N.S. nursing home residents abused 30 times
Published Wednesday January 7th, 2009
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 Health Department said 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, said 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.
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 is the president of Canadian Union of Public Employees in Nova Scotia, which represents workers at 13 of the nursing homes on the list. He 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 wait for 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 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's working to "create abuse-free environments" and has worked with its members to create anti-abuse policies and procedures.
The group said employees operate in a "demanding and often stressful work environment ... However, workplace pressures are no justification for unacceptable care actions."
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