Purpose: The purpose of this study is to define the caregiving stress process and adaptation to crises of Korean primary caregivers who provide care for their older family members with disabilities. This study investigates what stressors can lead to caregiving crises (elder abuse), and what variables mitigate caregiving crises.

Methods: This study used the data of the Comprehensive Study for the Elderly Welfare Policy in Seoul (2003). Eligibility criteria of this study required that caregivers provide at least 10 hours of care per week. The 960 primary caregivers of noninstitutionalized older Koreans with cognitive and/or physical disabilities were interviewed face-to-face and asked a series of systemized questions on demographic characteristics of caregivers and care recipients, informal social support, formal social support, caregiver burden, and elder abuse. Hierarchical multiple regression method was employed to identify the impact of caregiver stressors, resources (informal and formal social support), and perceptions on the level of elder abuse.

Results: The results showed that ADLs (â= -.061, p< .05), cognitive impairment (â= .326, p< .001), informal social support (â= .078, p< .05), use of formal social support (â= -.112, p< .001), and caregiver burden (â= .258, p< .001) were significantly associated with the degree of elder abuse. As the level of caregiver burden and the severity of cognitive impairment increased, the caregivers were more likely to abuse their older family member in the domestic setting; this finding is consistent with previous research. Accordingly, formal social support significantly buffered the degree of elder abuse. Contrary to the researchers' expectations, as the severity of ADL of patients increased, the caregivers were less likely to abuse their care recipients, and primary caregivers with a higher level of informal support were more likely to abuse older adults with disabilities.

Implications: Based on the findings of this study, there are important implications for practice and policy. Family caregivers who provided care to older adults with severe cognitive impairment were more likely to abuse their care recipients. Psychological support services and programs for family caregivers should be provided to reduce the prevalence of elder abuse in families. Current community services, including day care centers, food preparation (meal delivery), respite, home care programs, and nursing homes for severely impaired older adults, should be expanded so that all caregiving families have access.