Nursing home residents suffered 30 incidents of abuse
The Canadian Press
Published Wednesday, January 7, 2009 7:56AM EST
HALIFAX - Residents of nursing facilities in Nova Scotia suffered 30 incidents of physical, financial or emotional abuse by staff members over a one-year period, which an Opposition politician calls a "disturbing" signal that some caregivers are overworked and undertrained.
The list obtained by The Canadian Press under access to information laws is from 73 investigations done by the Health Department between Oct. 1, 2007, and Sept. 30, 2008. The investigations were done after complaints were filed under the Protection of Persons in Care Act, legislation that has been in force in the province for just over a year.
Health Department investigators determined there were 41 incidents of abuse at a wide variety of small and large nursing homes, as well as at hospital wards across the province.
Of those, the department says 30 cases involved staff abusing residents, four were cases of residents abusing other residents, and seven involved family members or visitors abusing a resident.
The total list of abuses is broken into categories: physical, emotional, a mixture of physical and emotional, sexual, financial and institutional neglect.
However, a Health Department spokeswoman declined to give a precise breakdown of how staff abused residents, other than to say "over half" of the 30 cases were of physical abuse, or a mixture of physical and emotional abuse.
Maureen MacDonald, a former social worker and a New Democrat member of the legislature, said the figures on staff abuse of residents are worrying.
"I'm disturbed," said MacDonald, who pushed the legislation through as a private member's bill. "Seniors in these facilities are vulnerable and they have a reasonable expectation their caregivers will treat them appropriately."
MacDonald argues the province has long realized that cases of abuse are occurring, due in part to frustrated and overworked staff coping with patients who aren't receiving enough hours of care.
"We know the staff-patient ratio are in some cases unacceptable. There are too many patients with very high needs for the number of staff on a shift," she said.
An administrative manual on the Health Department's website defines physical abuse as "the use of physical force resulting in pain, discomfort or injury including: slapping, hitting, beating, rough handling, tying up or binding."
Brett Loney, a Health Department spokesman, said the physical abuse ranged from serious incidents, such as staff members slapping a resident or handling them so roughly that bruising resulted, to less severe cases of staff forcing an unwilling resident to eat a meal or bathe.
Donna Dill, director of monitoring and evaluation in the Health Department's continuing care division, said "for most part it is not serious physical harm, but it's emotional harm and that concerns us too, and ideally we'd like to see no abuse."
She said the figures indicate the new legislation is a "success" in that cases are being reported, and remedies such as staff retraining are being implemented.
"Most of the time they (staff) didn't realize it was abuse. We need to work with them so they can understand what abuse is."
Dill said the incidents are rare considering there are more than 6,000 residents in the nursing homes and chronic care hospital wards around the province.
Still, in Manitoba, which has a similar-sized population to Nova Scotia and where protective legislation has been in place for seven years, the level of staff-to-resident abuse is much lower.
For 2007-08, the western province found that of 37 valid complaints of abuse, only nine involved staff, versus 14 cases where patients abused other patients, says figures provided by Manitoba's Health Department.
Jeanne Desveaux, a lawyer who frequently represents nursing home residents in Halifax, said she believes training of Nova Scotia staff is a key remedy.
"My position is that it's happening because you have staff who aren't trained to deal appropriately with the resident they're caring for," she said.
Desveaux, who is also president of the Alzheimer's Society in the province, notes that the largest facility in Nova Scotia, Northwoodcare Inc. in Halifax, has had no cases of abuse over that period, and she links that to training provided to its staff.
"The staff in the facilities who have had the dementia care course, they have an understanding of why some residents might be rebelling at their suggestion to get dressed," she said. "They understand the behaviour."
Danny Cavanagh, president of Canadian Union of Public Employees in Nova Scotia, which represents workers at 13 of the nursing homes on the list, said the union wrote a letter to the province when the Protection of Persons in Care Act was being drafted questioning whether staff were adequately protected from false accusations.
However, Cavanagh said he will have to await staff feedback before commenting on whether the first year's investigations were done fairly.
Dill said there were no cases of deliberate false accusations.
The list provided by the Health Department also shows two cases of sexual abuse, along with five cases of financial abuse and several of neglect.
Dill said the two instances of sexual abuse were unwanted advances by one resident towards another.
There were two cases of neglect, defined in the act as "failure to provide adequate nutrition, care, medical attention or necessities of life without a valid consent."
Dill said she couldn't provide details.
She said financial abuse - which is automatically sent to police - ranged from a family member who doesn't wish to pay a resident's bills, to cases where staff steal money from residents.
There have been cases where staff are let go as a result of the complaints, Dill said, but the majority of cases are handled through disciplinary measures and training.
Since 2006, she said the province has required staff to have a continuing care certification, and in recent years a course on dealing with "challenging behaviours" has been made available to nursing homes and hospitals across the province.
However, recruitment of staff remains a challenge, she added, noting there are times when nursing homes are short staffed because of a lack of qualified staff, which creates more stress for on-duty staff.
"When people are working short staffed they have less patience and less time to do many things," she said.
The Nova Scotia Association of Health Organizations, which represents the majority of the for-profit and not-for-profit nursing homes on the list, said in a statement it is working to "create abuse-free environments" and has worked with its members to create anti-abuse policies and procedures.
The group says employees operate in a "demanding and often stressful work environment. ... However, workplace pressures are no justification for unacceptable care actions."