Violent Patient Behavior Is Associated with Bodily Pain and a High Burden on Informal Caregivers

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 ≥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 (β-coefficient = 4.92; 95% CI: 1.95 to 7.88) and the Zarit Burden Interview (β-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.