This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Patient Safety/ Medical Error  • Aging/ Geriatrics  • Alert me on articles by topic

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In Reply: In response to Drs Herbert and Bradshaw, the Massachusetts Department of Public Health received more than 1000 reports of physically injured residents during the sampling time frame from which we chose cases. Many were reported as accidents, while the etiology of others was reported as unknown. Because we wanted to focus on aggressive behavior and its physical sequela, we choose "violence" rather than "injury" in the title and throughout the article.

We agree that describing the injured residents' characteristics might lead some readers to "blame the victim" but, as stated in our article, this was not our intent. Rather, we hoped to describe characteristics of the injured residents, as others have done in the literature about domestic elder abuse^1-2 because there is likely a complex interaction between the aggressor, the environment, and the injured resident. Each of these may be amenable to different interventions. Although most literature focuses . . . [Full Text of this Article]

Tomoko Shinoda-Tagawa, MD, MPH
Department of Health Policy and Management
Harvard School of Public Health
Harvard Injury Control Research Center
Boston, Mass

Ralph Leonard, MD, MPH
Division of Geriatrics
Yale Medical School
New Haven, Conn

Jean Pontikas, BA
Massachusetts Department of Public Health
Boston

John E. McDonough, DrPH
Healthcare for All
Boston

Donna Allen, BS, RN
Radius Management Services
Framingham, Mass

Paul I. Dreyer, PhD
Massachusetts Department of Public Health
Boston

RELATED ARTICLES

Aggressive Behaviors and Injuries Among Nursing Home Residents
Barbara Herbert and Ylisabyth S. Bradshaw
JAMA. 2004;291(17):2074-2075.
EXTRACT | FULL TEXT  

Resident-to-Resident Violent Incidents in Nursing Homes
Tomoko Shinoda-Tagawa, Ralph Leonard, Jean Pontikas, John E. McDonough, Donna Allen, and Paul I. Dreyer
JAMA. 2004;291(5):591-598.
ABSTRACT | FULL TEXT