Risk Factors and Risk Assessments for Violence in Residential Long-Term Care: A Scoping Review

Area of Science:

• Gerontology
• Healthcare Management
• Criminology

Background:

• Power imbalances and care stressors in long-term care facilities can foster violence.
• Violence in these settings can involve residents and staff as victims or perpetrators.
• Cognitive impairment, organizational issues, and interpersonal stress exacerbate violence risks.

Purpose of the Study:

• To review facility-specific risk assessment recommendations for preventing violence in residential long-term care.
• To identify and categorize risk factors associated with violence in these settings.

Main Methods:

• A comprehensive scoping review of literature from MEDLINE, CINAHL, and Cochrane Library, supplemented by grey literature.
• Searches focused on institutional risk factors and risk assessment tools in long-term care.
• Data extraction and analysis followed Joanna Briggs Institute guidelines with consensus from three reviewers.

Main Results:

• 64 articles were included; 3 focused on risk assessment validation, and 61 detailed risk factors.
• Eleven risk analyses from major providers identified four key risk domains: work/facility structures, residents, staff, and building aspects.
• Limited evidence exists for structured, institution-level risk assessment approaches.

Conclusions:

• There is a critical need for evidence-based risk assessment strategies in long-term care.
• Strategies should integrate staff training, organizational support, and tailored resident care plans.
• Addressing identified risk factors is essential for violence prevention in residential care settings.