Danger in Safe Spaces? Resident-to-Resident Aggression in Institutional Care

Abstract

When considering violent and aggressive acts against vulnerable older adults, possible victim-offender constellations are manifold. In recent years, specific safety risks in institutional care connected to aggressive behaviour of residents against fellow residents have received increasing attention. While not easily accessible for research, resident-to-resident aggression appears to be widespread; it includes severe forms of violence (up to lethal outcomes), affects quality of life and institutional climate and poses significant challenges for institution and nursing staff. This chapter reports data from a multimethod study in Germany, combining a standardized survey among nursing home staff on experiences of resident-to-resident aggression / resident-to-staff aggression as well as on institutional problem handling and individual coping strategies with a qualitative interview study in nursing homes including residents’ voices and those of staff and management. Violent and aggressive incidents between residents are highly diverse not only with regard to the nature of the acts (including physical violence, sexual harassment, verbal aggression, humiliating and socially excluding behaviour) but also with respect to timing, location, situational triggers, and personal, situational, institutional, and societal background factors. Findings are discussed with reference to perspectives for prevention and the significance of staff training in the frame of any prevention strategy targeting resident-to-resident aggression in institutional care.