Dementia is a group of conditions that gradually destroys brain cells and leads to a progressive decline in mental function. Alzheimer’s disease is a form of dementia. Alzheimer’s disease is not a normal part of aging, and most older individuals do not contract the condition. The disease is more commonly found among persons age 85 and older. It is a progressive brain disorder that gradually destroys a person’s memory and ability to learn, reason, make judgments, communicate, and carry out daily activities. As Alzheimer’s disease progresses, individuals may also experience changes in personality and behavior, such as anxiety, suspiciousness, or agitation. Alzheimer’s disease progresses at different rates. In early stages, areas of the brain that control memory and thinking skills are affected. As the disease progresses, other regions of the brain die. Patients in late stages of Alzheimer’s disease may need complete care.
The Impact of Dementia and Alzheimer’s on Cases of Abuse
Persons with dementia, including Alzheimer’s disease, may be vulnerable and, therefore, targeted by predators, who may financially exploit or abuse them. Older victims with dementia may be unaware or slow to recognize that abuse has occurred. Abusers may feel that victims are less likely to report abuse or be believed by professionals. Victims with dementia may have difficulty recounting the details of the abuse. They may be perceived as confused or recounting experiences from earlier in life. Gerontologists and experts in dementia may be able to work with law enforcement and adult protective services to gather information from a potential victim during an interview. In some cases, the case must be built without participation from the victim. Such cases should be approached like a homicide in which there is no victim to testify.
Offenders with dementia, including Alzheimer’s disease, present challenges to the justice, health care, and social service systems. In some stages, dementia and Alzheimer’s disease can manifest themselves in challenging, violent actions or inappropriate sexual behavior. These individuals are no longer able to control their actions due to their medical condition. Arrest and offender counseling treatment programs will not change the behavior because its source is organic rather than a personal choice. Perpetrators with dementia still need intervention to meet medical needs, manage their behavior, and provide for personal care.
However, persons in early stages of Alzheimer’s disease and other dementias retain the ability to control their actions. Often persons who were abusive throughout their lives use a diagnosis of Alzheimer’s disease as an excuse to escalate their violent behavior, telling family and professionals that they cannot control their behavior and, therefore, should not be arrested or held accountable.
Whether offenders with dementia are able to control their behavior or not, the focus of intervention must be on victim safety. Victims can benefit from accurate medical information and safety planning.