Much of the information that circulates regarding nursing home abuse describes scenarios where staff members neglect and abuse their residents directly. There’s also growing concern about specific types of abuse including sexual abuse and financial abuse, which are often more difficult to detect when committed against elderly people.

But an under-recognized problem in nursing homes is resident-on-resident abuse. A 2014 study aimed to shed light on this chronic problem. Weill Cornell Medical College and Cornell University, with lead author Dr. Mark Lachs, studied over 2,000 patients in 10 different urban and suburban nursing homes in New York.

The month-long study is considered the first of its kind as a large-scale study assessing resident-to-resident abuse specifically. Ultimately, the study concluded that nearly 20% of nursing home patients were involved in some form of aggressive encounter with one or more fellow nursing home residents during the four-week period.

The forms of mistreatment that the patients underwent ranged from verbal to physical violence and aggression to general unwanted encounters. The types of encounters the study examined included the following acts committed by a resident against another resident:

  • Coming into a resident’s room and rifling through their belongings
  • Being run over by a wheelchair
  • Having food taken off their plate without asking
  • Being called names or other verbal assaults
  • Undergoing physical violence
  • Being sexually assaulted

The study included any situation where the victim would suffer physical or psychological distress as a result of the actions of another resident. Based on observations and resident interviews during the study, the results indicated that 75% of encounters were verbal in nature and the remaining 25% of encounters were physical.

While the fact that resident-on-resident abuse does occur in nursing homes doesn’t come as a surprise to experts, the prevalence of these types of incidents is alarming. It’s especially concerning because of the nature of resident-on-resident abuse makes it more difficult to control and rectify.

With abuse committed by staff members, the employee can be fired, sued or prosecuted. But with abuse among residents, the problem needs to be rectified by creating a better living environment for everyone.

Creating a better environment in nursing homes that prevents resident-on-resident abuse starts with understanding why these incidents occur. Elderly people with cognitive degenerative disorders can be easily aggravated by certain environmental triggers. These triggers include lighting, noise or large crowds, which can send dementia patients into violent or distressed states. This creates an overall environment that causes unpredictable behaviors among patients that often results in violent outbursts or mistreatment towards others.

Experts, like those who conducted this study, recommend that nursing homes work with Alzheimer’s disease experts to better understand how to create an environment that prevents resident-on-resident abuse. This includes educating nursing home staff on how to respond to yelling among dementia ward residents so that they can control the noise level.

Hopefully with greater education, nursing homes can start to create a more positive culture that works proactively to prevent abuse among residents. Read more on this study.

References:

  1. http://news.weill.cornell.edu/news/2014/11/study-highlights-prevalence-of-mistreatment-between-nursing-home-residents-pillemer-lachs
  2. http://www.cbsnews.com/news/nursing-home-violence-common-but-from-an-unlikely-source/
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Christine Traxler, MD is a retired family practice physician, graduate of the University of Minnesota School of Medicine in 1986, and freelance writer, having worked with patients in rural Minnesota for two decades. She has written several books on medical topics and currently resides in Minneapolis, MN, where she works as a freelance writer on medical topics.

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