A recent study published in Nursing Inquiry reveals a disturbing trend: resident-on-resident attacks are not confined to American nursing homes but represent a global challenge within long-term care facilities. This research underscores the need for a comprehensive approach to addressing violence among residents, especially those with cognitive impairments.
The study, conducted by Australian researchers, analyzed data from multiple countries, including the US, Australia, Canada, China, France, New Zealand, Singapore, and the UK. Their findings suggest that resident-on-resident homicides, though underreported, are a significant concern. “Homicide involving older people is less likely to involve a post-mortem investigation as the cause for deaths is commonly thought to be related to age or a fall, rather than violence,” the study authors noted. This underreporting can lead to a lack of awareness and preventative measures.
Key Factors and Statistics
The research identified several key factors contributing to resident-on-resident violence. Notably, a dementia diagnosis was found to be a prominent risk factor. The study also revealed that these incidents often involve male residents with cognitive challenges or mental health disorders targeting older roommates.
“Of the data sources considered in the Nursing Inquiry review, 17 studies showed that residents with dementia had demonstrated aggressive tendencies before a homicide,” highlighting the critical role of cognitive impairment in these incidents.
Moreover, American researcher Eilon Caspi, PhD, has emphasized the role of environmental factors, such as invasion of personal space and conflicts between roommates, in triggering resident attacks. As Caspi stated to McKnight’s Long-Term Care News, “left untracked, ‘the phenomenon remains largely invisible.’” This underscores the importance of proactive monitoring and intervention.
Safety Recommendations
With the aging population and the increasing demand for long-term care, addressing resident-on-resident violence is crucial. The Nursing Inquiry study provided over 40 recommendations, categorized into three areas:
- Education and Research:
- Enhanced training for staff on dementia care, aggression management, and resident assessment.
- Thorough resident assessments at admission and throughout their stay.
- Facility Management and Staff:
- Lowering staff-to-resident ratios to improve monitoring and intervention.
- Comprehensive mental health assessments for residents.
- Government:
- Increased regulation of high-risk residents.
- Mandatory audits following violent incidents.
- Consistent investigation of unnatural deaths.
The study authors emphasized the need for a shift towards “contemporary and humanistic dementia care” to mitigate risks and ensure resident safety. They also stated, “The frequency of such incidents is expected to rise.” This means that the long term care sector must act now.