Resident-on-Resident Abuse

When most of us think about abuse at nursing homes or assisted living facilities, we think about actions taken by staff that directly harm residents. A large number of Maryland residents are actually abused by fellow residents, many of them suffering from dementia, personality changes, psychiatric illnesses or just the stress of living there. Though it may be one resident abusing another, that doesn’t mean nursing home management’s not responsible.

A new study by Cornell University researchers concludes that 20% of those living in nursing homes experience abuse from other residents. One researcher estimates resident-on-resident abuse is more common than abuse by staff. In addition to the physical abuse that may occur, the emotional toll may be overwhelming.

The study was done by researchers from Cornell and the Research Division of Hebrew Home at Riverdale, who evaluated 2,011 residents in ten nursing homes during a one-month period. They found that 407 residents, or 20.2% percent of the total, had suffered a least one resident-to-resident incident of mistreatment.

• 9% of victims suffered verbal abuse.
• 5% suffered “other” types of abuse, including invasions of privacy and menacing gestures.
• 5% encountered physical abuse.
• Less than 1% suffered sexual abuse.

Types of abuse include:

• Verbal aggression, such as screaming at another resident and use of foul language.
• Physical aggression, most commonly hitting and pushing.
• Entering another resident’s room without permission and taking or touching another’s property were common invasions of privacy.

Risk factors are:

• Cognitive impairment which may cause a person who would not be violent to have serious aggressive episodes.
• Those who are younger and/or more physically active are more able to go into other residents’ rooms and are more likely to be involved in abuse.
• Crowded common spaces like hallways and lounges can spark conflicts.
• Conflicts occurred more often in the winter, possibly because residents’ space is even more limited due to their inability to go outside.
• Low staffing levels lead to less oversight and control over residents more prone to abusing others.

Some of the possible causes of an aggressive outburst include:

• Waiting in line
• Dementia (fear and not understanding what’s going on)
• Hunger
• Pain
• Frustration
• A propensity for aggression
• Psychiatric illness
• Unresolved anger
• Lack of sleep
• Physical illness
• Depression
• An inability to cope with demands being placed on them.

A facility’s environment can also contribute to aggressive behaviors.

• The facility is chaotic, noisy, with yelling and a rushed atmosphere instead of being a place encouraging residents to be calm
• Having unrealistic expectations of residents
• Failing to screen possible residents ahead of time to prevent potentially abusive individuals from being admitted
• Failing to redirect the focus of residents becoming aggressive
• Allowing abusive residents to act with impunity or failing to address the underlying causes of aggression.

Researchers made suggestions to start dealing with the situation.

• Improving staff awareness of the problem
• Developing clear rules for dealing with aggression among residents
• More individualized care so those at greater risk of becoming aggressive have more supervision.

Management of nursing homes and assisted living facilities have an obligation to keep residents safe. That includes keeping them safe from other residents, not just minimizing the chances that they may fall, making sure they get their medications properly or preventing abuse by staff.

Before admission, residents should be screened to see if a potential new resident poses a risk of abusing another resident. Information can come from the person’s medical history and responses to questions to the person and their family members. A psychiatric evaluation should be done if the person appears to pose a potential threat to others.

If management takes a risk by admitting a person with a known history of abusive behavior and the abuse of others continues, the nursing home may be responsible for any harm done. If abuse happens at a facility, it needs to be documented and addressed to prevent it from happening again. Staff should be willing and able to get help if they are having problems with a resident. If need be, the resident should be removed to protect others, including employees and visitors.

Abuse by one resident of another does not occur in a vacuum. It’s the facility’s management who are responsible for keeping residents safe, including taking these steps:

• Screening potential residents
• Using preventive measures with a resident who may be agitated, to keep them from becoming violent
• Having sufficient staffing to oversee and protect residents
• Removing residents who cannot be controlled by staff.

Call the Law Offices of Roger Weinberg, LLC, at 410-825-3161 from anywhere in Maryland, or fill out this contact form if you or a loved one at a nursing home or assisted living facility has been abused or harmed by another resident. Our lawyers have been practicing in this area for decades, know the rights of nursing home patients in our state and understand the way the nursing home industry works. We can help get the justice and compensation that your loved one deserves. We recognize that while there are many facilities that do a respectable job, there are just as many that do not — and it’s the vulnerable, elderly residents who pay the price.