Assisted living facilities and nursing homes are supposed to keep residents safe, but hundreds of seniors contend with violence at the ends of their lives. Dementia is often blamed for altercations, but that is not because all people with dementia are inherently aggressive. They may act out when frightened, confused or in pain. Some hurt others because of behavioral problems that facilities are not equipped to manage. "It is stressful, it's often thankless and there is often a high turnover of these underpaid positions," said Dr.