Documentation of Resident to Resident Elder Mistreatment in Residential Care Facilities

• NCJ Number: 246429
• Date Published: March 2014
• Author(s): Mark Lachs, M.D., M.P.H.; Jeanne A. Teresi, Ed.D., Ph.D.; Mildred Ramirez, Ph.D.
• Length: 283 pages
• Grant Number(s): 2009-IJ-CX-0001
• Agencies: NIJ-Sponsored
• Publication Type: Research (Applied/Empirical)

Annotation

This study of resident-to-resident elder maltreatment (R-REM) in nursing homes is intended to improve institutional recognition of R-REM; to examine the convergence of R-REM reports across different methodologies; to identify the most accurate mechanism for detecting and reporting R-REM; to develop profiles of persons involved in R-REM by reporting source; to investigate existing R-REM policies; and to develop institutional guidelines for reporting R-REM incidents.

Abstract

The results presented in this report address only the urban sample. Overall, there were 335 reports of at least one R-REM incident within the 2-week prevalence period by any of the various data sources, i.e., resident report, staff report, observation, incident/accident report, and forensic chart review. The sources that reported the largest number of "unmatched" unique residents involved in incidents was the staff, followed by the residents. The highest convergence identified between report sources was between the staff reports and the shift coupons, but generally convergence across sources was low. The resident and staff sources were apparently the best sources for R-REM data. Residents involved in R-REM were likely to be non-Hispanic, White, and residing in segregated units for individuals with dementia. On average, they exhibited various types of problem behaviors. In addition, there was evidence environmental characteristics of nursing homes were associated with and contribute to R-REM, such as disturbing noises and the congestion of large numbers of patients with walkers and wheelchairs. Recommendations pertain to the development of guidelines that address the identification, reporting, and documentation of R-REM events; staff training on R-REM recognition and intervention; and research projects that examine residents' characteristics and contextual factors related to R-REM. This was an epidemiological prevalent cohort study with one wave of data collection that involved five urban and five suburban nursing homes. The current report addresses only the urban facilities. Extensive tables and 27 references