Tuesday, September 22, 2015

Long-Term Care Dementia, Alzheimer’s Violence: CNA Solutions (Research, Video 3:37)

Dementia is like a fluttering bee. As a hospice volunteer, I never knew when it would make honey or sting. There were times when nursing home residents with dementia were rude or violent. I have seen a resident slap a nurse assistant (CNA) in the face with such force I thought she would fall over. To her credit, the CNA took a deep breath and walked away while another CNA interceded. The resident probably forgot the incident soon afterward. During violent situations involving residents with dementia, caregivers had to protect themselves, restrain a resident if they could, but resist expressing rage and fighting back.

Resident-to-resident violence in nursing homes, unfortunately, is common and may involve victims who are too fragile to protect themselves. Some have even died as a direct result of being physically assaulted. This research on nursing home resident violence explores strategies developed by certified nurse assistants to prevent and manage resident to resident violence in nursing homes. The main theme is "Putting Residents First," a conscious effort by CNAs to put themselves or a beloved family member in the place of the resident while administering care.

Based on interviews and data analysis, the following themes are featured and suggested for formulating strategies for managing and decreasing resident to resident violence through the ability of the CNAs to empathize with the residents in their care. These strategies may provide a foundation for the development and testing of interventions aimed at preventing and managing resident to resident violence in long-term care.

(a) Knowing the Residents
(b) Keeping Residents Safe
(c) Spending Quality Time

In this video, Shirlee Engel reports on how dementia can cause aggression and how many nursing homes struggle to cope.


Frances Shani Parker, Author
Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes is available in paperback and e-book editions in America and other countries at online and offline booksellers.
Hospice and Nursing Homes Blog


  1. Having witnessed the way my mother has been treated in a nursing home, I believe that most aggressive behaviour and violence could be eliminated with proper care and the right environment. People with dementia are often blamed for responsive behaviours that are not their fault.

    We need a different kind of care, and differently trained care partners and more of them to help people with dementia live more fully.

    Here's an example of how aggressive behaviour can arise and be managed:

  2. I feel there is a general need for further education on behaviours as they represent communication on behalf of the person with dementia and they are generally unmet needs, need to know the life history of the person, their sexuality,clinical needs, what medications they are on, what other co-morbidities they have etc., . Staff to clients care, are they getting one on one time besides, just attending to the activities of daily living. Humans are so multi-layered and need individualised care plans with consistency of care.

  3. Thank you for sharing your comments. You both speak of the urgency for more education to appropriately meet person-centered needs of those with dementia. I couldn't agree with you more.