Associated factors of discrepancy between older adults and their family caregivers in reporting elder abuse

Aims and objectives: This study focuses on elder abuse against older adults with mild-to-moderate cognitive and physical impairment who were receiving family care in Chinese context. Specifically, the study examined the associated factors of discrepancy between family caregiver and care recipient reports of elder abuse committed by the caregivers. Background: Many studies identified the discrepancies between caregivers and care recipients reports of elder abuse, but they did not examine factors contributing to such discrepancies. Various cultural factors may contribute to the accuracy of elder abuse reports. Methods: A consecutive sample of 1,002 older adults with mild-to-moderate cognitive and physical impairment and their family caregivers was surveyed. Design: Quantitative study with cross-sectional design. Results: Moderate-to-substantial agreement in caregiver and care recipient reports was found for all forms of abuse (Cohen’s kappa = 0.39 to 0.76). Care recipient reports consistently generated higher rates than caregiver reports for psychological abuse (51.1% vs. 42.8%), physical abuse (1.2% vs. 1.0%), caregiver neglect (65.0% vs. 50.2%) and financial exploitation (40.8% vs. 34.2%). Similar factors were found for dyadic discrepancy in the reporting of various forms of elder abuse, which included desire to gain face, fear of losing face and sense of familism in the caregivers, as well as older age, cognitive impairment and female gender of the care recipient. This study was presented in adherence to the Strobe Checklist. Conclusions: The results suggest that family caregivers might not be reliable as the sole informants to report their care recipients’ victimization experiences. Information from multiple parties should be gathered and synthesized to obtain more accurate reporting of the frequency and severity of elder abuse. Meanwhile, cultural factors should be taken into account when seeking information related to elder abuse. Relevance to clinical practice: There is a need for multiple parties to provide and report information about the elder abuse. It is also need to consider cultural factors when detecting and intervening elder abuse.