Contemplating homicide while caring for family with dementia

Dr Siobhan O'Dwyer

Homicidal thoughts are a real and significant phenomenon among family carers of people with dementia.

This is the finding from world-first Griffith University research published this week in the journal Aging and Mental Health. 21 Australian carers aged 37 to 89 took part in the interview-based study which explored their thoughts of homicide, specifically their thoughts of killing the person with dementia.

“We already know that family carers of people with dementia have higher than average rates of suicidal ideation, but there has been never been any research on homicidal ideation in this population,” says research leader Dr Siobhan O’Dwyer from Griffith’s Menzies Health Institute Queensland (MHIQ).

Two of the 21 (who were all caring for parents or partners with dementia) had actively contemplated homicide or homicide-suicide. “Some participants also described passive death wishes, just hoping that the person with dementia wouldn’t wake up in the morning. Although the majority of carers in the study hadn’t contemplated homicide, almost all said they understood how others could reach that point,” says Dr O’Dwyer.

Reasons for contemplating homicide

Compassion, isolation, a sense of being trapped in the caring role, exhaustion, and self-defence were cited as reasons for contemplating homicide or thinking about the person’s death.

“Thoughts of homicide don’t guarantee homicidal behaviour, but the fact that carers are experiencing these thoughts is reflective of a bigger problem in our society. Family carers make a valuable contribution, but the work they do often goes unrecognised. As a society, we have a responsibility to provide better support for people with dementia and their families and, as our population ages, we ignore issues like this at our peril,” says Dr O’Dwyer

The findings also show how complex the issue of homicidal ideation is, not least because of the overlap with the issue of euthanasia. “Several participants discussed euthanasia when asked about homicide and commented on the lack of access to legal options for a dignified death in Australia,” says Dr O’Dwyer.

“Dr O’Dwyer’s research is a serious and timely reminder of the compassion, fatigue, frustration, and isolation that carers can experience when they are caring 24/7,” says Carers Queensland CEO Debra Cottrell. “We must do better at caring for carers and ensure that they have access to assessment, needs identification and support services, separate to those of the person they care for, to ensure their own ongoing mental health and wellbeing.”

Dr Samara McPhedran, senior research fellow with Griffith’s Violence Research and Prevention Program, also endorsed the significance of the study. “Our knowledge about homicide and related issues in older Australians is limited, so this work is very welcome. It adds to our understanding about the connections between stressful life circumstances and homicidal thoughts, among an often overlooked group of people.”