The National Institute of Health and Welfare (THL) reports that some 80 percent of elder care workers in Finland experience violence from their patients.
Many nurses say they are bitten, struck and spit on regularly by elderly patients with memory disorders. Sick days taken on account of "accidents at work" have also risen steadily since 2005.
THL research chief Timo Sinervo says the situation is dire.
"It would be easier to respond to the situation if there were a reason for the violence, but there is none that we have found," Sinervo says.
The new study says that memory disorders and the disorientation that accompanies them are linked to violence, and that adding staff would do little to curb the trend, which also shows that home care patients are likely to be more violent than institutionalised pensioners.
Sinervo adds that one possible reason may be in the government's home care scheme to keep pensioners in their own homes for as long as possible. The elderly who enter care service institutions are in worse physical condition than previously, which may be seen as an increase in violence and the strain on nurses.
An estimated 193,000 people in Finland have diseases or disorders that affect memory.
No police reports
Talk about the aggression nurses face seldom leaves the care homes or hospitals. One nurse who Yle interviewed anonymously says she has not even been able to tell her own family about the daily attacks she faces.
"It is an occupational issue and we are duty-bound to secrecy," the interviewed nurse says.
Employers and the care workers' union say nurses should always inform their superiors of aggression or the threat of violence. But the Union of Health and Social Care Professionals (Tehy) says that only the most heinous attacks are reported.
The Occupational Safety and Health Act states that employers must provide a risk-assessed working environment where violence is prevented.
Kaija Ojanperä from Tehy says that many nurses fail to report misdeeds because they are used to the behaviour or they do not believe their case would lead to any concrete measures.
This all means that the statistics on the violence faced by nurses are inadequate and only demonstrate the tip of the iceberg. Over 400 cases of violence have been recorded in the region of Northern Karelia this year alone.
Police are practically never involved when it comes to elder violence.
Alone at night
In many hospitals only one nurse is assigned to a full care unit overnight. Yle's anonymous interviewee says that nighttime is the worst, because potentially violent patients have to be faced alone.
Should a nurse be knocked unconscious by a person in their care, help might take hours to arrive. Calling another unit's nurse in leaves another unit unattended.
Bosses know of the nighttime dilemma, but cannot add staff due to tight budgets. Sometimes medication is used.
"Those with memory problems usually get a calming shot before shower time," the nurse says.
Another interviewed nurse points out that some patients are institutionalised due to their families being unable to cope with an aggressive elderly relative.
Nurses do not receive recompense for sustained injuries. Mental health workers do, when faced with violence or the threat of attack.