Homicidal ideation in family carers of people with dementia

Abstract

Objective: Family carers of people with dementia have higher than average rates of suicidal ideation, but there has been no research on homicidal ideation in this population. The aim of this study was to explore thoughts of homicide in family carers of people with dementia.

Method: A descriptive qualitative approach was taken. Twenty-one Australian carers (7 men, 14 women) participated in individual, in-depth interviews and the transcripts were analysed thematically.

Results: Seven themes were identified in the data – active thoughts of homicide; understanding homicidal thoughts in others; passive thoughts of death; euthanasia; homicidal thoughts in other caregiving situations; abuse; and disclosing thoughts of harm. Two of the 21 participants had actively contemplated the homicide of their care recipient, four expressed a passive desire for the care recipient's death, and four reported physically or verbally abusing the care recipient. Only one carer had previously disclosed these experiences.

Conclusion: Homicidal ideation is a real and significant phenomenon among family carers of people with dementia. Service providers and health professionals are encouraged to identify and support carers contemplating homicide, but to do so in a way that recognises the broader social context of carer burden.

Keywords:

• caregivers
• dementia
• homicide
• euthanasia
• abuse

Acknowledgements

Dr Siobhan O'Dwyer was supported by a Fellowship from the Dementia Collaborative Research Centres when this study was conducted and the first draft of this paper was written while Dr O'Dwyer was on a writing retreat. Dr O'Dwyer would like to thank Dr Sarah Pinto, Dr Sharon McDonough, and the State Library of Victoria for providing quiet writing space and intellectual support. The authors would like to acknowledge Candice Loopstra's assistance in developing the interview protocol and preparing the risk assessment and risk response components of the protocol. Finally, and most importantly, the authors extend their thanks and respect to the carers who generously and bravely shared their experiences for this study.

Disclosure statement

The authors declare that there are no financial interests or benefits arising from the application of this research.

Note

Notes

1. In a qualitative study of people with motor neurone disease and their carers, Whitehead, O'Brien, Jack, and Mitchell (2012) included one quote from a carer that clearly identified thoughts of homicide. Homicidal ideation was not the focus of the study, however, and there is no evidence that participants were systematically asked about thoughts of homicide.

Additional information

Funding

This work was supported by the Centre for Health Practice Innovation's Early Career Research Mentored Grant Scheme.