Long-term care report details ‘emotional abuse’
Residents subjected to degrading comments by overworked city staff
Residents of city-run long-term care homes have been subjected to demeaning comments by staff who are overworked and sometimes unsuited for the job, according to the full report filed by an independent consultant.
Greg Fougère, the long-term care expert hired by the city to review the four homes, found evidence of “emotional abuse” at each of the facilities during his site visits. His full report was made available to the public after a community and protective services committee meeting Monday.
“The prevalence of this type of abuse was lower than neglect, however the emotional impact on the residents involved was high,” Fougère’s report says.
“Examples provided by residents and families included insulting and humiliating comments to residents such as ‘You’re fat’; abrupt PSW orders such as ‘Come for your bath’; upsetting comments to a married resident; undignified care to a resident at night by pulling down the covers, feeling the resident’s incontinence brief, and announcing ‘You’re dry’; chastising a resident with ‘Don’t yell at me’; shunning, ignoring, cold, and non-smiling to residents; accusing comments about continence care such as ‘I just did you’ and ‘You go to the bathroom too often’; teasing comments to a resident; dehumanizing comments such as ‘heavy wetter’ and ‘feeder’; and comments such as ‘sweetie’ and ‘dearie.’ ”
Fougère conducted 240 interviews and discussions with staff, volunteers, residents and families and found no evidence to suggest there have been physical assaults on residents, beyond what the city discovered prior to the start of his probe last November.
His investigation found that people who provided insights were most concerned about systemic and individual neglect. People pointed to low nursing staff levels as the biggest reason.
According to Fougère’s report, “staffing levels resulted in rushed care and abrupt behaviour and comments to residents.”
After presenting his findings on Monday, Fougère explained that some staff, although good people, simply aren’t suited for the complex work in long-term care.
The community and protective services committee is recommending council use $800,000 from the city’s one-time and unforeseen expenses account to hire 35 more personal support workers this year. On Tuesday, the finance and economic development committee recommended council give staff the authority to dip into a separate $1-million fund, earmarked for long-term care equipment and technology, to bring new staff on board even sooner. Council will vote on those recommendations May 9.
Fougère, who analyzed city statistics, documents and compliance findings between 2015-17, also found evidence of resident-to-resident physical, verbal and emotional abuse, and resident-to-staff abuse. The incident reports he reviewed indicate that assault on staff represents about 30 per cent of all types of staff health and safety incidents.
There are more than 80 recommended actions in Fougère’s report. The city has created a work plan for long-term care based on recommendations made by Fougère, the auditor general, provincial compliance plans and participants of consultations.
One of Fougère’s recommendations is to create a new board of directors to oversee the city’s long-term care homes. The board would be made up of councillors and community members.
Mayor Jim Watson said he would consider the move if he’s re-elected in the Oct. 22 vote.
“I’m open to that as a suggestion,” Watson said. “I don’t want to create a committee just for the sake of creating it. If there’s clearly a reason to have a committee like that, I’d certainly entertain that at the governance report when it’s released. The key for me was to make sure we responded quickly and efficiently to the report’s call for more personal care time for our senior citizens.”
The 2018-22 governance report, which will be considered by the next council, will establish the rules of decision-making for the term.
Watson said he wants to send a signal to long-term care employees and residents’ families that “help is on the way.”
The new personal support workers would add $2.3 million to the city’s operating budget in 2019, but Watson, who usually calls for offsetting cuts when adding money to the budget, said there won’t be any opposition to the extra spending.
Watson said it’s “a pressure that is universally supported by members of council and certainly by the families of those who want the best care possible for their parents.”