Resident-to-resident aggression in long-term care facilities: insights from focus groups of nursing home residents and staff.
OBJECTIVE
To more fully characterize the spectrum of resident-to-resident aggression (RRA).


METHODS
A focus group study of nursing home staff members and residents who could reliably self-report.


METHODS
A large, urban, long-term care facility.


METHODS
Seven residents and 96 staff members from multiple clinical and nonclinical occupational groups.


METHODS
Sixteen focus groups were conducted. Content was analyzed using nVivo 7 software for qualitative data.


RESULTS
Thirty-five different types of physical, verbal, and sexual RRA were described, with screaming or yelling being the most common. Calling out and making noise were the most frequent of 29 antecedents identified as instigating episodes of RRA. RRA was most frequent in dining and residents' rooms, and in the afternoon, although it occurred regularly throughout the facility at all times. Although no proven strategies exist to manage RRA, staff described 25 self-initiated techniques to address the problem.


CONCLUSIONS
RRA is a ubiquitous phenomenon in nursing home settings, with important consequences for affected individuals and facilities. Further epidemiological research is necessary to more fully describe the phenomenon and identify risk factors and preventative strategies.
Rosen
Tony
T
Division of Geriatric Medicine and Gerontology, Weill Medical College, Cornell University, New York, New York, USA.
Lachs
Mark S
MS
Bharucha
Ashok J
AJ
Stevens
Scott M
SM
Teresi
Jeanne A
JA
Nebres
Flor
F
Pillemer
Karl
K
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000374:Aggression / Q000523:psychology*; D000544:Alzheimer Disease / Q000451:nursing* / Q000523:psychology; D003220:Conflict, Psychological; D004552:Elder Abuse / Q000517:prevention & control / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D010348:Patient Care Team; D010362:Patients' Rooms; D011287:Prejudice; D012307:Risk Factors; D012742:Sex Offenses / Q000523:psychology; D012931:Social Environment