Senior Care Risk: Co-Mingling of Residents With Behavioral Health and Cognitive Disorders

Susan Lucot, MSN, RN, MLT (ASCP), CPHRM

Co-mingling of younger residents who have behavioral health disorders with older adult residents suffering from dementia and/or behavioral health disorders is increasingly common in senior care settings, but it also presents risks.

Each resident is unique as far as preferences, abilities, and personalities. Most residents can co-reside within the same space without encountering conflict. However, having residents with varying diagnoses and degrees of mental deficits, as well as a lack of positive coping capabilities, increases the risk for verbal and physical altercations as well as sexual assaults.

Senior care organizations should keep in mind that every altercation and assault could result in a staff member or resident injury that leads to state complaint inspections, fines, penalties, and/or medical malpractice allegations. To address the potential for conflict and violence, senior care leaders and staff members can implement various risk strategies, such as the following:

• When considering new resident admissions, perform due diligence in screening each individual to ensure a safe environment is maintained for everyone, including new residents.
• Assess each resident’s cognitive abilities, behavioral triggers, and coping skills. Make sure to also evaluate physical strength and gait as part of the assessment.
• Based on the evaluation, determine which residents most likely can safely occupy the same living area without potential altercations.
• Document evaluation-based decisions about living arrangements, and update documentation if any changes occur.

For additional insights on providing care for residents who have behavioral health disorders and/or dementia in senior care settings, click here.

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