A prevalent concern, but under-recognized, public health problem of distressing and harmful resident-to-resident interactions in dementia in long-term care homes (LTC) (such as nursing homes and assisted living residences), is a major issue facing many countries today. This increase can, in part, be attributed to the growing population of older adults from the Baby Boom generation. These resident-to-resident incidents frequently lead to injurious and fatal consequences for vulnerable and frail elder residents.
For various reasons, these incidents are often underreported inside and outside the LTC home (such as to the Department of Health / state regulatory agency, police, and Coroners/Medical Examiners). Death investigators should play a critical role in timely and skilled investigations of these incidents. However, serious gaps in resources and training are a major barrier for change as they are the reality for many Coroner and Medical Examiner Offices and Law Enforcement Departments in the U.S. and abroad.
Improved communication and timely collaboration between external agencies is essential to addressing this phenomenon more effectively. Timely and skilled investigation can assist tremendously in determining the cause of death (which is critically important to family members of the deceased) and can also inform policy, legislation, systemic efforts, and training programs aimed at preventing similar tragic incidents in the future.
Question of this Episode
What are some of the ways in which best practices used by Coroner and Medical Examiner Offices and Law Enforcement can be developed, strengthened (building on existing successful models), and implemented in communities across the nation to address this persistent but mostly hidden problem to keep vulnerable elders with and without dementia safe?
Eilon Caspi, PhD, has worked in the aging field for 22 years. In the past decade he focused in various ways on prevention of distressing and injurious (including fatal) resident-to-resident interactions in dementia in long-term care homes.
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Deaths as a result of resident-to-resident altercations in dementia in long-term care homes: A need for research, policy, and prevention. Journal of the American Medical Directors Association, 17(1), 7-11.
Link to full text: http://www.jamda.com/article/S1525-8610(15)00640-4/pdf