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Resident-on-Resident Violence in Nursing Homes

Garcia & Artigliere

When 81-year-old William Leo McDougall was charged with one felony count of murder after beating his 94-year-old roommate over the head with a metal clothing rod, the case helped to expose a growing epidemic of resident-on-resident violence in nursing homes.

Imagine being attacked in your own home and never knowing when it will happen again. One of the most emotionally disturbing aspects of resident-on-resident violence is its unpredictability.

Yet there is a shocking lack of official reporting or legal action taken against violent residents who attack other residents.

Federal regulations require that every patient is given an initial comprehensive assessment of their functional, mental and behavioral characteristics when they enter the nursing home. This assessment notes violent tendencies and vulnerabilities. It also is supposed to list interventions staff can utilize.

But staff shortages and lack of staff training mean that few if any of these suggested interventions are implemented.

Since so many nursing homes function without enough staff or without the staff receiving ongoing training, it is important that you, as your loved ones caregiver, stay alert.

By visiting often you will get a sense of the other residents, their personalities, and their behaviors. If you see inappropriate behaviors, you will have the opportunity to discuss the situation with the nursing home staff and find out what is being done about that resident’s aggressive behavior.

If your loved one feels threatened by another resident, you can help make them feel safe by:

  • Making sure their room has a home-like environment, where they can retreat to when they feel threatened.
  • Encouraging them to call you when they feel stressed or scared. Connecting with a friend or family member can be a great way to alleviate stress by getting support and understanding.
  • Suggesting that your loved one gets involved in something they enjoy (if that is possible considering their physical or mental condition). Whether it’s knitting or watching tv, doing an enjoyable activity can help make them feel more secure in their home.
  • Taking your loved one out on excursions to change their scenery. Even just a walk around the block can help make them feel safer and more relaxed when you aren’t there.

If you have seen your loved one – or another resident in the nursing home — being threatened or bullied, you need to take action:

  • Talk to the management of the nursing home. Find out what action they will take to protect your loved one and other residents from the aggressive resident.
  • Collaborate with the nursing homes Interdisciplinary Team to ensure your loved one is not left alone or unprotected from violent residents.
  • Find out what training staff receives to help prevent or to disarm resident-on-resident violence. Also, ask how often the training is being re-done by each staff member to ensure that they know how to identify and stop nursing home violence.
  • Offer to contact and to bring in nursing home advocates to speak with the nursing home staff about the newest and best ways to prevent or to intercede in resident-on-resident violence.
  • Report any violence to the nursing home. If the violence is physical, report it immediately to the police.

When choosing a nursing home for your loved one, look for signs that resident-on-resident violence may be happening in a nursing home facility:

  • Ask if the home has personalized nursing home care plans for each resident. Do they include ways to identify violent residents? How does the facility keep other residents safe from aggressive residents?
  • Tour the nursing home facility before your loved one gets there to get a feel of how other residents act. Do a lot of the coherent residents seem fearful or ill-at-ease around specific residents?
  • Find out if the nursing home has abuse prevention training and how often they have staff re-take the training.
  • Ask what the staff-to-resident ratio is both during the day and during the night. The more staff, the more likely violent residents are being well monitored.
  • Find out if the nursing home has a separate area for patients with dementia and Alzheimer’s as these are the residents most likely to have violent outbursts.
  • Lastly, call the local police department to learn crime statistics at and around the nursing home. You should include questions about reports of theft, sexual assault, and physical assault in addition to general inquiries about how often the police visit the home and why they most often respond.

Everyone has the right to feel safe in their home. And you, as a caregiver, have the right to demand that safety for your


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