title: Perceptions and implications of violence from care home residents with dementia: a review and commentary.
abstract: OBJECTIVE
  This paper presents a critical review of the literature related to the violence staff in care homes experience from people with dementia. It attempts to identify the psychological consequences abuse has on care workers and the implications this has for practice.
  
  
  BACKGROUND
  Abuse in the form of violence or aggression against healthcare professionals is not new. However, when this is from residents with dementia in care homes it is considered to be part of the job. Consequently it is largely underreported and ignored which masks its true extent.
  
  
  CONCLUSIONS
  The magnitude of violence in care homes crosses cultural boundaries. Fear of being blamed, job insecurity and resignation that abuse should be accepted as part of the job is unique to this care setting. The cumulative effect of psychological abuse leads to emotional exhaustion and depersonalisation which results in care workers emotionally and physically withdrawing from residents. Being subjected to abuse, feeling undervalued, unsupported and lacking essential skills may compromise a workforces' ability to provide person-centred care. A rising ageing population and prevalence of dementia will place demands on commissioners and providers to deliver high quality care. Consistent recording and reporting procedures, dementia specific training and infrastructures to support staff is therefore crucial.
authors.affiliation: Mental Health Services for Older People, South Eastern Health & Social Care Trust, Lisburn & Queens University Belfast, Belfast, UK. ann.scott@setrust.hscni.net
authors.forename: Ann
authors.initials: A
authors.lastname: Scott
authors.forename: Assumpta
authors.initials: A
authors.lastname: Ryan
authors.forename: Ian
authors.initials: I
authors.lastname: James
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Mitchell
mesh_terms: D000368:Aged; D003704:Dementia / Q000451:nursing* / Q000523:psychology; D005851:Geriatric Nursing; D006801:Humans; D009735:Nursing Homes; D009740:Nursing Staff / Q000523:psychology*; D009784:Occupational Diseases / Q000523:psychology*; D014754:Violence / Q000523:psychology*