"I (am) scared I will hurt him, then I will regret it forever": Singaporean caregiver perspectives and elder abuse risk.

The global rise in aging populations presents concern about elder abuse risk. The caregiving burden for older adults predominately rests on informal caregivers, and caregiver stress and burnout are well-documented risk factors for elder mistreatment. In this qualitative study, we explored the perspectives of 19 informal caregivers in Singapore to better understand the contextual nature of the risk of elder abuse and mistreatment. Three themes explored: (i) the unbounded caregiver role and journey to caregiving; (ii) elder abuse risk, including relationship dynamics, caregiver emotions, and achieving compliance through fear, and (iii) protective strategies such as self-control, societal expectations, and external support. The findings present a nuanced picture of elder abuse, suggesting elder abuse risk is inherent in the caregiver role itself, with current prevention relying largely on caregiver self-regulation. Our study proposes that interventions to reduce elder abuse need to be integrated across individual, interpersonal, organizational, community, and societal levels.