When Caregivers Turn to Violence – The Dark Side of Caregivers’ Stress

Caregivers and family members looking after persons with disabilities (PwDs) or special needs occasionally get spotlighted in the media, and the challenges and stress that they experience become coffee-talk. When caregiving stress is not managed appropriately, there is a possibility of them escalating into unhelpful behaviours such as violence. Delving into the intersection of abuse, family violence and disability, SPD’s senior social worker Angela Chung explains why caregivers looking after PwDs could become abusive. The terms “abuse” and “family violence” are used interchangeably in this article.

According to the Women’s Charter, family violence is defined as:

Wilfully or knowingly placing or attempting to place a family member in fear or hurt
Causing hurt to a family member by an act which he or she ought to know would cause and result in hurt
Wrongfully confining or restraining a family member against their will
Causing continual harassment with intent to cause anguish to a family member, including verbal abuse, psychological or emotional abuse

There are five broad categories of abuse: physical, emotional or psychological, economic or financial, sexual, and neglect. Hence, abuse is both an act of commission and omission.

Family violence is hardly a one-off isolated incident. It is highly probable that it is recurring, of which the intensity and frequency increases with time if the triggers are not addressed and the caregiver’s stress continues to mount.

For example, verbal abuse by a highly stressed caregiver who has no reprieve or respite might eventually escalate to physical abuse such as slapping or hitting the person with disability over time.

Unfortunately, PwDs face increased risk factors or vulnerabilities from family violence by their carers due to several factors:

Probability of high dependency on their caregivers in most or all aspects of their living such as daily physical care, financial dependence, etc.

A sense of learned helplessness may prevail if the PwDs reckon that abuse is what they deserve for stressing their family carers (perpetrators) with their needs and they should endure it since their carers need an outlet to release their stress.

The lack of community visibility if the PwDs are not placed in schools, workplaces, community venues or places of worship as they could be bedridden or home-bound and lack access to the external environment.

The lack of community visibility and associated social isolation are further exacerbated by the effects of pandemic where prolonged work from home arrangement has created a blurring of work and personal boundaries. This could result in caregivers having to multi-task as they juggle work and caregiving responsibilities. Victims with disabilities and their perpetrators may also find themselves having to face each other over an extended period. Thus, even an argument could potentially escalate into physical abusive acts.

I remember a case during the Circuit Breaker in April 2020 when we suspended our day care programme temporarily and senior clients had to stay home. During this period, we made weekly phone calls to our clients to check on their well-being at home. In one of the calls, a senior told me in a hushed tone that her live-in son had been hitting her with a pair of slippers intermittently during the Circuit Breaker period.

Such confession of abuse did not come easy. This client, a widow in her 80s and a wheelchair user, had to wait till an opportune time when her son was not at home, to share details of her physical abuse with me over the phone after much cajoling. It is understandable since her son was in proximity with her in their HDB 3-room flat. Thankfully, I already had good rapport with her and explored safety plans with her over the phone.

When the Circuit Breaker was lifted and our centre was reopened, she could share the abusive episodes in detail with me at the centre. However, not all PwDs have access to community touchpoints as they could be home-bound most of the time due to the severity of their disability.

Reporting abuse or family violence by their caregivers (the perpetrators) is not an easy decision for the victims. Sometimes, these victims experience a sense of ambivalence, guilt and indecision. The reasons of ambivalence could be due to the highly dependent relationship that victims have with their caregivers/perpetrators and the concern about incurring more harm from the perpetrator when reporting the abuse. Therefore, people who are supporting the victims of abuse by family caregivers must exercise patience, understand their ambivalent position, and address their concerns for reporting while mapping out their safety plans.

Finally, acts of family violence or abuse towards persons with disabilities should not be viewed as a family issue, but a community or societal one. Thus, it is imperative that we develop community vigilance to detect and report any signs of family violence before it is too late.

If you are hesitating to report the abuse, always remember that by doing so, you are helping both the victims with disabilities AND the perpetrators to receive timely help in addressing their issues. Family violence acts are often a cry for help when perpetrators are no longer able to cope adaptively with their escalating caregivers’ stress and need external support and intervention. With this reframing, hopefully, bystanders and victims of family violence could better deal with their ambivalence in seeking help to stop the violence.

If you experience or witness family violence, please approach the following community resources: