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Nursing Home Abuse & Violence Among Residents Common, Yet Severely Understudied

Jul 12, 2007 | Parker Waichman LLP

Physical abuse in a nursing home is not always perpetrated by staff.  According to a Cornell University Study, resident-on-resident violence in long-term-care facilities is far more prevalent than previously thought.  But the authors of the study concede that they really don’t know how widespread this problem is because nursing home abuse is still woefully understudied.

The new study, funded by the National Institutes of Health (NIH), is only the second published report to look at patient-to-patient violence.  Cornell University examined the records of 747 nursing home patients over the course of the study.  Of those, 42 where involved in 79 incidents at nursing homes that actually required police intervention.  The finding surprised researchers, especially because the study was not even focused on nursing homes.  Rather, it looked at overall community crime, and nursing homes where just one area that was examined.

The report states that “abuse” might not be the correct term for these types of patient-related incidents. Many nursing home patients suffer from varying degrees of dementia, and this often plays a factor in the violence.  The violence is not usually malicious, but often is the result of confusion on the part of residents.  More often than not, these incidents involve a fight between two patients.  Common triggers can be unwanted touching or disputes over television.

Even though this type of violence does not fit the classic definition of nursing home abuse, it is often the byproduct of a neglectful staff.  Conflicts are far more likely to escalate to physical violence when patients are unattended.  However, attentive staff can take steps to separate feuding patients before the situation deteriorates.

The report also questions the wisdom of housing dementia patients together.  This is standard practice in most nursing homes, which generally have a dementia ward.  But, because dementia often triggers violence, the report suggests it might be better to incorporate these patients into the general population as much as possible.

The Cornell study highlights the need for more research into nursing home abuse.  Some estimates suggest that as many as one in 20 nursing home residents are victims of nursing home abuse, but it is not known how often the perpetrators are residents.   Because there is no uniform system for reporting nursing home violence, experts on elder abuse concede that current estimates are probably just the tip of the iceberg.  Compounding the problem is the fact that many nursing homes are loath to report incidences of abuse for fear of losing their licenses.  And there is no requirement to report resident-on-resident violence.  In fact, the Cornell researchers only looked at cases that involved police calls.  There were simply no records available to them detailing physical confrontations between residents that did not escalate to this level of violence.


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