Aggressive Behavior of Nursing Home Residents Toward Caregivers: A Systematic Literature Review

Aggression challenges and burdens caregivers face when working in nursing homes. The research questions in this review were (1) what types of residents' aggressive behavior do caregivers experience in nursing homes and how often? (2) In what situations does aggressive behavior occur? (3) What strategies do caregivers employ to manage aggressive behavior? Twenty one publications in English and/or German from 1996 to 2006 were identified by search strategies conducted in Medline, CINAHL, PsycINFO, and supplemented by screening citations, references, and unpublished manuscripts. Results show that all types of aggressive behavior occur in nursing homes with verbal and physical aggressive behavior combined. Personal care of the residents was the most frequent context in which aggressive behavior occurs. Strategies for preventing and dealing with aggressive behavior used by caregivers ranged from behavioral strategies aiming to prevent aggression, to medical treatment, or following written institutional gudelines for reducing aggressive behavior. Some care providers demonstrated predominantly positive and others predominantly negative strategies. Furthermore, there was a lack of information about "triggering" factors and interactive events during personal care in the referenced publications. (Geriatr Nurs 2009;30:174-187)