The inconvenient truth about resident-to-resident altercations. . .
By Susan Saldibar
Maybe you read about the case back in May, about the 64-year old dementia patient in Dade County, Florida, who beat to death another resident because “He wasn’t listening to me.”
Or perhaps you recall back in 2012 the killing of one assisted living resident and the brutal injuring of another in an attack by a fellow resident in the Scarborough district of Toronto.
And those are just a couple of high profile cases that were actually reported! A 2014 Cornell University study found that in New York alone each year, one in five nursing home residents are involved in a minimum of one aggressive encounter with a fellow resident.
What’s going on? The inconvenient truth is that resident-to-resident altercations, or “RRA” as they are referred to in our industry, are far more commonplace than most of us would like to think. And when an RRA happens, it can quickly bring a senior community to its knees.
I sat down with Jacquie Brennan, VP of Vigil Health Solutions, a Senior Housing partner and a leading provider of emergency call and monitoring solutions, to talk about a recent editorial published in JAMDA, the Journal of American Medical Doctors Association. It was written by Eilon Caspi, BSW, MA, PhD, who conducted an extensive study of RRA violence. In fact, the quote used in the title of this article was taken from one of his interviews.
Here are a few of the findings regarding RRA incidents:
81% occurred during evening hours.
70% were not witnessed by staff (even with hallway surveillance cameras).
62% occurred on weekends.
37% occurred between roommates.
The article goes on to list things that senior care providers can do to help guard against RRA. They even mention the Vigil Dementia System by name as a good example of alert technology, because it can generate signals in real time when residents leave their beds and enter other residents’ bedrooms.
I asked Jacquie to weigh in on the article and the mention of the Vigil System as a possible solution to help address some of the issues raised. “We certainly have seen our system used as a monitoring tool to help prevent RRA incidents,” says Jacquie. “The study suggests that understaffing may be a contributing factor. However, even with higher staff-to-resident ratios, the staff can’t be in all resident rooms at all times. The Vigil System passively monitors residents while they’re in their rooms and only alerts staff when the resident is acting outside of designated “safe” behaviors. It was designed that way to respect the privacy and independence of the resident, while freeing up staff and directing them only to situations that require intervention,” she told me.
Prevention and Detection
That makes sense. So I asked Jacquie to share some of the ways their clients use the Vigil System to detect and alert staff when an RRA is occurring:
Setting customizable “rules” to immediately alert when a newly admitted resident gets out of bed at night so that they can witness the resident’s behaviors when awake, but without having to dedicate staffing resources to 24/7 monitoring.
Turning on the “Room Departed” rule so that staff are aware when a resident they are concerned about leaves their room.
Setting the “Room Entered” rule to alert staff that someone has entered another resident’s room, so that they can intervene.
Alerting staff when residents in a shared room are out of bed in the night.
Of course before any measures can be taken to tackle the RRA issue, it needs to be raised to a heightened level of awareness. Many of these incidents are either going unreported or grossly under-reported as Karl Pillemer, the Hazel E. Reed Professor in the College of Human Ecology’s Department of Human Development reports. “Despite the acute urgency of the problem, resident-to-resident mistreatment is underreported. Increased awareness and the adoption of effective interventions are greatly needed,” said Pillemer, who also serves on the Weill Cornell faculty.
Clearly, RRA needs to be taken seriously and senior care providers need to begin to take concrete steps to improve staffing and training. After all, without real time surveillance and alerting, all the cameras in the world won’t prevent an RRA.
And the real goal, by all accounts, is to provide a safe haven for all those living in your community. As a resident in mid-stage Alzheimer’s was quoted in the article as saying, “I want to know that someone will be there for me if something happens to me.”
For more information on surveillance and alerting technology, please visit the Vigil Health Solutions website.