Process Models to Understand Resident-to-Resident Aggression Among Residents With Dementia in Long-Term Care [2020]

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.

David Burnes, Manaal Syed, Jessica Hsieh
Journal of Applied Gerontology, September 10, 2020
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