| Janet Wright’s voice fills with sadness as she describes how her elderly mother was knocked to the ground and kicked repeatedly by another resident at a Calgary nursing home last year.
The resident broke one of her mom’s ribs. Police had to be called to the southwest facility because staff couldn’t control him. The man is still living in the nursing home and Wright says her mother is terrified he’ll attack her again.
In her three years in the nursing home, Wright’s mother has also fallen and broken her hip and fractured her wrist. And Wright is convinced that her mother would’ve died earlier this year if she hadn’t visited her, seen how sick she was with pneumonia and called 911.
"She was totally out of it and dehydrated," she says. "If I hadn’t gone up there she would’ve died that night."
Wright says she has complained repeatedly to nursing staff about various incidents but she says nothing changes.
"It’s like beating your head against the wall," she says. "I think more people have to speak out."
Wright is far from alone in worrying about the kind of care her relative is receiving in Alberta’s nursing homes.
Nora (not her real name) is so worried about her father receiving substandard care at a northeast Calgary nursing home that she goes to see him at least twice a day. She asked not to be identified because she is worried about negative repercussions at the home for speaking out.
Nora says that when her father first moved into the facility a year ago, she would walk into his room and his oxygen tank would be empty or turned off. She says this happened at least a dozen times until she spoke to administration and the Calgary Health Region.
"He would feel it," she says. "He’d say, ‘It doesn’t feel like I’m getting any oxygen. Is the tank full?’"
She says there have also been times when her father has only received his medication because she made sure a staff member gave it to him. She also says she once found her father strapped into a wheelchair and he’d wet himself because he couldn’t get out of the chair to go to the bathroom. She has no idea how long he had to sit in a puddle of urine before she rescued him.
"If I weren’t there, I’m not sure what kind of care he’d be getting," she says.
Abuse complaints growing
Wright and Nora’s stories aren’t exceptional. In 2000, the province created the Protection For Persons in Care Act, which is supposed to protect people in Alberta institutions from abuse. Over the last two years, the government has received 594 complaints of abuse within long-term-care facilities. And complaints have increased every year since the act was created.
As well, the non-profit organization Families Allied to Influence Responsible Eldercare (FAIRE) has documented close to 300 cases of abuse and neglect throughout the province since the mid-1990s. FAIRE founder Bev McKay says the abuse continues to happen because legislation dictating standards of care for nursing-home residents is grossly inadequate, facilities aren’t monitored closely enough, and sanctions are rarely levied against institutions where seniors are abused or neglected. The Health Facilities Review Committee, a government-appointed body, is responsible for inspecting nursing homes ,but McKay says it often only inspects nursing homes once every two years and all it can do is make recommendations, not levy sanctions. It’s likely the problem will worsen as the baby boomer generation starts ending up in under-funded, understaffed nursing homes.
Care review launched
But the plight of vulnerable seniors in long-term care facilities is finally starting to get some much needed attention. The Alberta auditor general launched a review of the long-term care system earlier this year after strong lobbying from FAIRE. The auditor general is expected to release his report in January.
As well, former Alberta provincial court judge Tom McMeekin has sent a 1,500-signature petition to the Alberta government, which demands more staff and funding for long-term care.
McMeekin became a resident of Carewest Sarcee, a Calgary nursing home, after his multiple sclerosis became too debilitating late last year.
He says he’s often in "agony" waiting for someone to take him to the bathroom or else he’s had to sit on the toilet for half an hour before anyone comes to get him.
"It’s just beyond the pale… when you hear people screaming to get off the john or when you yourself are in agony because you can’t get on the john. Most people who are here have no choice but to be here," he says.
McMeekin also points out that residents only receive a bath once a week – a standard practice throughout Alberta nursing homes – unless they can afford to pay for nursing staff to come in, like he does.
"I think it’s become warehousing of the elderly and I think that’s the only way to express it," says McMeekin. "Obviously long-term care is very low on the priority list."
Nurses speak out
Nursing-home staff are also very concerned about what is going on where they work. Fast Forward interviewed a couple of registered nurses (RNs) who work at Bethany Care Centre Calgary, one of Western Canada’s largest nursing homes. Sarah and Beth (not their real names) asked not to be identified out of fear of losing their jobs.
The nurses say Bethany Care Centre cut 28 RN positions in August 2003 and replaced them with Licensed Practical Nurses (LPNs) who have half the education RNs do and are therefore cheaper. But they say Bethany hasn’t been able to fill all of the positions because there’s too much demand for LPNs, so the facility is often understaffed. As well, Bethany cut three physiotherapy positions in recent years so there is now only one physiotherapist for 442 people.
Such staffing trends aren’t limited to Bethany but are a provincial trend, according to the United Nurses of Alberta union.
Sarah, who works on a dementia ward , says that during the night shift there are sometimes only two staff members to deal with more than 60 people
"I’ve seen black eyes and small lacerations. People have been knocked down," she says. "People have sustained injuries that maybe they wouldn’t have if we had more staff to supervise them more closely."
She says sometimes residents climb out of bed and injure themselves because staff can’t get to their rooms soon enough when their bed sensors go off.
Beth says she’s concerned that the volume of medication one RN has to give out each day is unsafe.
"Just recently I was on a unit giving medications that were extremely numerous. It was a very busy unit and I said to the other person who happened to be an RN, ‘I think this is more medication than one person should safely be giving in an eight-hour shift,’" she says.
While staff has decreased, the needs of residents are increasing. Both nurses say there are many more residents that need to be moved with a lift that requires two staff members to operate.
And both agree residents sometimes have "excessive waits" to be taken to the bathroom or to be got out of bed in the morning or put in bed at night.
"I personally believe anyone who says I have to go to the bathroom should never be told ‘You’re wearing an Attend’ (incontinence diaper)," says Beth.
Both say the current long-term care system has been allowed to deteriorate because the government simply doesn’t care enough.
"They don’t value these people and they don’t value the people who look after them, either," says Sarah.
Beth says, "I think on the continuum of priorities for sick people the institutionalized elderly are definitely at the bottom and it’s not fair because these are the people who built this province."
However, Health and Wellness spokesperson Howard May says long-term-care funding has increased by about 20 per cent in the last six years. He says health regions spent $546 million on long-term care in 2003-2004 compared to $456 million in 1996-1997.
May says claims that staffing has decreased while severity of resident illness has increased "is simply not true" across the province. He says staffing requirements set out in provincial legislation are being "exceeded… by a substantial margin."
"I don’t think it’s fair to extrapolate anecdotal evidence across the province," says May. "Overall, across the province, the system is working."
May says there are mechanisms in place to ensure that complaints of abuse and neglect are properly investigated and dealt with. |
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