Violence in nursing homes an understudied threat By Anne Harding

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Wed Jul 11, 1:14 PM ET

NEW YORK (Reuters Health) – While the traditional view of elder abuse in nursing homes involves staff harming residents, new research suggests residents may have more to fear from their peers.

“I personally think…that it’s far more prevalent than any other form of interpersonal aggression that you see in older people,” Dr. Mark Lachs of Cornell University in New York City, the lead author of the study and an authority on elder abuse, noted in an interview with Reuters Health.

There has been exceedingly little research in this area, Lachs added, but he and his colleagues came across new evidence for the phenomenon in the current study — only the second published report on resident-on-resident violence in nursing homes. While Lachs said he has seen plenty of evidence that this is a problem, and front-line nursing home workers can attest to it, “for some reason it’s not on the radar screen.”

Lachs and his team looked at police records for elderly people participating in a long-term, National Institutes of Health-funded study, which was originally intended to look at community crime.

Among 747 who had been living independently at the study’s outset but were placed in long-term care facilities during the course of the study, 42 were involved in 79 different incidents in which the police were called to nursing homes.

In most instances, Lachs explained, the cases involved two residents physically assaulting each other. Triggers included competition over a seat in front of a TV, unwanted touching, or a resident wandering into another’s room.

Given that at least half of residents of nursing homes and other long-term care facilities have some degree of dementia, he added, “it stands to reason that they would be interacting in a way that could be potentially assaultive or physically violent.”

It may not be accurate to term this type of violence “elder abuse,” Lachs said, given that it is rarely malicious and instead usually due to dementia and confusion in one or both parties involved.

More research must be done to determine how prevalent resident-to-resident violence is in nursing homes, understand its triggers, and to find ways to deal with it, Lachs said. For example, the findings raise questions of whether people with dementia should be congregated together or incorporated into the general nursing home population.

“It’s an important area, it’s very understudied, and there are some very important questions,” Lachs said.

SOURCE: Journal of the American Geriatrics Society, June 2007.

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