Abstract
BACKGROUND: There have been no studies of the relationship between violent behavior by older patients and the physical and mental health of caregivers. OBJECTIVE: To evaluate the influence of violent behavior in vulnerable elderly patients on bodily pain and caregiver burden in their informal caregivers. DESIGN: Cross-sectional study. SUBJECTS: One hundred thirty-seven patients aged > or =40 years old with limited activity and mobility in ten facilities providing home-care services in Japan. MEASUREMENTS: Degree of caregiver-perceived violent patient behavior and caregivers' bodily pain derived from a self-administered questionnaire, and caregiver burden assessed using scores from both the Burden Index of Caregivers and the Zarit Burden Interview. RESULTS: The mean age of the 137 patients enrolled in this study was 80.9 years. Of these patients, 31.4% were men, and 34.3% had violent behavior. The mean caregiver age was 65.0 years, and 29.2% were men. Caregivers who looked after violent patients experienced significantly higher odds of having bodily pain [AOR = 3.51; 95% confidence interval (CI): 1.81 to 6.85]. Caregivers of violent patients also reported significant caregiver burden as assessed by the Burden Index of Caregivers (beta-coefficient = 4.92; 95% CI: 1.95 to 7.88) and the Zarit Burden Interview (beta-coefficient = 5.81; 95% CI: 2.92 to 8.70). CONCLUSIONS: Violent behavior among older patients is associated with significant increases in both physical and psychological burden in their informal caregivers.