Evidence map›Paper›PMID 42302162›Full record

ArticleJournal of the American Geriatrics Society2026

A Scoping Review on Strategies for Navigating Conflicting Rights Between Safety and Autonomy in Residential Long-Term Care in the United States.

Angela K Perone, Leyi Zhou, Ann Glusker, Jiwon Shin, Christina Xu, Poorvi Thairani, Yuka Iriguchi, Joseph George, Kati Khov, Ali Abud and 7 more

Abstract readScoping Review
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Geriatrics Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Angela K PeroneSchool of Social Welfare, University of California, Berkeley, Berkeley, California, USA.ORCID 0000-0002-3307-9662
Leyi ZhouSchool of Social Welfare, University of California, Berkeley, Berkeley, California, USA.
Ann GluskerSocial Research Library, University of California, Berkeley, Berkeley, California, USA.ORCID 0000-0002-2852-5293
Jiwon ShinCollege of Social Science, Seoul National University, Seoul, South Korea.
Christina XuSchool of Social Welfare, University of California, Berkeley, Berkeley, California, USA.ORCID 0009-0007-2326-0103
Poorvi ThairaniSchool of Social Welfare, University of California, Berkeley, Berkeley, California, USA.
Yuka IriguchiSchool of Social Welfare, University of California, Berkeley, Berkeley, California, USA.
Joseph GeorgeSchool of Social Welfare, University of California, Berkeley, Berkeley, California, USA.ORCID 0009-0005-2666-1418
Kati KhovCollege of Environmental Design, University of California, Berkeley, Berkeley, California, USA.
Ali AbudDepartment of Biology, Western University, London, Ontario, Canada.
Wendy Shu PengSchool of Social Welfare, University of California, Berkeley, Berkeley, California, USA.
Manan DuaSchool of Social Welfare, University of California, Berkeley, Berkeley, California, USA.
Amy Jillian WallrathSchool of Social Welfare, University of California, Berkeley, Berkeley, California, USA.
Anthony ChicotelCalifornia Advocates for Nursing Home Reform (CANHR), Berkeley, California, USA.
Lori WalshThe National Consumer Voice for Quality Long-Term Care (Consumer Voice).
Meredith ChillemiLeadingAge California.
Jessica KingPhi.

Funding

Albert & Elaine Borchard FoundationPatrick and Catherine Weldon Donaghue Medical Research Foundation
6 · The paper itself

Abstract

backgroundOlder adults in the United States increasingly require residential long-term care, where staff must frequently navigate complex conflicts between residents' rights to safety and autonomy. Despite the prevalence of these ethical dilemmas and the potential for legal or professional harm, guidance for staff remains scarce. This scoping review identifies and synthesizes existing empirical strategies used to resolve these conflicts within U.S. residential long-term care.

methodsFollowing the Arksey and O'Malley framework, a search was conducted across three academic databases (ProQuest Social Sciences, PubMed, and Scopus) for peer-reviewed, empirical studies published in English between 1987 and 2024. Two independent reviewers screened articles based on their focus on safety and autonomy conflicts and the inclusion of resolution strategies. Data were extracted from 14 final articles to categorize topics and solutions.

resultsThe review identified 14 empirical studies covering topics such as fall prevention, dementia care, sexual expression, and daily routines. Strategies were synthesized into five categories: Innovation (new tools/policies), Compromise (balancing values), Advocacy (defending preferences), Reflection (team discussions), and Education (training, information). Innovation was the most frequently used strategy (8 of 14 studies), while education was the least utilized but most frequently suggested for future implementation.

conclusionsA significant research gap exists regarding evidence-based strategies for navigating safety-autonomy conflicts. These five categories provide guidance for clinical care and policymakers to understand the diversity of ways staff can address conflicting rights. More research is needed on how residential long-term care staff understand and address conflicting rights on the ground and how to best disseminate these strategies more broadly.

Indexed as

Homes for the AgedLong-Term CareNursing HomesPatient SafetyPersonal AutonomyAgedHumansNursing Home ResidentsUnited Statesassisted livingeducationethicsliabilitynursing homesregulations

Identifiers

PMID42302162
PMCPMC13496346

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.