The most prolific perpetrators of elder abuse may be living among them

Researchers studying the prevalence of resident-to-resident mistreatment in nursing homes found that at least one in five elderly residents had experienced some form of verbal or physical mistreatment from other residents during a one-month surveillance period. The findings are published in Annals of Internal Medicine.

Resident-to-resident elder mistreatment is a recognized problem in nursing homes but well-designed studies of its prevalence are lacking. Having a better understanding of this type of abuse and its causes could help to inform the development of effective prevention strategies.

In the first large-scale, systematic study of its kind, researchers surveilled five urban and five suburban New York state nursing homes during a one-month period to estimate the prevalence of resident-to-resident mistreatment. Mistreatment was classified as any "negative and aggressive physical, sexual, or verbal interaction between long-term care residents that in a community setting would likely be construed as unwelcome and have high potential to cause physical or psychological distress in the recipient." The incidents of mistreatment were identified through resident interviews, staff interviews, shift coupons, observation, chart review, and accident or incident reports.

During surveillance, at least 20 percent of nursing home residents experienced resident-to-resident mistreatment. Verbal aggression was the most common form of mistreatment, but the rate of physical aggression between residents was substantial, and several episodes of sexual aggression were also seen during the study timeframe. The authors noted that one of the most compelling findings was that the traditional focus of violence mitigation in the nursing home—staff abuse of residents—may be disproportionate relative to the actual parties involved in the incidences of mistreatment.