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How to Identify Alzheimer's Patient Abuse

Guest Author - Debbie Mandel

One of the most difficult questions I am asked concerns the sensitive subject regarding Alzheimer’s patients and abuse by hired caregivers. Basically, the family and friends of the Alzheimer’s patient want to know, “How can I tell if the bruises on my loved one are accidental or due to physical abuse?” Because caregivers, especially those who are not specifically trained to deal with Alzheimer’s, can get overwhelmed, they might be too forceful with the patient in their care, ranging from a firm squeeze to a harsh slap.

Caregivers have to manage their own stressors in addition to the patients’. Some caregivers need the money and so commit to working with an Alzheimer’s patient for extra hours, more than they can emotionally and physically handle. Not only do they suffer, but imagine how the Alzheimer’s patient absorbs the caregiver’s stress and burn out. As a result, an Alzheimer’s patient might act out on a hallucination, shout, cry, or adamantly refuse to eat or be bathed.

It is a delicate balance to be professional and humane at the same time. When my mother was in the nursing home in her late stages, she had a wonderful LPN, Dorothy. Since I went to visit her regularly, I would see Dorothy laughing with the patients. Then for a whole month I did not see Dorothy. Upon her return, I naturally inquired. Dorothy explained that she had been on a month’s paid leave because an Alzheimer’s patient bit her on the arm and the wound became seriously infected. Dorothy spoke compassionately about the patient. The patient had pulled her pants down which bunched at her ankles causing her to trip and about to fall. Dorothy rushed from across the day room to put her arms around her from behind to hold her up. Unfortunately, the woman got scared, imagined that she was being attacked from behind and bit Dorothy very hard. From the patient’s point of view, this made a lot of sense. If Dorothy had not been in a professional state of mind, she might have struck the patient like a reflex action. Fortunately, this was not the case as Dorothy was in control over her stress – using humor and spirituality as coping skills.

So how can you tell whether it is a fall, or an accidental bruise and not an injury inflicted by a caregiver – when you are not around to monitor your loved one?
  • Ask the patient as though he or she were not suffering from dementia. Point to the injury and listen attentively for verbal and physical cues.
  • Observe how the patient interacts with the caregiver. Is there fear, even a subtle intimidation?
  • Ask the caregiver for the details about how it happened.
  • Go with your gut feeling!
  • Take the elderly patient to the doctor, and if you can, involve a geriatric psychiatrist to check out both the patient and the caregiver.
  • Do spot checks – coming unannounced and at unexpected times.
  • Let go of the guilt. You are human and doing the best you can to protect your loved one.

For more information on caregiving read my book, Changing Habits: The Caregivers' Total Workout. To listen to archived radio shows with guest experts visit Turn On Your Inner Light Radio Show





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Content copyright © 2014 by Debbie Mandel. All rights reserved.
This content was written by Debbie Mandel. If you wish to use this content in any manner, you need written permission. Contact BellaOnline Administration for details.

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