An aged care provider study has found that abuse between residents typically involves people with cognitive impairment and does not result in physical harm.

The research from Victorian provider Benetas explored the prevalence, nature, contributing factors and outcomes of resident‐to‐resident abuse over 12 months across 13 homes with over 900 beds.

It concluded that managing behavioural symptoms associated with cognitive impairment was critical to preventing and managing resident-to-resident abuse.

The study identified 169 incidents, most of which were physical (106) followed by verbal (34) then sexual (29).

Physical abuse most commonly involved a punch or strike (28 per cent) or a grab, pull, poke or scratch (21 per cent).

The most common sexual abuse involved kissing on the face or mouth (48 per cent).

Most incidents occurred in the dining room (31 per cent) or other communal areas (46 per cent).

Lead researcher Dr Catherine Joyce said they found that in nine out of 10 cases of aggressive behaviour, the resident had a notable cognitive impairment.

Dr Catherine Joyce

“This behaviour is largely displayed by people who are living with dementia or a form of Alzheimer’s, and who often experience poor impulse control and limited capacity to express themselves when they’re in pain or discomfort.

“People living with these diseases can also often have poor insight into the impact that their behaviour has on others,” said Dr Joyce, general manager of quality, outcomes and research at Benetas.

The research also found that one third of residents displaying aggression were involved in one incident of abuse, and 79 per cent of cases incurred little to no harm.

“Discussion of abuse can be alarming, but what we need to remember it is that in this instance it’s usually not deliberate and it requires effective clinical and behaviour management,” Dr Joyce said.

Call for behavioural management over reporting

Dr Joyce said Benetas undertook this research to better understand the prevalence of abuse between residents and the contributing factors that cause it.

“We’re very serious about achieving zero incidents of resident to resident abuse at Benetas.”

The findings come in the lead up to a new compulsory scheme for reporting serious incidents of aggression between residents in aged care.

The Department of Health is in the final stages of developing the Serious Incident Response Scheme (SIRS) following a public consultation last year (read our backgrounder here).

Dr Joyce said additional Government reporting requirements for these incidents would not reduce harms for residents.

“What we need is for services to proactively record cases, ensure that care is tailored to people’s individual needs and preferences, and proactively monitor residents to detect any changes in their circumstances.”

The research Prevalence and nature of resident‐to‐resident abuse incidents in Australian residential aged care was published online recently in the Australasian Journal on Ageing.

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2 Comments

  1. Dr Joyce’s comment “The research also found that one third of residents displaying aggression were involved in one incident of abuse, and 79 per cent of cases incurred little to no harm”.

    Makes it sound like it is all great, what about the psychological trauma of being assulted in your home and having to see that person on a daily basis and live in fear of them assulting you again.

    How would Dr Joyce like to be assulted by a stranger who lives in her home only to be told you have suffered little or no real physical harm so no problem and that stranger continues to live in her home and she has to see them every day and she has no idea if or when they will assult her again?

  2. I haven’t read the article, yet, but the report above – taken in isolation – does raise serious concerns.

    First, as Aged Care Worker points out, the statement that “79 per cent of cases incurred little to no harm” is very problematic. It assumes that emotional or psychological harm was not present. How can you be sure of this? Well of course you can’t. And it does seem reasonable that if one is in a push and shove incident in one’s own home there may be a great deal of emotional pain.

    Second, the comment that “this behaviour is largely displayed by people who are living with dementia or a form of Alzheimer’s,” is clumsy. It assumes that Alzheimer’s and dementia are two distinct and unrelated entities, a view common in the public arena as in ‘my dad had Alzheimer’s disease but at least he didn’t have a dementia’ – which is what someone actually said to me once. We should not be making these mistakes in either research or reporting.

    I also think that the idea that we can have ‘zero incidents of resident to resident abuse’, is totally unrealistic. Perhaps it was a throw away line to encourage trust in the organisation. I get that, but of course to totally eradicate any form of interpersonal violence in communal settings is simply not going to happen.

    Of course it is correct to say that the new reporting requirements will have no effect on resident to resident aggression, but then that is not why they are in situ. The government’s policy is (as per Yes Minister) that it is better to do something even if it has no effect whatsoever, than to do nothing. The public like to think that we are actually doing something. It makes them feel comfortable, and gives the impression that not only are we doing something but that we know what we are doing – both of which are quite false.

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