Nursing Home Abuse Unnoticed Perpetrators

A new study has found that around 20 percent of nursing home residents are abused by an often unnoticed perpetrator: other residents. The incidents of nursing home abuse that are brought to light and discussed by the public are often cases of staff or health care professionals mistreating residents. But senior study author Karl Pillemer, a professor at Cornell University’s College of Human Ecology and at Weill Cornell Medicine, said that this study found that roughly one in five residents is experiencing some type of abuse from another resident. “We were very surprised by the prevalence of aggression,” Pillemer said.

Along with Pillemer, Mark Lachs, a doctor at Weill Cornell Medicine and the study’s lead author, and other researchers looked at 2,011 residents in 10 New York state nursing homes over a period of one month. They conducted interviews with both staff and residents, and also observed them, reviewed their charts, and looked at accident reports. 407 of the people evaluated disclosed at least one instance of abuse or mistreatment directed at them from a fellow resident. Broken down further, 9 percent of the residents were verbally abused, 5 percent were physically abused, less than 1 percent were sexually abused, and 5 percent were mistreated by things such as an invasion of privacy. The emotional impact of each of these types of abuse was often severe, especially if the abuse was cumulative rather than a one-time event.

• The risk factors for resident-on-resident abuse were found to be the following:
• The number of residents with cognitive problems, leaving them prone to violent outbursts
• Overcrowding in common spaces, which allows residents who are mobile to enter others’ rooms
• Low staffing levels, leaving residents improperly monitored
• Poor staff training, leading to situations where yelling residents are ignored rather than being checked on
• A lack of quiet, safe, and/or private spaces for dementia patients, who tend to be more easily agitated and more likely to lash out

Pillemer, Lachs, and their coauthors believe that the best way to deal with this issue is to recognize its prevalence and set up protocols for addressing resident-on-resident abuse when it occurs. This may include setting up individual care plans for those most likely to be the aggressor or victim. As Lachs said, “Aggression between residents needs to be given attention.

You’re probably at greater risk than from a staff member.” However, he doesn’t want to see residents prosecuted necessarily for these abusive incidents. He would prefer to see more education on the problem so that it can be stopped early on before people get hurt. With so many elderly adults living in nursing home facilities these days, Lachs sees it as an important step comparable to nationwide efforts to address school bullying. “Look at the movement in schools now that makes bullying not okay,” he said. “We may be able to learn something from that process.”