Researchers at Kent State University College of Public Health conducted qualitative and quantitative analysis of 101 fatal resident-to-resident aggression (RRA) in long-term care (LTC) facilities using case data from the multistate National Violent Death Reporting System (NVDRS). The study, led by doctoral candidate Mrs. Kristen DeBois, with assistance from doctoral candidate Ms. Shelly Evans and assistant professor Dr. Sheryl Chatfield, was published in The Journal of Applied Gerontology.

Quantitative findings included:

• Most incidents involved a male victim and exhibitor.
• Most deaths were the result of a “push-fall” incident and did not involve use of a weapon or other object used as a weapon.
• In most cases, victims and exhibitors had dementia diagnoses.
• Exhibitors averaged 16 years younger than victims.
• Average time between injury and death was 17 days.

Qualitative findings included four themes:

• Incidents were described as Unexpected in nature and severity. In many cases, staff identified the victim and exhibitor as friendly with one another.
• Incidents often occurred as a result of either the victim or exhibitors attempting to regain or assert Control over spaces and objects.
• Many incidents escalated over a period of time or were perpetrated by an exhibitor who had demonstrated an escalating pattern of aggression, suggesting some were Preventable.
• Many incidents were perpetrated by exhibitors who were unaware of their actions, or did not imply intent to cause harm, resulting in Absolution responses from others.

Knowledge of these patterns and perceptions may enhance staff awareness of RRA incidents as well as allow for the development of policies and procedures to better protect LTC residents at risk of injury or death from RRA.