Antisocial behavior best predictor of abuse among residents with criminal history, analysis says

Many residents with criminal histories can smoothly transition to life in a nursing home, but a small subset of those with previous antisocial behavior can pose a danger, a new analysis says.

Researchers at a California skilled nursing facility looked at 46 residents who had been admitted with a criminal history, including sex offenses. Of those, 54% “smoothly transitioned” with minimal difficulties, with 24% having difficulties that were managed with the “standard resources” of the nursing home.

“At a minimum, sex offender registry checks should be performed; however, our study results suggest that simply identifying a resident as a ‘criminal’ through history or sex offender or other registries is of little benefit,” wrote Robert M. Gibson, Ph.D, J.D., and Rebecca Ferrini, M.D., M.P.H., C.M.D. “We found antisocial behavior to be the most meaningful predictor of abusive behavior in LTC settings and the best basis for care planning.”

Out of the group studied, 10 residents were “uniquely challenging,” committed intentionally aggressive acts, were extremely disruptive and “posed a danger to the facility, the residents, and the community.” In those cases, while the residents were known to have criminal histories, details about their antisocial behavior were obtained after admission.

The research is meant to help nursing homes work through obeying F-Tag 224, which says the facility should identify residents “whose personal histories render them at risk for abusing other residents,” a difficult challenge. The goal should be to tailor preadmission and screenings to identify signs of antisocial traits or an Antisocial Personality Disorder diagnosis, asking about harmful behaviors and criminal history and looking at the resident’s physical and mental capabilities, such as whether they are ambulatory, Gibson and Ferrini wrote.

Results appeared in Annals of Long-Term Care.