Aggressive Behavior Directed at Nursing Home Personnel by Residents' Family Members

Abstract

Anecdotal evidence suggests there is a significant amount of aggressive behavior directed at nursing home personnel by residents' family members. This exploratory study describes a random sample survey of 70 Florida nursing homes. Administrators reported 1,193 acts of verbal aggression and 13 acts of physical aggression for a 6-month period. Dissatisfaction over how the specific and overall care needs of residents were being met was most frequently cited as the contributing factor. Social work staff and directors of nursing were most often called on to resolve these conflicts. The authors conclude with recommendations for research and conflict resolution.

Aged Care Residential Facility and Family Interface: A Training Program for Staff

“…A series of workshops for staff were designed, conducted and evaluated, using the authors' experience of training groups such as doctors and bearing in mind reports of relevant content (e.g., communication skills, reducing blame) suggested by writers such as Vinton et al (1994) and Looman et al (2002).…”

Sources of Stress and Conflicts Between Elderly Patients, Their Family Members and Personnel in Care Settings

“…Dissatisfaction with care provided to the elderly person-Quality and adequacy of care, and other aspects of care provision are among the most laden fields of conflicts and dissatisfaction. Vinton and Mazza (1994) conducted a study in nursing homes and found that twothirds of the nursing homes surveyed reported some verbal aggression and 11% reported physical aggressive behavior by family members of residents toward staff members. The most frequent reasons for such aggressive behavior were: issues relating to the overall and specific care provided to the resident, theft of resident's belongings and disputes over billing.…”

“…Families may object and oppose various actions that seem to them inappropriate such as: restricting patient's mobility, binding to a wheelchair or to the bed, enforced feeding, artificial alimentation, sedation when the patient is agitated, shouting or annoying other patients, toileting, life prolongation etc. If the quality of care fails to meet the expectations of family members, especially in nursing homes, conflict may arise (Vinton & Mazza, 1994). Family caregivers of institutionalized elders may feel a strong sense of responsibility to their family members, no less than they felt before the placement in a long-term care facility took place and thus will continue to experience stress.…”

“…Personal problems, such as problems at work and one's own family, economic difficulties and health deficiencies, may also generate conflictual relationships. Vinton and Mazza (1994) suggest that aggressive behavior can be a way to reduce guilt feelings, frustration, fears and helplessness. These adverse feelings may be projected onto staff members and hidden behind the disguise of overprotection and extreme demands and criticism by family members of the staff.…”

“…Changing policies and humanizing facilities- Vinton and Mazza (1994) suggest that fundamental to conflict resolution is to understand the purpose of the specific aggressive behavior. One reason may be that family members perceive that aggressive behavior is the only avenue to bring about change in the facility on behalf of the residents.…”