New York Estate Planning & Elder Law Blog
New research released last week reported that conflict and violence among nursing home residents is widespread and that extremely high rates of violence are common in some facilities. The author of the study, Karl Pillemer, is a professor of gerontology at Weill Cornell College of Medicine, and he presented his findings at the annual meeting of the Gerontological Society of America. According to Professor Pillemer, over twenty percent of people living in the nursing homes studied were involved in at least one negative or aggressive encounter with another resident during a four week period.
Nursing Home Study
For the study, researchers looked at patient records at ten nursing homes in New York. They interviewed staff and residents and recorded incidents through direct observation. In a sample of over 2,000 residents, sixteen percent were involved in incidents that included swearing, screaming, or yelling.
In addition, six percent were involved in physical violence like hitting, kicking, or biting, one percent had “sexual incidents, such as exposing one’s genitals, touching other residents, or attempting to gain sexual favors” and over ten percent were involved in events that the researchers labeled “other.” This included situations where residents entered rooms uninvited or rummaged through another resident’s belongings.
Resident on Resident Aggression
While the study of nursing home abuse at the hands of staff or other authority figures is increasing, the amount of research for resident on resident incidents of bullying and conflict has received far less study or publicity. However, these incidents of violence and aggression happen all of the time. Professor Pillemer’s study found that the residents involved in acts of bullying tend to those more active, engaged, and cognitively intact in a nursing home.
However, mild to moderate dementia has also been shown to play a role in aggression because it can cause disinhibited behavior. Other factors that lead to an increase in conflict or violence in a nursing home facility include:
· Crowded conditions · Understaffing · Apathetic nursing home staff · Conflict’s cyclical nature
The study found that crowded conditions in a nursing home lead to higher rates of mistreatment among the elderly, especially in areas where residents are more densely gathered. In addition, facilities that are understaffed with lower staff to resident ratios also saw a higher instance of conflict among the residents.
Apathy among the nursing home staff can also lead to more aggression amongst the residents. Staff can become somewhat blinded to the problem because of the frequency with which it occurs. Finally, the study found that the cyclical nature of conflict can also have a detrimental effect and lead to higher rates of bullying among nursing home residents. Negative behavior and its results are contagious. Seeing these incidents can cause other residents to be fearful, anxious, and concerned which in turn leads to more negative behavior.
How to Address the Aggression
In many ways, aggression and conflict among nursing home residents is more complicated than typical forms of elder abuse. When a family member or nursing-home worker abuses an elder, the perpetrator is clear to an outsider. However, resident on resident aggression is a lot less clear cut.
Many experts believe that looking at causes and prevention, instead of in terms of perpetrator, victim, and punishment, nursing homes can improve care. It is also important to remember that seniors in nursing homes are some of the most vulnerable members of our society. Even if residents are perpetrating these acts, many believe that they should not be held accountable.
Many experts believe that it is the nursing home’s responsibility to ease aggression in their facilities, and the best way to accomplish this is by getting to the root of the issue. If staffing is an issue, hire more people. Personalizing care for residents can also be a way to reduce the amount of bullying and co