Action Ending violence in long-term care facilities

IT WAS NOT A MELLOW start to my day. Moses had forwarded an email he’d received from a friend. The email described the brutal beating Jack Acker received at the hands of another resident at St. Joseph’s Villa, the Dundas, Ont., long-term care facility he called home. Hours later, we received a media request to speak to manslaughter charges laid by police against a resident of the Camilla Care Community seniors’ home in Mississauga, Ont.

Sadly, these are not isolated incidents. Many people responded to our Facebook posts and radio show (“Fight Back with Libby Znaimer” on ZoomerRadio, a ZoomerMedia property) with woeful tales of their own. A study noted more than 20,000 reported incidents in Ontario care facilities in 2011, with a third (6,400) of them being resident-on-resident acts of aggression.

I’m not an advocate for sedating individuals with aggressive tendencies into oblivion (“Welcome to Zombieland,” pg. 56). But for the 150,000 individuals in Canada for whom long-term care facilities are home, we must do better. No one should fear for their safety, and those who are frail and vulnerable should receive greater protections, not face increased risks.

There are solutions. Research into best practices is clear and compelling. By providing appropriate levels of trained staff and specially designed environments, many incidents of aggression can be avoided.

Great facilities not only have sufficient staff, they have staff who are adept at identifying underlying needs and addressing them before agitation or aggression develops. Often what is seen as aggressive or agitated behaviour is really maladaptive coping. For example, a care facility resident who takes his clothes off in public may simply be trying to communicate that he needs to use the bathroom. Address the need and the anti-social behaviour stops.

Specially created environments are critical for treating dementiarelated aggression. With diminished capacity comes diminished coping skills. Experts recommend that all residents have private bedrooms and bathrooms. These provide individuals with sufficient personal space to retreat from noise, which greatly reduces their agitation. Providing welcoming private spaces also reduces the number of people in shared public spaces at any one time, lessening the likelihood of conflicts in those areas.

Ontario has made particularly problematic decisions about care facilities. Despite research that shows smaller nine- to 24-resident facilities – or smaller units within larger facilities – lead to far better outcomes, Ontario continues to build residences for 32 patients. No wonder Ontario also has the highest rates of aggression in the country.

So if research and best-practice care homes have showcased solutions, why are we still seeing horrendous problems like those that surfaced that week?

It all boils down to political will. In May of 2015, a private member’s bill calling for a national dementia strategy was introduced by NDP MP Claude Gravelle. It was voted down by the narrowest of margins, 140 to 139, under the governing Conservatives. Described as a no-brainer by health writer André Picard, it met opposition from Conservatives determined to leave health care to the provinces.

Last year, Ontario’s Ministry of Health and Long-Term Care consulted broadly on a dementia strategy for the province. Ministry staff is now working to develop a final strategy for release this year. CARP is partnering with Alzheimer’s Ontario to demand full funding of the strategy in the upcoming budget. Add your voice at www.CARP.ca/ FundDementiaNow and go to CARP. ca/MyVoice to write your MP or provincially elected official about this or any other matter where you want your voice heard.

Many of our members want to avoid living in a care facility. That’s why CARP advocates for better home care and improved support for caregivers. Taking out private care insurance can also help defray the costs of this care.

Most, though not all, of our members also support the right for people with a dementia diagnosis to access medical aid in dying. The federal Liberals have said they will explore extending dying with dignity to those with dementia. It would be beneficial if they’d invest in providing dementia sufferers with options for living with dignity, too.