What Is Known About the Intended or Unintended Homicide of One Resident Causing the Death of Another in Residential Aged Care Facilities? An Integrated Review of International Studies

The death of a resident, caused by another resident in Residential Aged Care Facilities (RACFS) is uncommon, yet under-reported. The perpetrator of the violent act may not be legally culpable, and the act may be unintended; however, media reports suggest that this is an increasing phenomenon. This article reports an integrated review that sought to critically report homicide or an unintentional incident where one resident causes the death of another in RACFs and to explain and understand how older people are supported within and external to RACFs and their under-representation in policy. The search was registered with PROSPERO registration number CRD42023409775. The databases CINHAL ultimate, Cochrane review, Embase, Psych Info, PubMed were searched. Additionally, a grey literature search was conducted of Analysis and Policy Observatory, Google Search, and Trove. Identified themes included: exhibitor and target attributes, incident details, staff and facility experiences, incident reporting and improved resident safety related to un/intentional homicide. From the findings, we extracted two discursive elements: (1) Space and perception of a person living with dementia and unequipped environments and (2) The disregarded deaths in RACFs and other systematic problems. Within RACFs factors, such as unacceptably low staffing numbers, a lack of clinically trained nurses, poorly designed environments and a lack of skills in caring for people who have dementia or mental illness were identified. More emphasis on research into this area is essential. Several key risk factors are identified in this review on the issue of un/intentional homicides in RACFs. There is a need for governments and policy makers to consider different models of care, responsive to the needs of people who live with dementia.