Aggression Between Residents in Nursing Homes More
Common than Widely Believed
Little attention from researchers; few proven
solutions to altercations
By Sheri Hall
June
3, 2008 - When people hear about elder abuse in nursing homes, they
usually think of staff members victimizing residents. However, research
by Cornell faculty members suggests that a more prevalent and serious
problem may be aggression and violence that occurs between residents
themselves.
Although such aggression can have serious
consequences for both aggressors and victims, the issue has received
little attention from researchers, and few proven solutions exist to
prevent resident altercations, says Karl Pillemer, director of the
Cornell Institute for Translational Research on Aging at the College of
Human Ecology.
He has co-authored two articles -- in Aggression
and Violent Behavior and in the Journal of the American Geriatrics
Society -- on "resident-to-resident mistreatment" this spring with Weill
Cornell Medical College professor of medicine Mark S. Lachs, M.D., and
medical student Tony Rosen.
Both studies report that verbal and physical
aggression between residents is common and problematic, and that more
research is necessary to identify risk factors and preventative
measures.
"Anyone who spends much time in a nursing home will
observe arguments, threats and shouting matches among residents, as well
as behaviors like pushing, shoving and hitting," Pillemer said.
"Given that nursing homes are environments where
people live close together, and many residents have lowered inhibitions
because of dementia, such incidents are not surprising," he said.
"Because of the nature of nursing home life, it is
impossible to eliminate these abusive behaviors entirely, but we need
better scientific evidence about what works to prevent this problem."
The studies found 35 different types of physical
and verbal abuse between residents at a large urban nursing home.
Screaming was the most common form of aggression, followed by such
physical violence as pushing and punching or fighting.
In related work, the authors found that 2.4 percent
of residents reported personally experiencing physical aggression from
another resident and 7.3 percent reported experiencing verbal aggression
over just a two-week period. Most respondents rated the events as
moderately or extremely disruptive to daily activities.
In another study, 12 nurse-observers identified 30
episodes of resident-to-resident aggression on just a single eight-hour
shift, 17 of which were physical. Research also indicates that victims
are more likely to be male, have behavioral problems like wandering and
be cognitively impaired.
While such incidents are difficult to prevent,
these types of studies will help nursing-home staff manage aggression
among patients, Pillemer said.
"At present, staff have few solutions available to
them and typical interventions in the nursing home may have negative
consequences for aggressive residents, including the use of psychotropic
medications or isolation of the resident," said Lachs, co-chief of
geriatrics at Weill Cornell. "We hope our work will help inspire a
vigorous search for programs that work to prevent aggression and
violence among residents in long-term care."
Sheri Hall is assistant communications director
for the College of Human Ecology.
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June
3, 2008 - When people hear about elder abuse in nursing homes, they
usually think of staff members victimizing residents. However, research
by Cornell faculty members suggests that a more prevalent and serious
problem may be aggression and violence that occurs between residents
themselves.