Process Models to Understand Resident-to-Resident Aggression Among Residents With Dementia in Long-Term Care. (October 2021)

• Record Type: Journal Article
• Authors: Burnes, David; Syed, Manaal; Hsieh, Jessica
• Is Part Of: Journal of applied gerontology. Volume 40:Number 10(2021)
• Page Start: 1236
• Page End: 1245
• Publication Date: 2021-10
• Subjects: dementia -- nursing homes -- abuse and neglect; Gerontology -- Periodicals; 362.6
• DOI: 10.1177/0733464820955089
• Languages: English
• ISSNs: 0733-4648

Abstract

Background/Objectives: Resident-to-resident aggression (RRA) is a prevalent form of interpersonal violence in long-term care (LTC) settings. Research to guide preventive interventions is limited. Using social-ecological and need-driven dementia-compromised behavior perspectives, we sought to generate process models representing common RRA pathways in dementia-specific LTC units. Research Methods: We used qualitative focus group methodology involving staff ( n = 36) exposed to everyday resident interactions at two urban LTC facilities in Toronto, Canada. Semistructured interviews were audio-recorded and transcribed. Two independent raters coded the transcripts using iterative, constant comparison analytic processes. Results: Two distinct RRA process models in dementia-specific LTC units were developed. Models reflect sequential pathways driven by residents' benign or responsive behaviors and cognitive processing limitations, with escalation points within resident dyads or groups. Implications: This study furthers RRA conceptualization as a process rather than an aggressive event. Models capture unique RRA manifestations in dementia-specific LTC units and entrypoints for prevention or management.