One in five SNF residents experience abuse from other residents, study finds

Many antipsychotics users had no clinical psychiatric diagnosis.
Many antipsychotics users had no clinical psychiatric diagnosis.

At least one in five seniors living in nursing homes has experienced some sort of resident-on-resident abuse, a new study finds.

Researchers tracked reports of resident-to-resident mistreatment over a one-month period at five urban and five suburban New York nursing homes through resident and staff interviews, observations and incident reports. Of the 2,011 residents included in the study, 407 — or more than 20% — said they had experienced at least one abusive event over the course of the month. The study was released Tuesday in Annals of Internal Medicine.

The most common forms of resident-on-resident mistreatment were verbal at 9.1% and miscellaneous instances, including invasion of privacy or menacing gestures, at 5.3%. Physical and sexual abuse incidents followed at 5.2% and 0.6%, respectively.

Factors such as a resident's level of cognitive impairment, whether the residents resided in a dementia unit and higher nurse aide caseload were linked to higher rates of resident-on-resident mistreatment, results showed.

The findings indicate that traditional efforts to curb nursing home abuse may be disproportionately aimed at staff mistreatment instead of resident-on-resident events, researchers noted.

In an editorial article accompanying the study, XinQi Dong, M.D., Ph.D., with the Rush Institute for Health Aging, pointed out that while further research is needed to develop “evidence-based, culturally appropriate” interventions for resident-on-resident mistreatment, providers and government entities “cannot wait” to advocate for better protections for residents.

“We must recognize that residents may be both victims and perpetrators of [elder abuse], and avoid blaming victims or resorting to interventions of convenience, such as the use of chemical sedation or physical restraints,” Dong wrote.

Providers also should look into ways that technology like cameras and data collection can help measure and prevent abuse, Dong added.

Resident-instigated abuse has recently made headlines in Kentucky, where a resident of a residential care facility was charged with another resident's murder, and in Texas, where a nursing home changed its name in the wake of a resident-on-resident double homicide.