Retirement and nursing homes may then use violence to attract attention, express their discomfort, defend themselves or because situations are misunderstood. In order to prevent violence, it is important to treat those in need of care in a mindful and respectful way. Organisational cultures in which the needs of those involved are focal and in which institutional support adapts to these needs help prevent violence. Reality shows, however, that elderly persons with impaired orientation and health issues are restrained to inactivity and are neither sufficiently animated nor supported in making independent decisions concerning the organisation of their everyday lives. Verbal abuse and negligence Violence research shows that those in need of care who can only express themselves with difficulty are particularly vulnerable and they are at considerable risk of being subject to violence. This often happens unintentionally. As far as critical actions on the part of nursing staff are concerned, verbal abuse and stress-related negligence are mentioned most frequently to the commissions. At times, it is difficult for those interviewed to admit that their daily work routine induces negative feelings (anger, frustration, revulsion etc.). Insufficient knowledge of care techniques also plays a great role in the occurrence of violence. Members of staff who, for example, do not know how to take someone out of bed or help them in the shower without straining their own back are subjecting their body to considerable strain. This can result in overexertion and irritability. The fundament for attacks is laid when there is no scope allowing for supervision and reflection to relieve the strain. A commission from Upper Austria reported that a resident suffering from dementia showed no reaction to the request to participate in washing herself and spat at the care assistant. Not knowing what else she could do, the care assistant asked a colleague to push the resident closer to the sink and held her mouth closed with a washcloth. The commission received reports of sexual assaults by three male residents on other female residents and a female caregiver in a home in Tyrol. The incidents were discussed in team meetings; however, it was conceded that there was no one available to effectively stop the assaults. None of the employees had received de-escalation training. In a home in Lower Austria, the staff saw no other short-term solution to protecting themselves against sexual assault by a resident than to lock him in his room. Several other examples show that the way in which nursing staff deals with sexuality in old age and with dementia is often inadequate and results in measures that would appear to be inappropriate. In Upper Austria, repeated masturbation by a resident was designated an “offence” in the documentation. The home reacted by clothing the resident in an overall at night, which could only be opened at the back and was meant to prevent touching the sexual organ. In spring 2019, the media reported about a highly sexually active dementia resident of a retirement home in Vienna who sexually harassed caregivers several times, exposed himself indecently, undressed repeatedly and sought intimacy with female residents also suffering from dementia. Questioning the female resident and the staff failed to establish without 29