Resident-to-Resident Aggression Can Be Common in Assisted Living Facilities


One in six residents of assisted living facilities is subject to verbal, physical or other aggression by fellow residents in a typical month, and those suffering from dementia are most at risk, new research finds in the first large-scale study of the phenomenon.

Involving 930 residents of 14 licensed assisted living facilities in New York state, the study, published May 3 in JAMA Network Open, found incidents of resident-to-resident aggression, also called resident-to-resident elder mistreatment, were nearly as prevalent as they are in nursing homes. That was unexpected, since assisted living residents tend to be less impaired, more mobile and have more privacy than those in nursing homes.

The results point to a need to train staff on how to recognize potentially harmful aggression and intervene, and for clearer policy guidance on how facilities should address the issue. The researchers are currently testing a training program they developed, “Improving Resident Relationships in Long-Term Care,” which they said has helped reduce injuries in nursing homes.

“Interpersonal aggression is common in assisted living facilities and staff are inadequately trained to deal with it,” said Karl Pillemer, the Hazel E. Reed Professor of Psychology in Cornell’s College of Human Ecology (CHE) and professor of gerontology in medicine at Weill Cornell Medicine. “Residents are vulnerable to psychological distress and physical injury from other residents, and that’s something we need to take very seriously.”

Dr. Pillemer is the first author of “Estimated Prevalence of Resident-to-Resident Aggression in Assisted Living,” published May 3 in JAMA Network Open. Co-investigators were Dr. Mark Lachs, co-chief of geriatrics and palliative medicine at Weill Cornell Medicine and NewYork-Presbyterian/Weill Cornell Medical Center and the Irene and Roy Psaty Distinguished Professor of Clinical Medicine at Weill Cornell Medicine; and Dr. Jeanne Teresi, assistant professor of medical sciences at Columbia University Irving Medical Center and co-director of the Columbia University Stroud Center for Aging Studies.

Read more in the recent Cornell Chronicle piece.