Aggressive behaviors in long-term care facilities pose significant challenges. This study aimed to revise the existing 10-item Aggressive Behaviour Risk Assessment Tool for predicting aggression in newly admitted long-term care residents. The original tool, while effective in acute care settings, lacked validation for long-term care.
This retrospective cohort study involved 724 residents admitted to 25 western Canadian long-term care homes between January and December 2014. Within 24 hours of admission, each resident was assessed using the original tool. Incident reports documented aggressive events within 30 days post-admission. Statistical analysis included multiple logistic regression and receiver operating characteristics (ROC) analyses.
Of the 724 residents, 53 exhibited aggressive behaviors. Analysis revealed that being under 85 years old was a significant predictor of aggression. This demographic factor was incorporated into a revised tool. The resulting six-item Long Term Care Violence Assessment Tool comprises: age less than 85, history of physical aggression, physically aggressive/threatening behavior, anxiety, confusion/cognitive impairment, and threatening to leave.
The revised tool, employing weighted scoring, demonstrated good discriminatory ability in identifying potential aggression. ROC analysis confirmed satisfactory sensitivity and specificity at a recommended cut-off score of 4. This revised six-item tool offers a practical and effective method for assessing aggression risk in new long-term care residents. This allows for proactive interventions and improved safety within the facility.
The revised tool enables early identification of residents at risk for aggressive behaviors. This proactive approach can facilitate the implementation of preventative strategies, promoting a safer environment for both residents and staff. By identifying and addressing potential aggression early on, long-term care facilities can enhance the overall well-being of their residents. Further research is recommended to validate these findings in diverse long-term care settings.
