The elderly, dementia, aggression and risk assessment

Abstract

There are no clear comprehensive guidelines on risk assessment with the elderly. This paper reviews the literature relevant to the subject in conjunction with the case history of a patient with dementia who committed homicide whilst in residential care. Suggestions concerning factors to be taken into consideration during risk assessment are made. Copyright © 2000 John Wiley & Sons, Ltd.

What Is Known About the Intended or Unintended Homicide of One Resident Causing the Death of Another in Residential Aged Care Facilities? An Integrated Review of International Studies

“…Five themes were synthesised from the 26 studies (see Supporting Information S2 ) that were; scholarly, peer‐reviewed articles ( n = 9) (Caspi 2016 ; Corey et al 1992 ; DeBois et al 2020; Hindley and Gordon 2000 ; Ibrahim et al 2017 ; Lindner et al 2007 ; Murphy et al 2017 ; Saint‐Martin et al 2012 ; Starr 2018 ) with the remaining 17 sourced from the grey literature (see Supporting Information S3 ) (Allen n.d . ; Associated Press 2023 ; Barnard‐Smith 2014 ; Bevege 2020 ; Calderwood 2019 ; Coroner's Court 2019 , 2020 ; Floyd 2014 ; Harris 2023 ; Livio 2023 ; Luciew 2014 ; McGilvray 2017 ; Palin 2018 ; Papa 2018 ; Stone 2019 ; Wall 2019 ; Zhou 2013 ).…”

“…Arguments between the exhibitor and the target were witnessed before the incident in six articles reporting on single cases (Barnard‐Smith 2014 ; Floyd 2014 ; Hindley and Gordon 2000 ; Papa 2018 ; Starr 2018 ; Zhou 2013 ). Starr ( 2018 ) found staff intervened at the time but neglected to later follow up on those involved.…”

“…Occasionally incidents unexpectedly occurred between residents who staff considered were friends (De Bois, 2020; Luciew 2014 ). There were reports that incidents took place when residents were new to the facility (Caspi 2016 ; Hindley and Gordon 2000 ; Murphy et al 2017 ).…”

“…Wall ( 2019 ) reported staff were held accountable for not managing the exhibitors. In three reports staff had not followed up on those involved despite witnessing arguments and incidents of aggression just before the incident (Bevege 2020 ; Hindley and Gordon 2000 ; Starr 2018 ; Wall 2019 ). Palin ( 2018 ) reported staff called for an ambulance to attend a resident who had been severely beaten, however, when offered a 1‐h response time or a 15 min response time from the paramedics, the staff chose the 1 h option without reason.…”

Homicide and Dementia: A Systematic Review

“…The study quality ratings ranged from 50 to 100%. Four studies were rated high quality (≥80%) [16, 22, 26, 29], an additional five rated good (≥70%) [24, 25, 28, 30, 31], and four were <70% (range 50–67%) [5, 23, 27, 32]. In one study [22], the detailed dataset was published separately [33], enabling relevant raw data to be extracted (i.e., subjects in the target age range of ≥55 years).…”