African-American caregivers’ perspectives on aggressive behaviors in dementia

Abstract

Purpose Although African-American dementia caregivers report less upset and more confidence managing aggressive behaviors when compared to whites, their contextual experience remains unclear and this study explores that context. Methods Semi-structured interviews with 13 African-American family caregivers were analyzed using content analysis. Results Two themes emerged, "It's the disease…not the person" and "You got to pick your battles." "It's the disease…not the person," reframing aggressive behavior, included three sub-themes. Sometimes the person with dementia seemed like a stranger but caregivers remembered "In there somewhere is that person." Aggressive behavior made this perspective difficult as they reported, "Sometimes it's hard not to take it personal." Premorbid dyadic conflict made caregiving difficult but caregivers remembered they were "Not who they were then." "You got to pick your battles," reflecting cognitive and behavioral strategies, also included three sub-themes. Participants prioritized caregiving over other commitments by reminding themselves "I got to do what I gotta do." Preventing aggressive behaviors was most successful when "We didn't argue…we didn't insist" and caregivers remembered "Don't put her in a position to fail" when involving the person with dementia in activities. Implications African-American caregivers described substantial challenges when confronted by aggressive behaviors. Strategies employed by caregivers enabled them to maintain a caring perspective and the person with dementia to maintain calm. Interventions that help caregivers manage aggressive behaviors may benefit by considering the challenges, cultural values, and effective strategies used by African-Americans.

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“…Additionally, there was some concern that demographic characteristics of staff may play a role in measurement quality. In a study exploring the caregivers' perspectives of BPSD episodes experienced by older adults diagnosed with dementia, findings report that African-American caregivers report less upset and more confidence in managing aggressive behaviors when compared to white caregivers (Hansen, Hodgson and Gitlin, 2018). Different cultures' varying perceptions, as a care provider of residents with dementia, could play a role in the number of reported, or underreported, BPSD episodes, which would alter the total documented episodes, as conducted in the present study.…”

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“…Foi possível observar que não há um ano mais frequente, os estudos são diversos em relação a isso, sendo um 2010, (12) um de 2011, (13) um de 2018 (14) e o mais recente de 2019. (15) Em relação aos países mais recorrentes nas revistas de publicação, evidencia-se os Estados Unidos da América.…”