Abuse of people with Alzheimer's disease by family caregivers: A Review

In the world today, health care systems are confronted with the phenomenon of population movement toward aging. Alzheimer's is a growing disease, and aging is considered an important risk factor. Family caregivers face many challenges in caregiving that make them more susceptible to abuse the person with Alzheimer's. Considering to the needs and quality of life of caregivers and people with Alzheimer's is an important issue. The purpose of this study is to increase awareness in this regard by presenting relevant factors and investigating preventive factors and improving situation.

In this review study, the literature has been systematically searched using articles in English-language databases Web of Science, Pubmed, Scopus, and Persian-language databases SID and Magiran from the beginning to 2019. The keywords Alzheimer's, family caregiver, dementia, abuse and violence and their equivalent in Persian were used in this search. According to the inclusion and exclusion criteria, the articles were selected and entered into the study.

A systematic review of 86 articles was selected. 17 articles were eligible to enter the study. The findings of this study showed that in Asian countries, the overall abuse rate among Alzheimer's patients was between 1.6% and 62.3%, mental abuse between 9.7% and 62.3% and physical abuse between 1.6% and 18%. In Western countries, overall abuse was reported between 5.4% and 51%, psychological abuse between 3.5% and 51% and physical abuse reported between 1.5% and 20%. Different factors are influenced by the caregiver (increased burden of care, depression, anxiety, social level and increased time of care) as well as factors by the caregiver (mental disorder, memory impairment and increased need for ADL).

The results show that by recognizing this issue and its effective factors in a timely manner and implementing programs to increase the ability and resilience of caregivers of Alzheimer's patients to meet the challenges encountered during care and implementing rehabilitation programs for people with Alzheimer's disease can be an important step in preventing abuse and improving conditions and thereby improve the quality of life of caregivers and people with Alzheimer's disease.
Keywords: Alzheimer's; family caregivers; abuse; systematic review