Add whistles to your caregiver’s toolkit

People are emotional. Others are downright angry. Then there’s a small amount that can even be violent.

And some inhabitants of nursing homes—well, they just can’t help themselves, according to recent findings that suggest an increased amount of residents are committing acts of rage against themselves and their caregivers.

Last year in Ontario, CBC News reported that violence had tripled compared to the previous few years in the province, with residents biting, choking, and in one case, murdering each other. One nurse from a local facility was quoted saying she has to regularly break up fights.

I doubt her employers listed refereeing in the job description.

Cornell University released a study in June stating resident aggression is much more common than widely believed, and in a single eight-hour shift, observers witnessed 30 episodes of aggression—defined as shouting matches or physical contacts.

Also in June, Swedish researchers penned the study Violence in nursing homes: perceptions of female caregivers, exposing the potential risk in staff member’s overreporting—or worse, underreporting—violence brought onto them by residents. The main finding of the study, researchers say, is that “perceiving an action as violent is in the eye of the beholder.”

It’s hardly a groundbreaking discovery, and an even sorrier summation of a terrible problem. What worries me is that with any violent action comes a reaction: Disciplinary recourse and self defense come to mind. The Swedish researchers say caregivers are subjectively analyzing the violent act for themselves, and then decide whether or not to report it. Yet I refuse to believe this is a decision caregivers caught in the middle of a resident brawl should make. It seems to me there would be a set protocol to follow in an instance of violence, especially with it being so prevalent. As the lady from Ontario said to reporters, recalling a previous fight in which one resident had torn off the scalp of another, “It’s what I go to every day. It’s what I live.”

These studies tell us that people with cognitive impairments will not cease to have the potential for being violent. There is a bigger stake, then, in developing sound methods to appropriately handle violence in nursing homes. Caregivers should at least be told by their superiors when to blow the whistle on aggressive behavior, and unfortunately, when things get violent, how to intervene.

Certainly, there is a legal and moral obligation for nursing homes to provide a safe environment for residents. But that same promise of protection also exists for staff who are being abused by residents. If you have any policies, recommendations, or stories on how to deal with resident violence against caregivers and themselves, please discuss them. Sharing your insights may help to create safer facilities.