title: Staff-reported strategies for prevention and management of resident-to-resident elder mistreatment in long-term care facilities.
abstract: Resident-to-resident elder mistreatment (R-REM) in nursing homes is frequent and leads to adverse outcomes. Nursing home staff responses may significantly mitigate R-REM's impact, but little is known about current practices. The objective was to identify common staff responses to R-REM. The authors interviewed 282 certified nursing assistants (CNAs) in five urban nursing homes on their responses during the previous 2 weeks to R-REM behaviors of residents under their care. Ninety-seven CNAs (34.4%) reported actions responding to R-REM incidents involving 182 residents (10.8%), describing 22 different responses. Most common were physically intervening/separating residents (51), talking calmly to settle residents down (50), no intervention (39), and verbally intervening to defuse the situation (38). Less common were notifying a nurse (13) or documenting in behavior log (4). Nursing home staff report many varied responses to R-REM, a common and dangerous occurrence. CNAs seldom documented behaviors or reported them to nurses.
authors.affiliation: a Division of Emergency Medicine , Weill Cornell Medical College , New York , New York , USA.
authors.forename: Tony
authors.initials: T
authors.lastname: Rosen
authors.affiliation: b Division of Geriatrics and Palliative Medicine , Weill Cornell Medical College , New York , New York , USA.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Lachs
authors.affiliation: c Columbia University Stroud Center and New York State Psychiatric Institute , New York , New York , USA.|d Research Division , Hebrew Home at Riverdale , New York , New York , USA.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Teresi
authors.affiliation: d Research Division , Hebrew Home at Riverdale , New York , New York , USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Eimicke
authors.affiliation: e Program for Person Centered Living Systems of Care, College of Nursing, The Pennsylvania State University, University Park , Pennsylvania , USA.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Van Haitsma
authors.affiliation: f Department of Human Development and Cornell Institute for Translational Research on Aging , Cornell University , Ithaca , New York , USA.
authors.forename: Karl
authors.initials: K
authors.lastname: Pillemer
mesh_terms: D000368:Aged; D004552:Elder Abuse / Q000517:prevention & control*; D006707:Homes for the Aged; D006801:Humans; D008134:Long-Term Care; D009735:Nursing Homes; D009740:Nursing Staff
keywords: Aggression; dementia-related behaviors; nursing home