Incidents of neglect and abuse in Canada’s nursing homes have prompted
an advocacy group to develop a bill of rights and demand national
legislation to protect the elderly in care.
“It is a way of life none of us would tolerate for ourselves,” said Bev
McKay, president of FAIRE, or Families Allied to Influence Responsible
Elder Care. Her mother had Alzheimer’s disease and ultimately died in a
nursing home.
“There is enough anecdotal evidence to suggest that abusive behaviour
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is a widespread and regular aspect of institutional life,” she said.
Families Allied to Influence Responsible Elder Care formed in 1994
after McKay became concerned over the quality of care her mother
received in the last years of her life.
Based in Cochrane, Alta., it has become an advocacy group for the
elderly in care who cannot speak for themselves because of medical
conditions or intimidation. Alberta has legislation to protect persons
in care but FAIRE said it does not impose high enough standards.
FAIRE wants national legislation replacing all provincial laws to
establish a benchmark of care that must be met or exceeded by all
provinces. This would include independent bodies conducting semi-annual
inspections of facilities.
Most recently the group compiled a report entitled The Shame of
Canada’s Nursing Homes. The report includes studies from across the
country decrying the state of long-term care facilities. It talks about
problems of physical and emotional abuse, malnutrition, neglect and
inhumane practices such as the use of restraints and antipsychotic
drugs.
The United Nurses of Alberta also has concerns about the state of
nursing homes in the province and nationally.
“There have been some serious deteriorations in long-term care,
particularly around ‘care’,” said Heather Smith, president of the
nurses’ union.
The union worries about the trend toward assisted living facilities
where standards for nursing care differ from nursing homes. Public
money is being used to build these for-profit facilities and, if a
family wants nursing care, it buys a package to ensure the elders
receive proper attention, she said.
Assisted living units come under different legislation and care
standards than public nursing homes.
Concern also arises when unlicensed staff is allowed to carry out
duties that registered nurses used to do. This not only includes
dispensing medication but administering nursing care to frail patients.
Smith said groups like FAIRE are assuming an important advocacy role
because many seniors’ groups are reluctant to lobby government for
improved standards of care.
“Until you are confronted with someone in a long-term facility, you are
not aware,” she said.
Charmaine Spencer, researcher at the gerontology research centre of
Simon Fraser University, said the situation appears to be the same in
private and public care facilities.
“Just because you pay the big bucks doesn’t protect you from abuse and
neglect,” said Spencer.
About 260,000 seniors are living in care at any given time in Canada,
which is about 10 percent of all Canadians over the age of 65.
Spencer said trends in the last 15 years indicate people enter homes
later in life and in a more frail state. One in three are over 85 years
of age. Many are institutionalized because of stroke, dementia or
incontinence.
Their care needs are more complex but staff skills have not kept up
with the needs of frail people, said Spencer.
While Spencer and McKay acknowledged many facilities provide excellent
care, others do not. The provinces were criticized for ignoring
warnings or complaints about the poor care observed by families in many
facilities nationwide.
Poor care is attributed to inadequate funding, little or no standards
governing staff ratios or training for care of the elderly, high staff
turnover and inadequate supervision by nurses and doctors of workers
and aides.
The family often sees poor sanitation. Frail elderly people may suffer
physical attacks from a roommate or staff person, fall or require help
getting to the bathroom. Staff may handle people roughly, restrain
them, swear at them, steal money or commit sexual abuse.
McKay said if these offences were committed against adults in the
community, the police would be summoned. However, there is often a lack
of solid evidence and since the police have little experience with
these incidents, usually no action is taken.
FAIRE’s bill of rights for the elderly lists 27 points of respectful
treatment as an adult, including:
- The right to share a room with a spouse or partner.
- The right to food, water and daily grooming.
- The right to privacy and the right to communicate privately with
family, friends or advocates.
- The right to view one’s own medical records.
- The right to compassionate palliative care and, when death is
imminent, the right to have family members present 24 hours a day.
- Freedom to form friendships.
- The right to be outdoors on a regular basis.
- The right to raise concerns or grievances over quality of care
without fear of reprisal.
- The right to manage financial affairs when competent to do so.
To view the report online, visit www.faireldercare.org or call
403-932-5557.
