Exploring Overt Racial and Ethnic Conflict in Resident-to-Resident Aggression in Long-Term Care Facilities.
E-Shien Chang, Sonya Jhaveri, David W Hancock and 7 others
PMID 39101042WHAT IT FOUND
Overt racial/ethnic conflict was documented in 35 nursing home residents involved in resident-to-resident aggression during 1 month, often repeatedly in shared bedrooms, dining rooms, and hallways.
Key findings
01Overt racial/ethnic conflict was documented in 35 residents, 8.6% of residents involved in any resident-to-resident aggression, during the 1-month observation period.
02Compared with residents involved only in other resident-to-resident aggression, those involved in overt racial/ethnic conflict were more likely to be African American (28.6% vs 9.6%) or Hispanic (31.4% vs 14.8%) and to live in higher proportion minority facilities (62.9% vs 41.1%).
03Overt conflicts took 5 forms, including physical violence, discrimination, racial/ethnic slurs, stereotyping, and microaggression, and were commonly triggered by congested or noisy living spaces.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 35 residents had overt racial/ethnic conflicts, so the quantitative comparisons are unstable. This was an observational secondary analysis, not a trial, so it does not show that any prevention or room-change strategy works. Only overt racial/ethnic conflicts were identified, so incidents motivated by race or ethnicity without explicit slurs or threats may have been missed. Residents were grouped as initiators or recipients, so characteristics of those who start aggression may differ from those who receive it. The study could not tell whether overt racial/ethnic language was the main motive or an expression of frustration about noise, roommates, or unmet needs. The data were collected from 2009 to 2013 in 10 New York facilities, so current facilities may differ. The observation period was only 1 month, so longer patterns may be missed.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read this as evidence that a room change or staff response reduces resident aggression. The study only described 35 residents with overt racial/ethnic conflicts over 1 month, did not test interventions, and could not tell whether the acts were primarily racially motivated or expressions of frustration.