title: Resident-to-resident aggression in long-term care facilities: insights from focus groups of nursing home residents and staff.
abstract: 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.
authors.affiliation: Division of Geriatric Medicine and Gerontology, Weill Medical College, Cornell University, New York, New York, USA.
authors.forename: Tony
authors.initials: T
authors.lastname: Rosen
authors.forename: Mark S
authors.initials: MS
authors.lastname: Lachs
authors.forename: Ashok J
authors.initials: AJ
authors.lastname: Bharucha
authors.forename: Scott M
authors.initials: SM
authors.lastname: Stevens
authors.forename: Jeanne A
authors.initials: JA
authors.lastname: Teresi
authors.forename: Flor
authors.initials: F
authors.lastname: Nebres
authors.forename: Karl
authors.initials: K
authors.lastname: Pillemer
mesh_terms: 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