Resident-to-Resident Abuse within Nursing Homes

Elder abuse in nursing homes

Elderly abuse and neglect by staff are on the radar of any family member faced with the decision to place their loved one inside an assisted living facility or a nursing home.  However, did you know that conflict, and even outright abuse, between residents, is a very palpable threat? There are also times when the bullying crosses the line into criminally abusive behavior worthy of charges being pressed.

This article will point out ways to identify the potential for abuse and protect your loved one from bullying, or worse, from other residents within a facility. 

Weill Cornell Medical College and Cornell University partnered together to highlight the prevalence of misconduct between nursing home residents. What they found was that the problem has been growing silently under the radar for years. Resident to resident mistreatment was so common that every four weeks, one in five residents experienced an aggressive confrontation with another resident. The misconduct could be anything from harsh verbal altercations to inappropriate sexual conduct.

Elder Abuse is a Crime No Matter Who Commits it 

In the past twenty years or so, nursing home neglect and elder abuse has had a lot of light shed on it. The focus has been on family members and even nursing home staff, but as a result of all the uncovering in those areas, researchers found the need to address abuse between nursing home residents.

The reality is that those at greater risk of becoming a victim are residents who are frailer and cognitively more vulnerable than their neighbors. They are typically 80 years old or older and female.

On the other hand, seniors with early dementia are more likely to engage in the verbally abusive behavior prompted by the manifestation of the disease’s symptoms, which include aggressive behavior and verbal outbursts.

According to the Weill/Cornell study, the types of crimes that have been reported include:

  • Yelling, screaming, or cursing
  • Actual physical altercations with kicking, biting, and hitting
  • Snooping in another resident’s room with unwelcomed entry
  • Sexual misconduct
  • Financial exploitation

Identifying Resident to Resident Elder Mistreatment 

Victims of abuse are reluctant to report their incidents, just like any other victim of domestic violence or sexual abuse. They fear retaliation or they simply lack the cognitive ability to report it. The most common symptoms that your loved one is being mistreated include:

  • Increase in anxiety
  • Changes in sleep patterns and appetite
  • Unexplained bruising, particularly around thighs, buttocks, breasts and arms
  • Sexually transmitted diseases
  • Withdrawal from social activities and family visits

Identifying mistreatment between residents of a nursing home facility is often difficult, as medications can make bruising easier and cause the behavioral changes associated with abuse. With abuse victims being less likely to have the ability to communicate, any time they report a form of abuse, it should be taken seriously and reported to the adult protective services (APS) agency in your state. Other residents may also be helpful in getting to the bottom of abusive behavior. Nursing home facilities should implement programs to encourage the reporting of abusive incidents, even if done so anonymously.

Preventing Resident-to-Resident Elder Abuse: SEARCH 

Researchers in 2014 have begun to implement within nursing homes the SEARCH program: Support, Evaluate, Report, Care plan, and Help to avoid abuse. It is an approach to training staff on how to better identify and handle resident to resident abuse that for the most part has gone on unnoticed. With initial outcomes holding promise, SEARCH will hopefully be implemented in nursing homes across the nation and remove the notion that nursing home resident abuse is trivial and normative by providing a protocol to effectively identify and manage the abuse.

The best way to protect your loved one is to openly communicate with him or her. Consider taking over finances to protect against financial exploitation. Talk with them about what to do if someone inappropriately enters the room. Check in with your loved one often. Seniors can still have a high quality of life, even when aging in place means aging in a nursing home when proper precautions from staff members and family members are taken to minimize the risk of abuse.

Read more:

When The Elderly Lash Out – Caregiver Abuse


Ellis, J., Teresi, J.A., Ramirez, M., Silver, S., Boratgis, G., Kong, J., Eimicke, J. P., Sukha, G., Lachs, M. Szpillemer, K.A. (2014). Managing Resident to Resident Elder Mistreatment in Nursing Homes: the SEARCH Approach. The Journal of Continuing Education in Nursing, 45(3): 112-123. Available at Last Visited March 9, 2016.

Metlife Mature Market Institute and National Committee for the Prevention of Elder Abuse. (2013). The Essentials: Preventing Elder Abuse. Available at Last Visited March 9, 2016.

Weill Cornell Medical College. (November 6, 2014). Study Highlights Prevalence of Mistreatment Between Nursing Home Residents. Weill Cornell Newsroom. Press Releases. Available at Last Visited March 9, 2016.