Personal conflicts, even violence, are not uncommon in long-term care

Those most likely to be involved are younger and able to walk, “able to move and put themselves in harm’s way,” Dr. Pillemer said. Most had at least moderate cognitive impairment. The studies also found that incidents occurred more often in specialized dementia units.

“Memory care has positive elements, but it also puts residents at greater risk of assault,” Dr. Pillemer said. “More people with brain diseases, uninhibited people, gather in a smaller space.”

Because so many, both perpetrators and victims, suffer from dementia, “sometimes we can’t say what started it all,” said Leanne Rorick, director of a program that trains staff on dementia intervention and reduction. voltage. “An initiator is not necessarily someone with malicious intent.”

A resident may be confused about which room is hers, or angry if someone asks her to be quiet in the TV room. In one case observed by Ms. Rorick, a resident rejected by her staff attempted to calm her when she believed someone had taken her baby, until she was reunited with the doll she loved and her calm returned.

“These are people with severe brain disease, doing the best with their remaining cognitive abilities in stressful, scary, overcrowded situations,” Dr. Caspi said. Residents may face pain, depression, or reactions to medications.