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Workplace injuries from violent nursing home residents

People might not typically think of a nursing home as a place where violence is likely to break out. But the truth is that many residents who are suffering from the side effects of dementia tend to lash out violently at the health care workers who are their daily caregivers.

While it may be impossible to avoid all instances of violence from nursing home residents, the facilities must have strict protocols in place that detail how potentially violent residents are evaluated, assessed and managed. There must also be steps to follow for staff to de-escalate the patients at the onset of a possibly violent confrontation.

Various paths to resolution possible

Residents with mild cognitive impairment who lash out violently at staff may be momentarily confused but still able to be calmed with verbal de-escalation. But some residents might need to be controlled physically until their urge to lash out has been subdued with appropriate techniques.

Certainly no health care worker wants to call the police to report violence on the part of one of their patients. Still, that would be preferable to staff members accidentally injuring the resident while attempting to defend themselves from an attack. Then, too, if certain residents are highly prone to act aggressively toward staff or other residents, it may be that the facility is no longer able to safely maintain them in their present environment. Transferring residents to more secure facilities might be the safest option available.

Are attacks reported?

With dementia, an aggressive act can come out of the blue in a single, unrepeated occurrence. But it is far more likely that residents who have been assessed as violent will tend to repeatedly lash out as their disease takes control of their cognitive functions.

It is therefore vital to staff safety that all incidents of violence from nursing home residents is reported and tracked internally. All caregivers who come into contact with potentially violent or physically aggressive patients should know of their tendencies and have a plan in place to react appropriately should this occur. No nurse, aide or orderly should be kept out of the informational loop and potentially exposed to serious harm.

Consequences of staff injuries

Last year, an Occupational Safety and Health Administration (OSHA) investigation into a nursing home in a western state revealed that the facility neglected to sufficiently protect their workers from residents' aggression — including punches, bites, kicks and grabs that bruised and cut the staff members.

The facility faced fines in excess of $9K. They also were told to remove from the residents' rooms any potential items that could be weaponized and used against staff, install addition security alarms and cameras and improve staff levels and safety training.

What injured staff can do

It shouldn't take an OSHA investigation to prompt nursing home management and owners to do right by their employees and protect them from harm. However, sometimes that can be the case. In addition to filing for workers' compensation benefits for their injuries, health care workers who are injured by nursing home residents' aggression may need to notify authorities of the problems they face.

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