The prevalence of resident- To-resident elder mistreatment in nursing homes

Mark S. Lachs, Jeanne A. Teresi, Mildred Ramirez, Kimberly Van Haitsma, Stephanie Silver, Joseph P. Eimicke, Gabriel Boratgis, Gail Sukha, Jian Kong, Alexandra M. Besas, Maria Reyes Luna, Karl A. Pillemer

Research output: Contribution to journalArticlepeer-review

74 Scopus citations


Background: Resident- To-resident elder mistreatment (R-REM) in nursing homes can cause physical and psychological injury and death, yet its prevalence remains unknown. Objective: To estimate the prevalence of physical, verbal, and sexual R-REM in nursing home residents and subgroups. Design: 1-month observational prevalence study. Setting: 5 urban and 5 suburban New York state nursing homes. Participants: 2011 residents in 10 facilities randomly selected on the basis of size and location; 83% of facilities and 84% of eligible residents participated. Measurements: R-REM was identified through resident interviews, staff interviews, shift coupons, observation, chart review, and accident or incident reports. Results: 407 of 2011 residents experienced at least 1 R-REM event; the total 1-month prevalence was 20.2% (95% CI, 18.1% to 22.5%). The most common forms were verbal (9.1% [CI, 7.7% to 10.8%]), other (such as invasion of privacy or menacing gestures) (5.3% [CI, 4.4% to 6.4%]), physical (5.2% [CI, 4.1% to 6.5%]), and sexual (0.6% [CI, 0.3% to 1.1%]). Several clinical and contextual factors (for example, lower vs. severe levels of cognitive impairment, residing on a dementia unit, and higher nurse aide caseload) were associated with higher estimated rates of R-REM. Limitations: Most facilities were relatively large. All R-REM cases may not have been detected; resident and staff reporting may be subject to recall bias. Conclusion: R-REM in nursing homes is highly prevalent. Verbal R-REM is most common, but physical mistreatment also occurs frequently. Because R-REM can cause injury or death, strategies are urgently needed to better understand its causes so that prevention strategies can be developed. Primary Funding Source: National Institute on Aging.

Original languageEnglish (US)
Pages (from-to)229-236
Number of pages8
JournalAnnals of internal medicine
Issue number4
StatePublished - Aug 16 2016

All Science Journal Classification (ASJC) codes

  • Internal Medicine


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