Citation

Caspi E. Dementia (London) 2013; 14(4): 528-546.

Affiliation

Geriatrics & Extended Care Data & Analyses Center, Providence VA Medical Center, Providence, Rhode Island, USA.

Copyright

(Copyright © 2013, SAGE Publishing)

DOI

10.1177/1471301213502588

PMID

24339115

Abstract

Aggressive behavior between residents with dementia in long-term care residences is a concerning but understudied phenomenon. The goal of the study was to identify the circumstances, sequence of events, and triggers that lead to these behaviors. I collected the data during 10 months in two special care units of an assisted living residence. I used participant observation as the primary data collection strategy, complemented by review of clinical records and semi-structured interviews with care staff and managers. As the analytic framework, I used Grounded Theory informed by Miles and Huberman's approach. In a substantial number of the reported 85 incidents, I identified observable early warning signs; in the majority, I identified observable causes or triggers prior to the aggressive acts. The majority of incidents were situational-reactive (circumstance-driven) and therefore potentially modifiable. Twelve effective staff prevention strategies were identified. I suggest incorporating the study findings into care staff training programs.

Language: en