Recognising Abuse in an MS Care Giving Relationship.

None of us would like to think that we would abuse a
vulnerable loved one but the fact is, it happens. In this first article about abuse in a caregiving relationship I will outline the types of abuse that can happen to that vulnerable person in your life.

 

Introduction

 

In many cases, living with MS leads family members to be even more appreciative and attentive to each other but families are not always able to maintain a positive adjustment to MS – sometimes the relationship between a person with MS and their family caregiver can deteriorate so that the relationship becomes abusive.

 

 

This can happen for any number of reasons including

• The physical or emotional stress
  of the caregiver,
• The difficulty of the person with
  MS to adjust to increasing disability
• Difficulties that the spouse or
  partner caregiver may have in managing both the intimate aspects of their
  relationship and caregiving needs ( which may include bowel and bladder
  management)
• Dealing with cognitive
  dysfunction.- it can be very frustrating to the caregiver when a seemingly
  normal adult doesn’t seem to know what’s going on in their life

 

Caregiver stress is an internal experience that can result from the physical or emotional burden of caregiving. When a caregiver
responds to that stress and isolation by inflicting harm on the person with MS they care for, it becomes abuse.

 

Different types of abuse

 

Abuse can be split into a number
of different types:

 

• Adult physical abuse – substantial physical injury
  experienced by an adult that result from cruel and inhumane treatment or an
  intentionally harmful act committed by any person.
• Sexual abuse – any form of forced sex or sexual
  degradation. This includes forcing an individual to participate in or observe
  sexual behaviours.
• Emotional abuse – this is the most difficult form
  of abuse to concretely define or detect  but it is generally considered the most
  harmful because of the long-term effects
• Neglect – failure of a
  responsible person to provide a minimal
  level of care includes health, nutrition, shelter, supervision, affection or
  attention.
• Exploitation and theft – misappropriation of money or
  property, theft, and coercion to sign legal documents that benefit the
  offender.

 

In a study of people with MS at the Mellen MS Center, Dr Jack Conomy and colleagues concluded that “. . . domestic violence among persons with MS appears common [and] . . . no age, race, gender, or socioeconomic group of people with MS is immune from personal violence.”

 

No one living with MS is immune to the possibility of abuse. There is little doubt that people with MS are victims of neglect or
violence, but the extent is not clearly known. We believe that the pattern of abuse in families with a history of domestic violence (pre-dating the MS diagnosis) will continue and may escalate as the disease worsens. Just as importantly, families with no previous history of domestic violence may find themselves in abusive relationships as a result of the stresses of living with
MS.

 

When family, friends or health care professionals are concerned about the potential for abuse or neglect in a family living with MS,
the first step is to acknowledge concern. Try empathising with the caregiver by saying something such as “Everyone has a limit as to how much stress and responsibility they can take – how close do you think you are to your limit?”,

 

Since the laws around reporting neglect and abuse differ between countries, it is important that family members and health care
professionals understand their responsibilities and know the relevant authorities to contact if they have any concerns.

Tags:cognitive dysfunction,emotional abuse,emotional burden,emotional stress,inhumane treatment,sexual abuse,sexual degradation,vulnerable person