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Understanding and Preventing Resident-to-Resident Incidents in Aged Care Facilities

An inquest in Victoria highlights the dangers of resident-to-resident aggression in aged care.Here’s what families need to know to protect their loved ones.

Recent attention has focused on resident-to-resident aggression in aged care facilities, with the Coroners Court of Victoria investigating the deaths of eight residents in 2021 following interactions with other residents.

If you have a family member in aged care, understanding the risks and preventative measures can help ensure their safety and well-being.

What is Resident-to-Resident Aggression?

Resident-to-resident aggression involves unwelcome interactions between residents that cause physical or psychological distress. These interactions can include physical, sexual, or verbal aggression. However, it’s important to note that in many cases, the residents involved may not intend to cause harm.

The estimated prevalence of resident-to-resident aggression in aged care is around 20%, though it might potentially be under-reported. This means that approximately one in five residents may experience such an incident in a given month,often involving verbal abuse or privacy invasion.

The consequences can range from functional decline to physical injury or even death.

Factors contributing to Resident-to-Resident Aggression

A study identified 28 deaths over 14 years related to resident-to-resident aggression in Australian nursing homes. Key findings included:

• Almost 90% of residents involved (either as the “exhibitor” or the target) had dementia.
• Three-quarters of those with dementia had behavioral and psychological symptoms, such as wandering and physical aggression.
• Exhibitors of aggressive behavior were often male (85.7%), younger, and more recently admitted to the facility.
• Incidents leading to death often involved pushing, resulting in falls and injuries like hip fractures or head trauma.
• Most incidents occurred in communal areas.

Lessons from Past incidents

The death of a resident at the Oakden facility in South Australia previously highlighted the issue of resident-to-resident aggression. This case led to a coronial inquest and the facility’s closure in 2017.

Key issues raised included the need for regular clinical reviews for residents exhibiting potentially aggressive behavior, detailed documentation, and proper reporting of incidents.

Since 2021, facilities must report incidents involving “unreasonable use of force” through the Serious Incident Response Scheme, monitored by the Australian Aged Care Quality and Safety Commission.

Prevention requires a extensive approach, including reviewing trends at the facility, provider, and national level