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Resident-to-resident aggression: what do stakeholders think about it?

Many people working in aged care see resident-to-resident aggression (RAA) happen daily but don’t have access to much evidence surrounding its prevention, a new study has said.

Led by Dr Briony Jain from Monash University, Victorian researchers interviewed 15 people working in aged care senior management, policy and external stakeholder roles to find out what they knew about RRA and how they felt it could be curbed.

The majority (53.3 per cent) of the participants said they had witnessed RRA on the job and the same number agreed it was preventable.

Just under three quarters of those interviewed said this aggression occurred monthly – one fifth of which said it was daily.

Interviewees felt that some potential causes of RRA were maladaptation to nursing home life, and physical environment and staffing-related issues. Some also believed that the issues started outside of the nursing home environment and were transferred over.

While some said that RRA was dangerous and unpredictable, respondents also considered it expected behaviour in a nursing home setting.

Most participants believed that key to tackling the issues was a person-centred care approach that would encourage and allow “nursing home staff to really get to know the resident”.

This would include getting a detailed personal history of the resident and establishing a positive relationship with the family in order to be aware of previous incidents, conduct risk assessment and recognise triggers.

“This may help better understand the resident’s journey, develop a sense of empathy and to combat any stigma associated with disclosing mental health or behavioural issues,” the paper read.

Its authors advocated for increased reporting of both minor and major incidents of RRA, saying that would help identify patterns and inform appropriate responses. “However, a cultural shift is first required to recognise RRA as a manageable and preventable healthcare and adult safeguarding issue,” they added.

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