Aggressive Behavior of Nursing Home Residents Toward Caregivers: A Systematic Literature Review

Abstract

(Geriatr Nurs 2009;30:174-187) Aggressive behavior of residents continues to challenge and burden caregivers working in nursing homes [1,2]. Working in a nursing home or long-term care facility is associated with a high risk of experiencing aggression [3].Studies show that aggressive behavior is more likely to occur among older people with cognitive impairment than among those with no cognitive impairment [2,4,5] although cognitively intact residents also threaten or assault the caregivers [6]. Irrespective of whether demented residents can be held responsible for their aggressive behavior, many gerontological nurses find that physical or verbal attacks by an elderly person they are giving nursing care to is one of the most difficult, emotionally distressing, and potentially dangerous aspects of their work [7], often resulting in feelings of powerlessness, sadness, anger, and ineffectiveness [8].Some studies have investigated the prevalence of aggression and associated factors in nursing homes, but it is probable that nursing home residents' aggressive behavior often goes underreported in both prevalence measures and nursing documentation. Possible causes for underreporting are a lack of competence to cope with aggressive behavior, feelings of failure, or the assumption that aggressive behavior is a common feature in the care of the elderly, especially those with psychological disturbance [1,4,9,10]. Psychological disturbances and other illnesses in the elderly may lead to aggressive behavior irrespective of situational factors. However, because such illness processes can be influenced only indirectly by nursing

Verbal and Physical Aggression Directed at Nursing Home Staff by Residents

“…25 Complicating the study of RSA is underreporting both in chart documentation and research studies. 24,25,27 Underreporting may have many causes, including acclimation to and tolerance of abusive behavior as well as fear of reprisals from resident families or administrators or job loss.…”

“…22,23 RSA may have deleterious effects on staff, including physical injury, psychological duress, reduced job satisfac-tion, burnout, and emotional reactions including anger, sadness, guilt, and helplessness. [24][25][26][27][28] RSA has important potential consequences for nursing home administrators as well, including financial costs for staff medical and psychological care, additional security, increased absenteeism, staff turnover, and litigation. 24,25 RSA may also lead to reactive abuse and neglect of long-term care residents.…”

“…[24][25][26][27][28] RSA has important potential consequences for nursing home administrators as well, including financial costs for staff medical and psychological care, additional security, increased absenteeism, staff turnover, and litigation. 24,25 RSA may also lead to reactive abuse and neglect of long-term care residents. Due to frustration, staff members may respond to an aggressive resident with verbal or physical abuse, [28][29][30] potentially triggering a vicious circle of escalating aggression.…”

“…Unfortunately, nursing home administrators and staff victims frequently do not report and, when possible, even ignore RSA, which is often considered "part of the job." 24,25,31 In this article, we report on the prevalence of RSA and the characteristics of the events and involved residents in five nursing homes using methodology explicitly created for the study. To our knowledge, this represents the largest systematic study of the phenomenon to date.…”

Egészségügyi dolgozók ellen elkövetett agresszív cselekmények

“…A lakók pszichoszociális stressze is kiválthat agresszív viselkedést. Ilyen stresszkeltő esemény a házastárs halála vagy a lakó kívánságának megtagadása [30]. A betegek részéről agressziót kiváltó ok lehet továbbá a szolgáltatással való elégedetlenség, rossz hír és a késedelmes ellátás [13].…”