A case of undue violent behavior associated with Alzheimer's disease

Violence against caregivers of older adults with chronic diseases is associated with caregiver burden and depression: a cross-sectional study

BACKGROUND

Caregivers play a vital role in caring for the aging population, however the occurrence of violence against the caregiver is an increasing area of concern. This study aimed to investigate the prevalence of violence against the primary caregivers of community dwelling older adults with chronic diseases, and to determine the factors associated with violence and its association with caregiver outcomes.

METHODS

A cross-sectional study was conducted. HITS questionnaire, the 22-item Zarit Burden Interview and Patient Health Questionnaire-9 were used to assess violence against caregiver, caregiver burden and depression, respectively.

RESULTS

Out of 123 caregivers of older adults, the overall prevalence of violence was 28.46%. Independent variables which could be the protective factors for violence against caregiver included higher ADL, older age of caregiver, and being a relative. The patient characteristic that is a potential risk factor for violence against caregiver was having cancer as a principal diagnosis. Statistically significant associations were found between violence and caregiver burden (aOR 4.94, p 0.004) and depression (aOR 7.03, p 0.006).

CONCLUSION

Violence against caregivers of older adults is not uncommon. Experiencing violence was found to be associated with caregiver outcomes including depression and caregiver burden. Therefore, this important issue must not be ignored.

Health Care Redesign for Responsive Behaviours—The Behavioural Supports Ontario Experience: Lessons Learned and Keys to Success

Our health care system is ill prepared for the growing number of older adults and their families/caregivers who live with responsive behaviours associated with cognitive impairment. Considering the burden of illness, quality of life issues, and escalating costs, system-wide redesign is warranted. The Behavioural Supports Ontario (BSO) project is a province-wide, regionally implemented, evidence-informed change strategy that utilizes quality improvement principles and knowledge translation best practices as critical enablers. This paper describes the project and key lessons learned in the implementation of this initiative that can be applied to other jurisdictions wishing to enable large-scale system redesign and sustainable system change.