Strategies for Preventing and Responding to Resident Aggression in Memory Care Settings

Resident aggression is a common challenge in residential senior care communities, but it’s particularly prevalent in residential memory care settings. As a result, memory care programs need to take precautions to protect residents and staff.

A 2016 study on resident-to-resident mistreatment in nursing homes revealed that 1 in 5 residents experienced aggressive interactions in the prior 30 days. The most common types of mistreatment were verbal, other (such as menacing gestures), physical, and sexual. The study notes that contextual factors, like residents residing on a dementia level, correlated with higher levels of mistreatment.

Why Resident Aggression Occurs

Kristie McGinn, co-owner and chief operating officer at Assurance Home Care

Numerous factors contribute to resident aggression within care facilities. “Many older adults, especially those living with dementia or Alzheimer’s, can become easily overwhelmed or disoriented, leading to aggressive behaviors,” says Kristie McGinn, co-owner and chief operating officer at Assurance Home Care. “It can manifest in various ways, like verbal outbursts, shouting or name-calling, or physical aggression, such as hitting, pushing, or grabbing. It can also be passive, such as refusing care or isolating oneself.”

Aggression can jeopardize the safety of other residents and staff. Physical aggression can cause injury, while verbal aggression can create emotional stress and a tense environment. If caregivers consistently deal with unpredictable resident behaviors, they may experience burnout or anxiety. “The atmosphere of care can shift dramatically when aggression becomes a frequent issue, and this can affect the quality of care provided,” explains McGinn.

How to Identify Residents with Aggressive Tendencies

The first step to effectively managing resident aggression is to identify residents who are prone to such tendencies. McGinn encourages staff to carefully observe behavior patterns and to note any triggers like overstimulation, confusion, or pain. Next, it’s important to create personalized care plans that focus on the individual’s needs and triggers. “For example, simplifying and maintaining routines, limiting changes, offering calming activities, and ensuring proper pain management can go a long way in reducing stress-related aggression,” she says.

The Role of Staff Training in Managing Resident Aggression

“Continuous training is essential to ensure caregivers are equipped to manage aggressive behaviors effectively,” says McGinn. She notes that programs should offer ongoing training that teaches staff how to understand dementia-related aggression. The training should encompass de-escalation techniques and strategies for non-verbal communication with residents. “A gentle persuasive approach and re-direction are key to managing aggression,” explains McGinn. “Regular team meetings or care reviews allow caregivers to stay updated on any changes in a resident’s condition or behavior.”

The Cornell Institute for Translational Research on Aging has created an Improving Resident Relationships (IRRL) program to help train staff to recognize resident aggression in long-term care facilities. The program includes training to help staff manage aggression and improve quality of life for residents.

Additional Supports to Reduce Resident Aggression

Engaging residents in daily activities that are specifically tailored to their abilities can help to keep residents’ minds stimulated, lowering frustration levels. “Cognitive therapies, music therapy, or even pet therapy can provide a calming effect,” she says. “Suggest looking at family photos or items that are displayed in their room to remind them of happier times.”

Additionally, it’s essential to not overlook the importance of providing caregivers with support. McGinn states that respite care, counseling, and peer support groups can all help caregivers manage the stress of caring for individuals who display aggression.

By proactively managing resident aggression and ensuring that staff have ongoing training and support, memory care programs and other residential senior care settings can prioritize the safety of other residents and staff.

Paige Cerulli

Paige Cerulli is a contributing writer to i Advance Senior Care.