Staff-reported strategies for prevention and management of resident-to-resident elder mistreatment in long-term care facilities

Abstract

Background Resident-to-resident elder mistreatment (R-REM) in nursing homes is frequent and leads to adverse outcomes. Nursing home staff responses may significantly mitigate R-REM's impact, but little is known about current practices. Objective To identify common staff responses to R-REM Methods We interviewed 282 certified nursing assistants (CNAs) in 5 urban nursing homes on their responses during the previous 2 weeks to R-REM behaviors of residents under their care. Results 97 CNAs (34.4%) reported actions responding to R-REM incidents involving 182 residents (10.8%), describing 22 different responses. Most common were: physically intervening/separating residents (51), talking calmly to settle residents down (50), no intervention (39), and verbally intervening to defuse the situation (38). Less common were notifying a nurse (13) or documenting in behavior log (4). Conclusions Nursing home staff report many varied responses to R-REM, a common and dangerous occurrence. CNAs seldom documented behaviors or reported them to nurses.

Implementation and evaluation of an education programme for nursing staff on recognising, reporting and managing resident‐to‐resident elder mistreatment in aged care facilities

“…The educational programme including content, material and research tools were implemented and validated previously (Ellis et al., ; Rosen et al., ). This study will use the Guskey's () Evaluating Professional Development framework to compare the study's findings with this model and assess the impact of this educational programme for nursing staff on reducing and managing R‐REM at this aged care facility.…”

“…Researchers have used different words to describe these aggressive interactions between older people living in aged care facilities (R‐REM) including mistreatment (Ellis et al., ; Lachs et al., ; Ramirez et al., ; Rosen et al., ; Teresi et al., ), aggression (Pillemer et al., ; Rosen, Lachs, et al., ; Rosen, Pillemer, & Lachs, ), abuse (Castle, ), violence (Snellgrove, Beck, Green, & McSweeney, ), violence incidents (Shinoda‐Tagawa et al., ), relational aggression (Trompetter, Scholte, & Westerhof, ), among others (McDonald, Hitzig, et al., ).…”

“…Therefore, educational programmmes for nursing staff may have the potential to improve the quality of care and life of older people living in aged care facilities, and assisting staff to reduce R‐REM (Ellis et al., ; Rosen et al., ; Teresi et al., ). Consequently, the aim of this project was to implement an educational programme targeted at nursing staff in aged care facilities on recognising, reporting and managing R‐REM using the SEARCH (Support, Evaluate, Act, Report, Care Plan, Help to Avoid) approach (Ellis et al., ; Teresi et al., ).…”

“…Importantly, previous studies have shown that R-REM could be reduced by educational programmes for nursing staff (Irvine, Bourgeois, Billow, & Seeley, 2007;Irvine et al, 2012;Karel, Teri, & McConnell, 2016;Narevic et al, 2011;Richardson, Kitchen, & Livingston, 2002;Teresi et al, 2013). Therefore, educational programmmes for nursing staff may have the potential to improve the quality of care and life of older people living in aged care facilities, and assisting staff to reduce R-REM (Ellis et al, 2014;Rosen et al, 2016;Teresi et al, 2013). Consequently, the aim of this project was to implement an educational programme Why this study is needed • There is a paucity of studies concerning educational programs in nursing aimed at managing and reducing resident to resident elder mistreatment in aged care facilities.…”

“…We expect that this educational programme will increase the understanding of R-REM and may encourage nursing staff to consider that R-REM can be managed despite the complexity of factors affecting R-REM (Ellis et al, 2014;Rosen et al, 2016;Teresi et al, 2014).…”