Factors associated with aggressive behaviour in persons with cognitive impairments using home care services: A retrospective cross-sectional study.

Only six non-profit home care services in German-speaking Switzerland were included by convenience sampling, so the results may not apply to other settings or countries. The study used nursing documentation, and staff reported that only severe aggression was often noted, so aggression is likely underreported. The Cohen-Mansfield Agitation Inventory was developed for nursing homes, not home care, so it may not measure the same behaviours in homes. Diagnosis lists were not available for all clients, and dementia may be underdiagnosed in home care, so the cognitive impairment group may include people without a recorded dementia diagnosis. Clients aged over 65 were over-represented, with 82.5% of the sample, compared with 70% of home care clients in Switzerland. The study is cross-sectional and documentation-based, so it can show associations but cannot show what causes aggressive behaviour.

The authors declare that there is no conflict of interest.

Do not read the 14.8% figure as the true rate of aggression in home care. It is the rate documented in nursing reports, and the authors state that aggression may be underrepresented and that only severe incidents were often noted.