Unsettled relationships (UR) understood as open or covert conflicts among residents or between residents and staff play a significant role in patient's well-being in long-term care facility (LTCF) as well as in staff's job satisfaction.

The aim of this study was to assess the prevalence and identify factors associated with UR among residents (RR), URs between residents and staff (RS) and staff's frustration in contact with resident (SF). This cross-sectional study was conducted over 288 residents in one of the biggest Polish LTCF, using the interRAI-LTCF questionnaire and logistic regression analysis.

In our study, UR were observed in 28.8% of LTCF residents, with the highest frequency of RR (20.5%), followed by RS (19.4%) and SF (17.4%). We found that men demonstrated higher than women risk of the analyzed UR. Interestingly, moderate to severe cognitive impairment decreased the odds of RR and SF. We used to think that dementia and psychiatric diseases are the main predictors of conflict behaviors in LTCF setting. However, our findings show that behavioral, psychotic and depressive symptoms are the major factors which enhance the risk of UR in LTCF. Hence, we recommend clinicians to focus on better detecting, monitoring and controlling these symptoms to prevent the URs in LTCF. The second important study results is that some somatic diseases may also independently increase the risk of UR between the residents and the staff.