About 88,000 (6.8 percent) of U.S. nursing home residents are physically aggressive every week--hitting, shoving, scratching or sexually abusing others. This aggression can inflict physical and psychological harm on staff and other residents, according to background information in the article. Verbal aggression, when residents threaten, scream or curse at others, also can cause difficulties.
Ralph Leonard, M.D., M.P.H., of CALM-MD, LLC, St. Louis Park, Minn., and colleagues studied nursing home residents age 60 years and older with dementia who resided in one of five states: California, New York, Ohio, Pennsylvania or Texas. The authors used data from the participants' Minimum Data Set (completed in 2002), a health assessment completed regularly for all residents of nursing homes that receive federal funds. The assessment contains information about the resident's medical condition and functional status.
Of 103,344 residents (average age 84 years) who met the criteria for the study, 7,120 (6.9 percent) had been physically aggressive in the week before their assessment and 10.5 percent had been verbally abusive. After the researchers considered other factors that may play a role in aggression, including age, sex and the level to which residents were able to perform daily tasks on their own, they found that symptoms of depression, delusions, hallucinations and constipation were associated with physical aggression. With the exception of constipation, the same factors also contributed to verbal aggression.
Previous studies have linked psychological conditions to aggression, but this study was one of the first to examine the effects of constipation, the authors write. "We chose t
Contact: Ralph Leonard, M.D., M.P.H.
JAMA and Archives Journals