VICTORIA - The deaths of 16 elderly people in three years along with hundreds of aggressive incidents at residential care facilities has prompted British Columbia's seniors' advocate to launch a review of resident-on-resident violence.

Isobel Mackenzie said Wednesday that data available for the first time shows there were as many as 550 incidents of violence between residents that caused injuries at B.C. care facilities in 2014-2015.

She said the violence numbers could be viewed as small when considering there are more than 27,000 seniors at care facilities, but the human toll is substantial.

“We were able to gather data for the first time that tells us how many incidents of resident-on-resident aggression resulting in harm occurred in our licensed facilities in B.C.,” said Mackenzie. “We know that it is between 425 and 550.”

The review will include in-depth research to determine if there are patterns or systemic issues that contribute to increased aggression she said.

A 60-page Monitoring Seniors' Services report found 1,026 cases of physical aggression in a one-year period from 2014-2015, but the study will focus on the estimated 550 incidents of harm due to violence. The report stated there were 235 serious violent incidents at residential care facilities during that one-year time period.

“We have worked with the coroner's office,” said Mackenzie. “The aggression I have spoken to are incidents that resulted in harm. We want to focus on the ones that resulted in harm. The ultimate harm that could have been the result is obviously death.”

She said 16 people have died as a result of violence among senior residents.

“It's complicated,” said Mackenzie. “You are dealing with a population who, the majority, have a diagnosis of dementia. Anybody who has either lived with or worked with people with dementia know how sudden a person can change their presentation and go from docile to violent.”

Emily Houston, 84, died in July 2015, days after she was pushed down and punched by another female senior at a Kamloops, B.C., care facility. RCMP investigated the death, but decided against recommending charges.

Houston's daughter said at the time that her mother's attacker had dementia and was upset that her mother had been moved into the woman's former room.

Bill May, 85, died in August 2013, after an attack at a Vernon care facility by a 95-year-old male resident. The Crown later stayed a charge of second-degree murder against John Furman because of his advanced dementia.

Health Minister Terry Lake said he welcomed the review of the troubling issue of resident aggression in residential care facilities.

He said eliminating violence among elderly, frail and unpredictable people is challenging, but increased training among health-care workers that involves calming seniors, and recognizing and de-escalating potentially violent situations can lead to reductions in violence.

Lake said care facilities that provide single occupancy rooms and relaxed atmospheres can also reduce the likelihood of violence.

“I don't want to make it sound like we have the ability to decrease incidents to zero, but we need to try to reduce it to the lowest number possible,” he said.

On a positive note, Mackenzie said her office finds that 96 per cent of B.C. seniors have their own doctor and four out of five people 85 years and older have no diagnosis of dementia.