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Violence and Aggression in the Elderly: Nondirected Aggression and Clinical Causation 

Violence and Aggression in the Elderly: Nondirected Aggression and Clinical Causation
Chapter:
Violence and Aggression in the Elderly: Nondirected Aggression and Clinical Causation
Author(s):

Ghulam Mustafa Surti

, Laura Stanton

, and Robert Kohn

DOI:
10.1093/med/9780199374656.003.0024
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date: 22 February 2020

In nursing homes, aggression is seen in almost 32% of residents. Often, there are medical causes associated with delirium to account for such aggressive behaviors. This chapter discusses the incidence of and issues related to resident-to-staff and resident-to-resident aggression involving patients with major neurocognitive disorders in long-term care settings. Often such aggression results in physical injuries to staff. Resident-to-staff aggression most commonly occurs during direct caregiving. Resident-to-resident assault is not uncommon and has been categorized into 13 major subtypes. Use of physical restraint and pharmacological interventions in response to agitation and aggression in nursing homes carries liability due to risk of injury. The chapter also addresses sexuality of elderly nursing home residents, federal regulations mandating the allowance of expression of sexual needs of residents, and barriers that can impede expression of sexuality by residents. The chapter concludes with a discussion of elder-to-caregiver aggression in the community, including violent behavior toward family and caregivers employed by home healthcare agencies.

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