Female caregivers' perceptions of reasons for violent behaviour among nursing home residents

Threats and violence against professional caregivers present a growing health and safety problem in elderly care. We aimed to explore female caregivers' perceptions of reasons for violent behaviour among nursing home residents. Forty-one caregivers at three nursing homes were interviewed and their responses were subjected to qualitative content analysis, which revealed three content areas of perceived reasons for patient violence: patient characteristics, caregiver approach and environmental aspects. The caregivers' perceptions were formulated in three core statements: 'they (the residents) are not who they used to be', 'we (the caregivers) have acted inappropriately' and 'we (residents and caregivers) are all surrounded by disorder'. Our findings indicate that the reasons for violence are complex and multifactorial, so interventions should be individually tailored. Caregivers involved in a violent situation need to see the person behind the behaviour, try to interpret what the behaviour is meant to communicate and adjust the intervention according to individual need.

Female caregivers' experiences of exposure to violence in nursing homes

Although earlier studies have examined caregivers' experiences of exposure to violence, few have investigated female caregivers working in nursing homes with a specific focus on experiences throughout the entire scenario of a violent situation. This study illuminates female caregivers' experiences of being exposed to violence in nursing homes. Twenty caregivers working in three nursing homes located in northern Sweden were asked to narrate about a situation in which they had been exposed to violence. Their narratives were analysed by using qualitative content analysis. We found that the caregivers had preconceived ideas about violent behaviour, that they experienced a loss of control over the situation, and that they then strove to regain control. Experiences such as these may influence caregivers' interactions with residents who display violent behaviour. As a result of violent interactions, caregivers may distance themselves from the residents, an attitude that may decrease the quality of care. There is a risk that violence in nursing homes is accepted and normalized as a part of the job and hence persists.

Caregivers' experiences of exposure to violence in services for people with learning disabilities

Exposure to violence is a commonly encountered problem in services for people with learning disabilities; Swedish studies have reported that 51-61% of caregivers are exposed to violence each year, and caregivers describe violence as being a 'normal' part of their working life. To illuminate the experience of being exposed to violence, we performed 50 narrative interviews with 44 caregivers working in services for people with learning disabilities. The tape-recorded interviews were transcribed verbatim and subjected to qualitative content analysis. The main findings indicate that caregivers' experiences of being exposed to violence can be related to two themes: falling apart, and keeping it together. Falling apart includes feelings of fear, powerlessness, sadness, anger and timelessness, while keeping it together concerns pleasure, respect, self-reflection and habituation. Destructive experiences of falling apart are balanced by a more constructive view of the situation, with the aim of respecting the resident as a whole person, and keeping the situation, and the caregivers themselves, together.