Resident to Resident Assaults

The Problem

As a nursing home attorney, I have witnessed the harm caused by these assaults on the victim and the assailant. Resident-to-resident incidents in nursing homes are common. Often lack of staff or inadequate training are contributing factors. These incidents are injurious, and deadly.

Eilon Caspi is a gerontologist and assistant research professor at the UConn and co-director of the documentary film “Fighting for Dignity” (Terra Nova Films, 2020). She also authored “Understanding and Preventing Harmful Interactions Between Residents with Dementia” (Health Professions Press, October, 2021).

She wrote a great editorial for STAT News about resident to resident assaults. Resident-to-resident incidents are defined as “negative, aggressive, and intrusive verbal, physical, material, and sexual interactions between long-term care residents that in a community setting would likely be unwelcome and potentially cause physical or psychological distress or harm in the recipient.”

Caspi writes about the tragic and preventable case of Dwayne E. Walls, a Korean War Veteran and an investigative reporter at the Charlotte Observer. Walls suffered Alzheimer’s disease. A South Carolina nursing home accepted him as a resident. The facility promised his wife and family that the facility would keep him safe, maintain his safety and well-being.

However, a confused Walls accidently walked into another resident’s room. The fellow resident (also with dementia) beat Walls with his cane. Walls was found severely injured, bleeding, and unconscious in a fetal position on the floor. He died a week later.


If it is predictable, it is preventable. A Cornell University study found that one in five nursing home residents suffered in resident to resident altercations in a single month. Caspi writes that the unmet needs of residents underlie the majority of these episodes. Low staffing levels, lack of staff training, inadequate supervision, and poor risk assessment and care planning are common factors that contribute to resident-to-resident incidents.

These incidents occur when nursing home residents with dementia interact without supervision. Conflicts between roommates is another common scenario epically with roommates of different cultural backgrounds.

No one keeps track of resident to resident altercations or assaults. Nursing home residents, care advocates, and experts need to understand if harmful incidents are due to staff-to-resident abuse or resident-to-resident episodes.

“When a common and harmful phenomenon such as resident-to-resident incidents is not being tracked, it remains hidden for all practical purposes. And by remaining hidden, it poses a threat to vulnerable and frail elders…and their loved ones who believe nursing homes are safe havens.”

The problem is getting worse. The time to act is now.