Study Finds 20% of Skilled Nursing Residents Involved in Aggressive Behavior

Nearly one in five nursing home residents were involved in at least one negative and aggressive encounter with one or more fellow residents between October and early November, a new study finds.

Negative behavior included acts of verbal or physical abuse, inappropriate sexual behavior, or invasion of privacy, among other incidents, known collectively as resident-to-resident elder mistreatment, according to the latest research from Weill Cornell Medical College and Cornell University.

Recent attention to elder abuse has been focused on those older adults who live someplace other than a nursing home. And while research has started to focus on abuse by nursing home staff against vulnerable residents, this latest study, funded by the National Institute on Aging, suggests a more frequent threat to residents is aggression committed by other residents.


“The findings suggest that these altercations are widespread and common in everyday nursing home life,” says Dr. Karl Pillemer in a written statement. “Despite the acute urgency of the problem, resident-to-resident mistreatment is under-reported. Increased awareness and the adoption of effective interventions are greatly needed.” 

Pillemer is a professor of gerontology in medicine at Weill Cornell and the Hazel E. Reed Professor in the Department of Human Development at Cornell University.

Pillemer and study co-author, Dr. Mark Lachs, randomly selected 10 skilled nursing facilities with more than 2,000 residents in New York state. The facilities were comparable in size and classification to other large nursing homes at the state and national level. Researchers used methods including staff interviews and reports, direct observation, and a research-based questionnaire for both residents and staff to record the total number of incidents of mistreatment between residents.


Resident-to-resident elder mistreatment affected 19.8% of residents over a four-week period, according to the study. The study did not distinguish victims from perpetrators of resident-to-resident elder mistreatment.

Specific types of mistreatment included verbal incidents, such as cursing, screaming or yelling at another person (16%); physical incidents, such as hitting, kicking or biting (5.7%); and sexual incidents, such as exposing one’s genitals, touching other residents, or attempting to gain sexual favors (1.3%). A fourth category, which involved 10.5% of people, included unwelcome entry into another resident’s room or going through another resident’s possessions.

“People who typically engage in resident-on-resident abuse are somewhat cognitively disabled but physically capable of moving around the facility,” says Pillemer. “Often, their underlying dementia or mood disorder can manifest as verbally or physically aggressive behavior. It’s no surprise that these individuals are more likely to partake in arguments, shouting matches, and pushing and shoving, particularly in such close, crowded quarters.”

Written by Cassandra Dowell

Companies featured in this article: