Physically violent behaviour in dementia care: Characteristics of residents and management of violent situations

Abstract

Objective: Physically violent behaviour (PVB) is common among residents with dementia and often complicates nursing care. This study aims to explore types of caring situations, resident characteristics related to PVB and professional caregivers’ management of PVB.

Methods: The study included 40 group homes for 309 residents with dementia. Data was gathered by means of structured interviews, the Multi-Dimensional Dementia Assessment Scale and the Geriatric Rating Scale.

Results: Ninety-eight of the residents (31.7%) were assessed as showing PVB during the preceding week. Three factors were independently associated with PVB: male gender, antipsychotic treatment and decline in orientation. Violent residents were more likely to have impaired speech, difficulties understanding verbal communication and prescribed analgesics and antipsychotics than were non-violent residents. PVB occurred mainly in intimate helping situations and was managed by symptom-oriented approaches, such as distraction, medication and isolation. The working team also held frequent discussions about the residents with PVB.

Conclusion: This study shows that PVB is frequently displayed among residents in group homes for persons with dementia and the caregivers mainly manage PVB in a symptom-oriented way. To enhance the quality of care for patients with dementia, there is a need for interventions that aim to understand and manage the residents’ physical violent behaviour.

Keywords:

• dementia
• group homes
• management
• physical violence

Acknowledgements

This study was supported by grants from Stiftelsen Lions Forskningsfond för Åldersrelaterade Sjukdomar [Lions Research Foundation for Age-related Diseases], Erik and Ann-Marie Detlofs Foundation and the GERDA-project: ‘Voices of those involved in elderly care’. The authors would also like to thank Tony Pellfolk for his help in data collection.