衰老科学杂志

抽象的

Changes in Conflict Resolution Style over Time: The Risk for Persons with Alzheimer's Dementia

VandeWeerd C, Paveza G, Estefan L and Corvin J

Background: Elder mistreatment is a serious issue affecting between 300,000 and 800,000 older adults. Elder mistreatment has serious consequences for older adults and can include immunological dysfunction, increased mortality and emotional difficulties such as depression, feelings of inadequacy and self-contempt. Sub-groups such as persons with Alzheimer’s disease have heightened risk for elder mistreatment, but it is not clear whether this heightened risk represents life-long patterns of abuse between persons or whether they represent a change in conflict style over time as a result of changes associated with dementia.

Methods: Data analyzed in this study were collected as part of the Aggression and Violence in Community Based Alzheimer’s Study [AV-CAD] and represents patient caregiver/dyads who received care at one of five state funded medical clinics or who belonged to one of three local chapters of the Alzheimer’s Association. Data were collected via in-person interview and mailed survey, and changes in conflict resolution style (reasoning, verbal aggression and violence) pre and post dementia were measured using the Conflict Tactic Scale (CTS) and analyzed using McNemar’s Test.

Results: Reasoning was used as a conflict resolution style in 91.4% of caregivers and 89.3% of elders prior to the onset of dementia and in 66.3% of caregivers and 45.3% of elders in the past year (post dementia diagnosis). Reasoning in the post dementia period was significantly related to use of reasoning in the pre dementia period for caregivers (X2=7.47, p=.0032) and approached significance for elders (X2=6.00; p=.057). Use of verbal aggression (VA) and violence (V) as a conflict resolution style post dementia was higher for both caregivers (VA: 59.3%; V: 16.8%) and elders (VA: 68.7%; V: 24%), but was not significantly related to behaviors in the pre-dementia period for caregivers (V: X2=1.55, p=.536; VA: X2=0.67, p=.528) or elders (V: X2=0.54, p=.628; VA: X2=0.43, p=.621)

Conclusions: This study lends support to the idea that elder abuse in a large number of persons with Alzheimer’s disease may be in part a result of the etiology of the disease and is susceptible over time. Implications for policy, practice and future research are discussed.