver stress             high levels of care, experience no stress, while others
and abuse.                                                       who provide relatively little care experience high levels           Is aggressive or combative                           Agencies can:
                                                                 of stress. Many experts believe that these differences              Is verbally abusive                                       Carefully screen caregivers and patients for the
                                                                 can be explained by subjective factors such as how
What is a caregiver?                                             caregivers feel about providing care, their current and             Exhibits disturbing behaviors such as sexual              risk factors associated with caregiver abuse.
     The term refers to anyone who routinely helps               past relationships to those they care for, and their coping         “acting out” or embarrassing public displays              Provide caregivers with information and support
others who are limited by chronic conditions. “Formal”           abilities. Some caregivers find certain behaviors by                                                                          to lower their risk.
caregivers are volunteers or paid employees connected            care receivers to be particularly stressful, including        The caregiver and the care receiver:                            Provide instruction to caregivers (through
to the social service or health care systems. The term           aggression, combativeness, wandering and                            Live together                                             materials, classes, websites or support groups)
“informal caregiver” refers to family members and                incontinence. Others report that they experience stress                                                                       in conflict resolution and how to deal with difficult
friends, who are the primary source of care for nearly           because they don’t get enough rest, privacy, support or             Had a poor relationship prior to the onset of the         behaviors such as violence, combativeness and
three-quarters of the impaired older adults who live in          time for themselves.                                                illness or disabling condition                            verbal abuse.
the community. Caregivers assist with such basic task                                                                                Are married and have a marital relationship that
as bathing, dressing, preparing meals and shopping.                                                                                                                                            Promote better coordination between agencies
                                                                 Are all “stressed caregivers” at risk for                           is characterized by conflict                              that offer protection to victims and those that offer
Some have the added responsibilities of administering            becoming abusive?
medications, making sure that an immobile person is                                                                                                                                            services to caregivers. This can be achieved
turned frequently to avoid developing pressure sores,                 It is true that some of the same factors that are        What can be done?                                               through cross-disciplinary training, interagency
and other tasks related to the older person’s illness or         believed to cause caregiver stress also raise the risk of                                                                     protocols and multidisciplinary teams.
                                                                                                                               Reducing the risk of elder abuse by caregivers will
disability.                                                      abuse. For example, when the relationship between a           require the efforts of caregivers, agencies and the
                                                                 caregiver and care receiver was poor to begin with, the       community.                                                 Concerned citizens can:
How large a problem is abuse by                                  caregiver is more likely to feel stress and to become
                                                                 abusive. But the link between caregiver stress and                                                                            Lend a hand to a caregiver who needs help.
caregivers?                                                      abuse is not yet fully understood, and more research is
                                                                                                                               Caregivers can:
                                                                                                                                                                                               Report abuse. In most communities, Adult
     Although it is known that in 90% of all reported elder      needed to understand what factors predict or contribute             Get help. Making use of social and support                Protective Services (APS) is the agency that
abuse cases the abuser is a family member, it is not             to caregiver abuse. Specific areas that need to be                  services, including support groups, respite care,         accepts and investigates reports. Look in the city
known how many of these abusive family members are               explored include how aggression by care receivers                   home delivered meals, adult day care and                  or county government section of the telephone
also caregivers. Researchers have estimated that                 raises the risk of abuse, why some caregivers fear that             assessment services, can reduce the stress                directory under “Aging Services” or “Social
anywhere from 5% to 23% of all caregivers are                    they will become abusive, whether caregivers who are                associated with abuse.                                    Services,” or contact local Area Agencies on
physically abusive. Most agree that abuse is related to          afraid of becoming abusive are more likely to actually              Learn to recognize their “triggers,” those factors        Aging.
the stresses associated with providing care.                     abuse, and how caregivers’ coping patterns play a role.             that cause them the greatest stress or anxiety.           Advocate for public policy to increase the supply
                                                                                                                                     Learn to recognize and understand the causes              and scope of services available to caregivers.
What is caregiver stress and why is it                           Are there “red flags” to watch for?                                 of difficult behaviors and techniques for handling        Volunteer. Volunteers can make friendly visits,
harmful?                                                              Drawing from what is currently known about                     them more effectively.                                    serve as guardians or bill payers, or provide
      Stress is often described as the body’s “fight or          caregiver abuse, the following factors may be cause                 Develop relationships with other caregivers.              respite care.
flight” response to danger. When the body goes on “high          for concern:                                                        Caregivers with strong emotional support from             Arrange to have speakers make presentations
alert” to protect itself, essential functions like respiration                                                                       other caregivers are less likely to report stress         on caregiving at churches, clubs or civic
and heart rate speed up, while less essential functions,         The caregiver:                                                      or to fear that they will become abusive.                 organizations.
such as the immune system, shut down. Although the                      Fears that he or she will become violent                     Get healthy. Exercise, relaxation, good nutrition
stress response is a healthy reaction, the body needs                                                                                and adequate rest have been shown to reduce
to repair itself once danger is removed. For caregivers,                Suffers from low self esteem
                                                                                                                                     stress and help caregivers cope.
whose stress often results from fatigue and conflicts                   Perceives that he or she is not receiving
that never go away, their bodies never get a chance to                  adequate help or support from others                         Hire helpers. Attendants, chore workers, home-
heal. If the immune system isn’t functioning fully, the                                                                              makers or personal care attendants can provide
                                                                        Views caregiving as a burden