Our own Alison Hirschel.......
Mild to moderate dementia is clearly a factor in much of the aggression, however, because it causes disinhibited behavior. Other factors, Pillemer says, include:
• Crowded conditions: The study found higher rates of mistreatment in more crowded facilities, and in areas within facilities where residents were more densely gathered.
• Understaffing: The study found higher rates of resident-on-resident aggression in nursing homes with lower staff-to-resident ratios.
• Nursing-home workers who are inured to the problem: “Staff can become somewhat blinded to this,” Pillemer says, “because of the frequency with which it occurs.”
• Conflict’s cyclical nature: “The negative behavior and effects are contagious,” Pillemer says. “Seeing these incidents causes other residents to be fearful, anxious, concerned—and that can lead to more of the behavior.”.........
Alison Hirschel, the elder law attorney for the Michigan Poverty Law Program and director of the Michigan Elder Justice Initiative, agrees. She cites cases in which relatively simple adjustments by nursing-home staff eased elders’ “difficult behaviors.” One man, a former police officer, had worked the night shift for decades before going into a nursing home. Staff expected him to sleep at night; but he found this impossible, and became frustrated and aggressive. Eventually the nursing aides figured out what would help. They gave him a clipboard and allowed him to wander around his unit at night. His frustration and challenging behaviors eased.
Another woman, who’d lived in an abusive orphanage as a child, did better when treated in ways that didn’t trigger terrifying memories. And a blind resident needed to hear from staff the steps they’d take as they bathed her.
Such adjustments by staff require knowledge of residents’ emotional needs and of their life histories — not just of residents’ medical charts. Acquiring such knowledge takes greater effort and skill, but Pillemer says that workers are generally eager to learn how to better address aggressive behaviors. “Staff feel very powerless to deal with this,” he says. “They don’t quite know how to handle it.”