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Resident-to-resident elder mistreatment highly prevalent in nursing homes

At least 20% of nursing home residents have experienced some kind of resident-to-resident elder mistreatment, according to study results.

While verbal mistreatment was most common, physical mistreatment also occurs, researchers reported in the Annals of Internal Medicine.

“Resident-to-resident elder mistreatment (R-REM) in nursing homes can cause physical and psychological injury and death, yet its prevalence remains unknown,” Mark S. Lachs, MD, MPH, Irene and Roy Psaty Distinguished Professor of Medicine at the Weill Cornell Medical College, and co-chief of geriatrics and palliative medicine, and the director of geriatrics for The New York Presbyterian Health Care System, and colleagues wrote. “Our goal was to estimate the prevalence of R-REM, including verbal, physical, and sexual mistreatment, and examine the prevalence according to location and timing of events and patient-, environment-, and facility-level characteristics.”

In order to evaluate the occurrence of physical, verbal, and sexual R-REM among nursing home residents and subgroups, the researchers designed a 1-month observational prevalence study which was conducted in five urban and five suburban New York state nursing homes that were randomly selected on the basis of size and location. R-REM was identified through resident and staff interviews, shift coupons, chart review, observation, and accident or incident reports.

The researchers found that among 2,011 residents, 407 experienced at least one R-REM event: The total 1-month prevalence was 20.2%. The most common forms were verbal (9.1%; 95% CI, 7.7- 10.8), physical (5.2%; 95% CI, 4.1-6.5), sexual (0.6%; 95% CI, 0.3-1.1), and other, such as menacing gestures and invasion of privacy (5.3%; 95% CI, 4.4-6.4). In the urban facilities, overall prevalence estimates ranged from 10.4% to 31.2%, while prevalence in suburban facilities ranged from 11.6% to 28.1%. Associated with higher estimated rates of R-REM were several clinical and contextual factors, such as residing on a dementia unit, lower vs. severe levels of cognitive impairment, and higher nurse aide caseload.

“R-REM in nursing homes is highly prevalent,” Lachs and researchers wrote in their conclusion. “Verbal R-REM is most common, but physical mistreatment also occurs frequently. Because R-REM can cause injury or death, strategies are urgently needed to better understand its causes so that prevention strategies can be developed.” – by Savannah Demko

Disclosure: The researchers report no relevant financial disclosures.