Noha Ferrah1, Briony J Murphy1, Joseph E Ibrahim1, Lyndal C Bugeja1, Margaret Winbolt2, Dina LoGiudice3, Leon Flicker4, David L Ranson1. 1. Department of Forensic Medicine, Monash University and Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank, Victoria 3006, Australia. 2. The Victoria and Tasmania Dementia Training Study Centre, Australian Centre for Evidence Based Aged Care, Australian Institute for Primary Care and Ageing, Faculty of Health Sciences, La Trobe University, Melbourne, Victoria 3086, Australia. 3. National Ageing Research Institute and Melbourne Health, Melbourne, Victoria, Australia. 4. Western Australian Centre for Health and Ageing, Western Australian Institute for Medical Research, University of Western Australia, Crawley, Western Australia, Australia Royal Perth Hospital, Perth, Western Australia, Australia.
Abstract
BACKGROUND: resident-to-resident aggression (RRA) is an understudied form of elder abuse in nursing homes. OBJECTIVE: the purpose of this systematic review was to examine the published research on the frequency, nature, contributing factors and outcomes of RRA in nursing homes. METHODS: in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement, this review examined all original, peer-reviewed research published in English, French, German, Italian or Spanish between 1st January 1949 and 31st December 2013 describing incidents of RRA in nursing homes. The following information was extracted for analysis: study and population characteristics; main findings (including prevalence, predisposing factors, triggers, nature of incidents, outcomes and interventions). RESULTS: eighteen studies were identified, 12 quantitative and 6 qualitative. The frequency of RRA ranged from 1 to 122 incidents, with insufficient information across the studies to calculate prevalence. RRA commonly occurred between exhibitors with higher levels of cognitive awareness and physical functionality and a history of aggressive behaviours, and female targets who were cognitively impaired with a history of behavioural issues including wandering. RRA most commonly took place in the afternoon in communal settings, was often triggered by communication issues and invasion of space, or was unprovoked. Limited information exists on organisational factors contributing to RRA and the outcomes for targets of aggression. CONCLUSIONS: we must continue to grow our knowledge base on the nature and circumstances of RRA to prevent harm to an increasing vulnerable population of nursing home residents and ensure a safe working environment for staff.
BACKGROUND: resident-to-resident aggression (RRA) is an understudied form of elder abuse in nursing homes. OBJECTIVE: the purpose of this systematic review was to examine the published research on the frequency, nature, contributing factors and outcomes of RRA in nursing homes. METHODS: in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement, this review examined all original, peer-reviewed research published in English, French, German, Italian or Spanish between 1st January 1949 and 31st December 2013 describing incidents of RRA in nursing homes. The following information was extracted for analysis: study and population characteristics; main findings (including prevalence, predisposing factors, triggers, nature of incidents, outcomes and interventions). RESULTS: eighteen studies were identified, 12 quantitative and 6 qualitative. The frequency of RRA ranged from 1 to 122 incidents, with insufficient information across the studies to calculate prevalence. RRA commonly occurred between exhibitors with higher levels of cognitive awareness and physical functionality and a history of aggressive behaviours, and female targets who were cognitively impaired with a history of behavioural issues including wandering. RRA most commonly took place in the afternoon in communal settings, was often triggered by communication issues and invasion of space, or was unprovoked. Limited information exists on organisational factors contributing to RRA and the outcomes for targets of aggression. CONCLUSIONS: we must continue to grow our knowledge base on the nature and circumstances of RRA to prevent harm to an increasing vulnerable population of nursing home residents and ensure a safe working environment for staff.
Authors: Mark S Lachs; Jeanne A Teresi; Mildred Ramirez; Kimberly van Haitsma; Stephanie Silver; Joseph P Eimicke; Gabriel Boratgis; Gail Sukha; Jian Kong; Alexandra M Besas; Maria Reyes Luna; Karl A Pillemer Journal: Ann Intern Med Date: 2016-06-14 Impact factor: 25.391
Authors: Karl Pillemer; Stephanie Silver; Mildred Ramirez; Jian Kong; Joseph P Eimicke; Gabriel D Boratgis; Rhoda Meador; Leslie Schultz; Mark S Lachs; Julia Nolte; Emily K Chen; Jeanne A Teresi Journal: J Am Geriatr Soc Date: 2021-12-27 Impact factor: 5.562
Authors: Annelies E Veldwijk-Rouwenhorst; Sytse U Zuidema; Martin Smalbrugge; Anke Persoon; Raymond T C M Koopmans; Debby L Gerritsen Journal: BMC Geriatr Date: 2022-09-16 Impact factor: 4.070