In the first large-scale study on resident-to-resident elder mistreatment (RREM) in nursing homes, researchers found a one-month prevalence of all RREM types of 20%.
The sample consisted of 2,011 residents in 10 facilities in New York. Breaking down mistreatment, the study cited verbal aggression as most common at 9%, followed by physical aggression at 5%, other forms of mistreatment at 5%, and sexual mistreatment at 0.6%. These findings shed light on a prevalent yet often underreported issue in long-term care facilities.
To reduce the RREM consequences, including physical injury, psychological distress and increased staff burnout, the study identified potential solutions. Nursing homes might implement targeted interventions for residents with milder cognitive impairment, behavioral symptoms, and those residing in special care units for dementia — all groups at higher risk of RREM involvement. Additionally, ensuring adequate staffing levels would allow for personalized strategies focused on residents, although increasing staff is not always a viable option.
Key takeaways:
1. RREM aggression ranges from verbal abuse, such as name-calling or threats, to physical altercations, like hitting or shoving, and even sexual mistreatment in some cases.
2. Residents with milder dementia, behavioral symptoms and better functional abilities were more likely to be involved in RREM incidents. Those with more severe cognitive impairment were less prone to instigating or being involved in mistreatment.
3. Special care units for dementia have an elevated risk for RREM due to a greater number of residents with cognitive and behavioral problems, like wandering, yelling, and rummaging through others’ belongings.
This study’s lead author, Karl Pillemer, the Hazel E. Reed Professor of Psychology in Cornell’s College of Human Ecology (CHE) and professor of gerontology in medicine at Weill Cornell Medicine, emphasized a need for next steps. “Interpersonal aggression is common in assisted living facilities and staff are inadequately trained to deal with it. Residents are vulnerable to psychological distress and physical injury from other residents, and that’s something we need to take very seriously.”
