Screening for abuse and neglect of people with dementia.
OBJECTIVE
To investigate characteristics of people with dementia and their caregivers (CGs) that are associated with mistreatment in order to inform clinicians about screening for mistreatment.


METHODS
A convenience sample of CG-care recipient (CR) dyads were assessed for literature-supported factors associated with mistreatment, and evidence of mistreatment for the prior year was collected. An expert panel considered the evidence and decided on occurrences of psychological abuse, physical abuse, and neglect based on criteria adopted before data collection.


METHODS
Participants' homes.


METHODS
One hundred twenty-nine persons with dementia and their CGs.


METHODS
CG and CR characteristics (demographic, health, and psychosocial variables), relationship characteristics, and three elder abuse and neglect detection instruments.


RESULTS
Mistreatment was detected in 47.3%. Variables associated with different kinds and combinations of mistreatment types included the CG's anxiety, depressive symptoms, social contacts, perceived burden, emotional status, and role limitations due to emotional problems and the CR's psychological aggression and physical assault behaviors. The combination of CR's physical assault and psychological aggression provided the best sensitivity (75.4%) and specificity (70.6%) for elder mistreatment as defined by the expert panel. This finding has potential to be useful as a clinical screen for detecting mistreatment.


CONCLUSIONS
The findings suggest important characteristics of older adults with dementia and their CGs that have potential for use in a clinical screening tool for elder mistreatment. Potential screening questions to be asked of CGs of people with dementia are suggested.
Wiglesworth
Aileen
A
Program in Geriatrics, School of Medicine, 101 The City Drive South, Orange, CA 92868-3298, USA.
Mosqueda
Laura
L
Mulnard
Ruth
R
Liao
Solomon
S
Gibbs
Lisa
L
Fitzgerald
William
W
D000368:Aged; D000704:Analysis of Variance; D002140:California; D017028:Caregivers / Q000523:psychology; D003430:Cross-Sectional Studies; D003704:Dementia / Q000523:psychology; D004552:Elder Abuse / Q000517:prevention & control* / Q000706:statistics & numerical data; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D012372:ROC Curve; D018570:Risk Assessment; D012680:Sensitivity and Specificity