Annotated Bibliography
Elder Abuse and MentalHealth/Alzheimer's Disease/Dementia
October 2000

CANE (Clearinghouse on Abuse and Neglect of the Elderly) is the nation's largest and most utilized computerized collection of elder abuse materials and resources. With over 3,000 holdings, CANE has the ability to perform customized searches of over 100 keywords producing annotated bibliographies available to the professional community and to the public.

CANE is a service of the National Center on Elder Abuse (NCEA), which is supported by the U.S. Administration on Aging.

The following articles addressing elder abuse and mental health/Alzheimer's disease/dementia are available by request from CANE. Please be aware of each article's file number. The digits following the hyphen in the file numbers indicate the total number of photocopied pages. For example, if the file number is A78-11, then this article (number A78-11) is 11 pages in length. Articles of interest will be forwarded to you at a cost of $.20 per page.

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University of Delaware
Newark, DE 19716

PLEASE NOTE THAT A CHECK MADE OUT TO CANE-UD MUST ACCOMPANY YOUR ORDER. For further information on ordering materials, contact CANE at (302) 831-3525, or at CANE-UD@udel.edu .

1. A39-6
   Reifer, B., Cox, G., and Hanley, R.
   Problems of Mentally Ill Elderly as Perceived by Patients, Families and Clinicians
   The Gerontologist; Vol. 21 (2), 165-170, 1981
   
   Keywords: Caregiver-stress/burden
   
   This study investigates the similarity of elders' family members and clinicians assessment of the elders' mental impairment. Assessments of clinicians and family were similar, indicating that elders are often unaware of mental health problems or unwilling to report them. Implications for research based on elders' reports are addressed.
   
   
2. C2058-12
   Houlihan, J.
   Families Caring for Frail and Demented Elderly: A Review of Selected Findings
   Family Systems Medicine; Vol. 5 (3), 344-356, 1987
   
   Keywords: Caregiver-children, Caregiver-stress/burden, Alzheimer's/dementia
   
   This article focuses on the characteristics and burdens of the caregivers for the frail and demented elderly. Two types of caregivers are compared and contrasted with respect to intervention, and supportive programs for each type are discussed.
   
   
3. D2458-5
   Sweer, L., Martin, D., Ladd, R., et al
   The Medical Evaluation of Elderly Patients with Major Depression
   Journal of Gerontology: Medical Sciences; Vol. 43 (3), 53-58, 1988
   
   Keywords: Depression
   
   This article describes a study which determines the frequencies of abnormal findings on screening examinations in an elderly population hospitalized for major depression, the incidence of newly discovered medical problems, and the impact of those evaluations on diagnosis and treatment. Results show that elderly patients with major depression experience a great deal of morbidity due to unrecognized medical illnesses.
   
   
4. D2480-11
   Gubrium, J.
   Family Responsibilities and Caregiving in the Qualitative Analysis of the Alzheimers Disease Experience
   Journal of Marriage and the Family; Vol. 50, 197-207, 1988
   
   Keywords: Alzheimer's/dementia
   
   Following the trend of research on the caregiving side of Alzheimer's disease experience, field data are presented in illustration of the interpretive dynamics of the family responsibility. Four features are addressed: social comparison, issue contingency, family history and kinship priority. It is argued that qualitative analysis offers empirical lessons about family responsibility that remain untaught by other methods.
   
   
5. E2617-5
   Kinney, J. and Stephens, M.
   Caregiving Hassles Scale: Assessing the Daily Hassles of Caring for a Family Member with Dementia
   The Gerontologist; Vol. 29 (3), 328-332, 1989
   
   Keywords: Alzheimer's/dementia, Caregiver-family
   
   The Caregiving Hassles Scale was designed to assess the daily hassles of caring for a family member with Alzheimer's disease. Primary caregivers of AD patients completed the Caregiving Hassles Scale on two occasions to report on their own well-being. The 42 nd item on the scale provides a reliable and psychometrically sound instrument for assessing hassles associated with assistance in basic activities of daily living, assistance in instrumental activities of daily living, care-recipient's cognitive status, care-recipient's behavior and caregivers social network.
   
   
6. E2766-17
   Brody, E., Saperstein, A., and Lawton, M.
   A Multi-Service Respite Program for Caregivers of Alzheimer's Patients
   Journal of Gerontological Social Work; Vol. 14 (1/2), 41-73, 1989
   
   Keywords: Alzheimer's/dementia
   
   This paper describes the services and procedures of the Philadelphia Geriatric Center's multi-service respite service demonstration project for 305 caregivers of elderly Alzheimer's patients. Of all caregivers who were offered respite, 52% actually took advantage of the services, of those, two-thirds chose in-home services with smaller proportions using daycare and institutional respite. Advantages and disadvantages of several types of respite care were covered.
   
   
7. E2877-6
   Thompson, J., Pender, K., and Hoffman-Schmitt, J.
   Retaining Rights of Impaired Elderly
   Journal of Gerontological Nursing; Vol. 13 (3), 20-25, 1987
   
   Keywords: Health care, Alzheimer's/dementia
   
   Complex ethnological issues face nurses today, especially when dealing with the cognitively impaired person. This article reviews residents' rights in the long-term care setting, discusses issues of competency and decision making as they affect the nurse's role in health care planning and identifies an approach to solving these problem issues.
   
   
8. E2924-9
   Lund, D., Pett, M., and Caserta, M.
   Institutionalizing Dementia Victims: Some Caregiver Considerations
   Journal of Gerontological Social Work; Vol. 11 (1/2), 119-135, 1987
   
   Keywords: Caregiver-children, Alzheimer's/dementia
   
   The purpose of this study was to identify factors associated with caregivers' perceived likelihood of institutionalizing dementia victims. Forty-five primary caregivers of non-institutionalized victims completed questionnaires dealing with sociodemographic characteristics of the victim and caregiver, the level of impairment, and several variables related to the caregiving situation. Results are discussed.
   
   
9. F2954-5
   Linderborn, K.
   The Need to Assess Dementia
   Journal of Gerontological Nursing; Vol. 14 (1), 35-39, 1988
   
   Keywords: Alzheimer's/dementia
   
   This paper presents a model based upon a series of state-level initiatives in the Commonwealth of Pennsylvania for improving coordination between the aging and mental health systems to better serve elderly persons with mental health problems.
   
   
10. F3172-11
    Moritz, D., Kasl, S., and Berkman, L.
    The Health Impact of Living With a Cognitively Impaired Elderly Spouse: Depressive Symptoms and Social Functioning
    Journal of Gerontology; Vol. 44 (1), 17-27, 1989
    
    Keywords: Caregiver-spouse/partner, Depression
    
    The purpose of this study was to identify the social and psychological consequences of living with a cognitively impaired spouse among community-dwelling elderly individuals. It examines the relationship between level of cognitive functioning in one spouse and indicators of depressive symptomatology and social functioning in their partners.
    
    
11. H3306-6
    Reed, B., Stone, A., and Neale, J.
    Effects of Caring for a Demented Relative on Elder's Life Events and Appraisals
    The Gerontologist; Vol. 30 (20), 200-205, 1990
    
    Keywords: Caregiver-family, Caregiver-stress/burden
    
    This study examined the potential sources of distress for a caregiver when caring for a demented relative. It focused on two aspects of the caregiver's experience to identify if the responsibility of giving alters the rate of quality of non-giving activities and to see how caregiving changes events and thoughts. The caregivers reported more negative events and appraisals and rated these as more undesirable than did the control subjects, but did not differ on any positive events or appraisals.
    
    
12. H3309-4
    Weinberger, M., Gold, D., Divine, G., et al
    Expenditures in Caring for Patients with Dementia Who Live At Home
    American Journal of Public Health; Vol. 83 (3), 338-341, 1993
    
    Keywords: Alzheimer's/dementia
    
    This study compared the expenditures of caring for patients with dementia who live at home with those who reside in nursing homes. 141 primary caregivers of dementia patients who had been referred to a university-based memory disorders clinic were interviewed by clinic social workers. During follow-up interviews, caregivers spent on average 105 hours a week in caregiving activities. The average total expenditures were high and did not include opportunity costs. Nearly $1500 more per patient was expended annually for home-based care.
    
    
13. H3312-6
    Hamel, M., Gold, D., Andres, D., et al
    Predictors and Consequences of Aggressive Behavior By Community-Based Dementia Patients
    The Gerontologist; Vol. 30 (2), 206-211, 1990
    
    Keywords: Caregiver-stress/burden, Alzheimer's/dementia
    
    This study examined patient aggression from a sample of 213 community-based dementia patients, the caregivers' reaction to patient behavior, and the association between aggression and cognitive functioning in demented individuals. 57% of the patients were reported to be occasionally aggressive of which most aggression was cited as verbal. Higher levels of premorbid patient aggression and troubled premorbid relationships between the care-receiver and caregiver are predictors of patient aggression. Patient aggression predicted the decision to discontinue home care.
    
    
14. I3574-5
    Lusis, S., Hydo, B., and Clark, L.
    Nursing Assessment of Mental Status in the Elderly
    Geriatric Nursing; Vol. 14 (5), 255-259, 1993
    
    Keywords: Health care
    
    The purpose of this study was to identify common characteristics in patients who become acutely confused after admission to medical nursing units. Those who become delirious may have a longer length of stay, a higher mortality rate, and an increased risk of institutionalization. Delirium in an older person is often associated with an acute medical illness or drug reaction. Recent studies have underlying cognitive impairment. This study suggests that at this particular institution, the "young" older patient who is cognitively intact on admission is not likely to become confused while hospitalized for medical illness.
    
    
15. I3594-7
    Reese, D., Gross, A., Smalley, D., et al
    Caregiver's of Alzheimer's Disease and Stroke Patients: Immunological and Psychological Considerations
    The Gerontologist; Vol. 34 (4), 534-540, 1994
    
    Keywords: Caregiver-stress/burden
    
    Demands of caregiving for Alzheimer's Disease patients have been reported to affect psychological and immunological health of the caregivers. The question of whether the observed psychological and immunological changes were unique to AD caregivers was addressed in this study. The subjects were 25 caregivers of AD patients, 25 caregivers of stroke patients, and 25 noncaregiving individuals. Comparisons of all subjects made on several psychological and immunological indices indicated that the AD caregiving group was more psychologically distressed than a control group. With respect to immunological function, there were no differences among the three groups. Implications of the findings are discussed.
    
    
16. J3887-11
    Mittelman, M., Ferris, S., Shulman, E., et al
    A Comprehensive Support Program: Effect on Depression in Spouse-Caregivers of AD Patients
    The Gerontologist; Vol. 35 (6), 792-802, 1995
    
    Keywords: Caregiver-stress/burden, Alzheimer's/dementia
    
    Caregivers of Alzheimer's Disease patients often suffer from depression. Using a longitudinal treatment/control study, the effects of a comprehensive support program on depression in spouse-caregivers was studied. This psychosocial intervention program treats the primary caregiver and family members over the entire course of the disease through individual and family counseling, the continuous availability of ad hoc counseling, and support group participation. Results of the study suggest that enhancing long-term social support can have a significant impact on depression in caregivers.
    
    
17. J3946-4
    Jakubiak, C., and Callahan, J.
    Treatment of Mental Disorders Among Nursing Home Residents: Will The Market Provide?
    Generations; Winter 1995-1996
    
    Keywords: Health Care, Alzheimer's/dementia, Institutional care-abuse/neglect
    
    Mental disorders are common among nursing home residents with more than two-thirds having one or more psychiatric symptoms. Nursing homes have replaced state mental hospitals as the center of institutional care for older mentally ill and demented people. In the U.S., ninety-four percent of all institutionalized elderly people with a mental disorder receive their care in a nursing facility, though very little treatment was being provided. This study concluded that the prevalence of mental disorders is higher in independent for-profit and public facilities than in facilities that are part of a chain.
    
    
18. J4069-5
    Paveza, G., Cohen, D. Eisdorfer, C., et al
    Severe Family Violence and Alzheimer's Disease: Prevalence and Risk Factors
    The Gerontologist; Vol. 32 (4), 493-497, 1992
    
    Keywords: Alzheimers/dementia, Caregiver-family
    
    This study describes the prevalence of violence and the risk factors for violence in 184 Alzheimer patients and their primary caregivers living in the community.
    
    
19. K4185-4
    Coyne, A., Reichman, W., and Berbig, L.
    The relationship between dementia and elder abuse
    American Journal of Psychiatry; Vol. 150 (4), 643-646, 1993
    
    Keywords: Alzheimers/Dementia, Cargiver stress/burden
    
    This article focuses on a study that investigated the relationship between dementia and abusive behavior in a sample of demented patients and their family member caregivers in community settings. Abuse was investigated both by demented individuals toward their caregivers, and by caregivers toward the demented individual. Results suggest that psychological and physical demands of caregiving both contribute to abuse, and that abusing caregivers had been in the caregiving role for more years, were providing care for more hours each day, and were caring for more impaired individuals than nonabusing caregivers. Results also suggest a "cycle of violence," in which caregiver abuse is elicited in retaliation to violence by the care recipient.
    
    
20. K4186-7
    Kilburn, J.
    Network effects in caregiver to care-recipient violence: A study of caregivers to those diagnosed with Alzheimer's disease
    Journal of Elder Abuse and Neglect; Vol. 8 (1), 69-80, 1996
    
    Keywords: Alzheimers/Dementia, Caregiver stress/burden
    
    This article explores the relationship between caregiver support networks and violent feelings toward the care recipient. Data from studies conducted by Pillemer and Suitor of caregivers to family members with Alzheimer's disease were reanalyzed, and this article further investigates whether the structure of caregivers' social networks helps explain which caregivers are more likely to fear becoming violent toward their elderly care recipients.
    
    
21. K4210-9
    Bond, J., Cuddy, R., Dixon, G., Duncan,K., and Smith, D.
    The financial abuse of mentally incompetent older adults: A Canadian study
    Journal of Elder Abuse and Neglect: Vol. 11 (4), 23-38, 1999
    
    Keywords: Alzheimers/Dementia, Financial abuse/fiduciary, Canada
    
    Results of a pilot study on the financial abuse of mentally incompetent clients of the Office of Public Trustee, Manitoba, Canada are presented. The study sought to: 1)establish incidence of suspected financial abuse, 2) identify the characteristics of mentally incompetent older adults at risk, and 3) identify indictors of financial abuse. Women over the age of eighty were over-represented as victims of financial abuse. A list of financial abuse indicators is included as a potential reference for professionals and service providers.
    
    
22. K4240-6
    Ferguson, S. and Koder, D.
    Geropsychology: Some potential growth areas in psychological research and practice
    Australian Psychologist: Vol. 33 (3), 187-192, 1998
    
    Keywords: Alzheimer's/Dementia, Suicide, Depression, Australia, Caregiver stress/burden
    
    This article reviews the issues of depression, suicide, and management of behavioral problems due to dementia among the elderly. The article emphasizes the role of psychologists in identifying risk factors, creating treatments, and monitoring treatment effectiveness.
    
    
23. K4254-8
    Quayhagen, M., Quayhagen, M., Patterson, T., Irwin, M., Hauger, R. and Grant. I.
    Coping with dementia: Family caregiver burnout and abuse
    Journal of Mental Health and Aging: Vol. 3(3), 357-364, 1997
    
    Keywords: Alzheimer's/dementia, caregiver-children, caregiver-spouse/partner, caregiver stress/burden
    Caregiver burnout and abuse both by caregivers and patients are examined and reported in this study focusing on dementia. Qualitative interview data was collected from couples in an abusive situation, non-abusive couples on a level of deterioration, and healthy control couples. Differences between the groups and situations are discussed with regard to burnout, mental health, stress and coping strategies. Situations where the abuser is the patient are differentiated from those where the caregiver si the abuser and situational differences are discussed. Findings support the need for investigation of abuse and possible early intervention to decrease the impact of progressive deterioration.
    
    
24. K4262-4
    Dyer, C., Pavlik, V., Murphy, K. and Hyman, D.
    The high prevalence of depression and dementia in elder abuse or neglect
    Journal of the American Geriatrics Society: Vol. 48(2), 205-208, 2000
    
    Keywords: Depression, Alzheimer's/Dementia
    
    This study describes the characteristics of patients experiencing abuse or neglect referred to an urban geriatric assessment and treatment center, and compares the prevalence of depression and dementia in these patients with that of patients referred to the geriatric program for other reasons. It was hypothesized that depression, as well as dementia, could be significant risk factors for abuse or neglect.
    
    
25. K4261-4
    Compton, S., Flanagan, P., and Gregg, W.
    Elder abuse in people with dementia in Northern Ireland: Prevalence and predictors in cases referred to a psychiatry of old age service.
    International Journal of Geriatric Psychiatry: Vol. 12(6), 632-635, 1997
    
    Keywords: Alzheimer's/Dementia, Europe, Caregiver-children, Caregiver spouse/partner
    
    This study examines whether or not there exists a difference in caregiver and patient characteristics between abused and non-abused populations of community-dwelling older persons patients with dementia. Conclusions do not support other research findings that caregiver characteristics such as financial dependence, criminal or psychiatric history, lifestyle changes, and/or substance abuse were associated with elder abuse. Results of this study suggest that elder abuse is associated closely with aspects of the patient/caregiver relationship.