Aggression toward staff by nursing home residents: findings from a grounded theory study.

Aggressive behaviors by nursing home residents are common and can result in injury to both staff and residents. In addition, such aggressive behavior may lead to resident abuse by staff. This article describes a grounded theory study of nursing home staff response to aggressive residents and explores the problem of aggressive behaviors by nursing home residents, the conditions and context of aggression, and strategies staff use to prevent and manage aggression. To effectively deal with resident aggression, staff must become proactive, which involves three dynamic and interactive processes: practicing vigilance, intuiting, and strategizing. This article details these processes as well as the strategies staff use to deal with aggressive behaviors and makes specific recommendations for handling aggression toward staff.