A recent JAMDA-On-The-Go podcast (click here, with free CMD credits available) reviewed an article from Hong Kong on Staff Turnover Intention at Long Term Care Facilities: Implications of Resident Aggression, Burnout, and Fatigue. In this article, 800 nursing assistants in 70 LTC facilities were interviewed regarding the job satisfaction impact of resident aggression witnessed and experienced as well as other factors. They found resident aggression to be the greatest risk factor for a CNA to consider leaving a facility.

Resident-to-resident and resident-to-staff aggression occur frequently in nursing homes, particularly by persons living with dementia. This may go unrecognized by frontline staff and management until a crisis event occurs. This can be very traumatic for both affected residents and the supervising staff. Evidence-based training for improving staff expertise is available from CITRA (Cornell University College of Human Ecology) called IRRL (Improving Resident Relationships in Long-Term-Care). I first became aware of this program at an AMDA webinar in the Spring of 2022. Our recently retired CALTCM nursing home administrator and educator, KJ Page, also attended that webinar and over time was able to implement parts of this program. Last September, the California Partnership for Improving Dementia Care partnered with CITRA’s Dr. Karl Pillemer for a Train the Trainer webinar. This webinar was not recorded, but excellent training videos and materials are available at: https://citra.human.cornell.edu/irrl 

Throughout my lengthy career in the PALTC setting, most administrative focus was on crisis management rather than on programs to reduce the development of a crisis. We now have good evidence linking resident aggression to staff turnover. Is it time for your facility to explore the IRRL program for improving resident relationships?