Title : Managing resident aggression in the long-term care setting: A resident-centered de-escalation intervention
Abstract:
Elder abuse in long-term care facilities has traditionally focused on staff-perpetrated abuse. However, recent studies highlight the need to address resident-to-staff aggression (RSA) and resident-to-resident aggression (RRA). Research indicates that approximately 16% of staff have experienced aggression from residents, including physical, verbal, and sexual forms. Similarly, RRA is a significant concern, with nearly 20% of residents experiencing aggression from another resident. This aggression negatively impacts quality of care, facility safety, job satisfaction, and staff turnover. A significant relationship exists between caregiver assaults in nursing homes and occupational strain, stressors, and anger, necessitating effective interventions. Over the past 25 years, research has focused on behavioral approaches to reduce agitation in long-term care residents, leading to RRA and RSA. Despite their effectiveness, long-term care facilities often lack mandatory training for staff, forcing them to react without proper protocols or support, potentially leading to reliance on pharmacological interventions. As the Centers for Medicare & Medicaid Services act against unnecessary drug prescriptions, facilities may lose medical interventions without replacements. RRA and RSA often represent unmet needs of those perpetrating the acts. Addressing these requires a resident-centered intervention. Our training program, developed by experts at the Pennsylvania Psychiatric Institute and Penn State College of Medicine, Division of Geriatric Medicine, aims to equip staff with the necessary skills to de-escalate situations effectively. This initiative is crucial for ensuring the safety and well-being of both residents and staff in long-term care facilities. It is our responsibility to reduce harm in facilities where residents not only receive care but call home. This training addresses an unmet need in long-term care, with significant consequences for both staff and residents.
