One in six seniors mistreated
His family installed the camera after suspicions arose from a number of unexplained injuries. The images floored them. Xiao, meanwhile, was criminally charged, pleading guilty to assault.
Those who work in the field, however, say we shouldn’t be shocked.
Mary Schulz is the director of education at the Alzheimer Society of Canada. Admitting the story was “very disturbing,” Schulz was asked whether a similar thing might be happening on an almost daily basis across Canada.
“I think the odds are pretty high,” she responded.
“We have a vulnerable population. We’ve got staff who perhaps are not fully trained in understanding what dementia is and its impacts. We have a care system that is usually, in many areas of the country, underfunded and understaffed. And sometimes, let’s face it, we have the wrong people in the job.”
Elder abuse takes many forms. Most commonly, it is psychological or financial, and caregivers are often to blame. Witness nurse Elizabeth Wettlaufer and her quiet rampage through Ontario nursing homes that left at least eight dead. (And, as for oversight, if not for her own admissions, she’d still be at grandpa’s bedside.)
Prevalence is hard to pin down. But, in a report released in June, the World Health Organization said one in six people over the age of 60 have been subjected to some form of abuse or neglect. A study by the Registered Nurses Association of Ontario (which reviewed literature from around the world) concluded that one in four older adults is at risk of abuse.
It pointed to a survey in Germany that found 70 per cent of nurses self-reported they had acted in an abusive or neglectful way toward a patient in the previous year.
And we’ve come to know this in Ontario: With the laudable gains in home care, the elderly are arriving in long-term-care facilities as older, sicker and probably more mentally feeble individuals than a generation ago. (Some 60 per cent of long-term-care residents battle a form of dementia.)
“Even the most well-resourced, close, loving family is going to have a lot of trouble caring for someone with dementia until the very end,” Schulz said.
Thus are the needs more complex. The dementia-afflicted can lash out at staff because they’re confused or feel threatened, often having difficulty comprehending what’s happening around them. On the other hand, said Schulz, staff only know this diminished human being who arrives to them late in life, not the vibrant individual they once were.
“Quite often, what we know is that staff are frustrated, they are hurried, they are understaffed,” Schulz said. “They’re people, too, and they get to the end of their rope, and sometimes they lash out at somebody who, unfortunately, can’t defend themselves.”
You can’t help but wonder what will happen when twice as many Canadians are in institutional care, in the next 20 or so years.
“It’s just a huge issue,” said Maureen Etkin, executive director of Elder Abuse Ontario. “(But) I think the larger issue is the accountability in long-term care. Where is the oversight, where is the supervisor?”
She noted there is a legal requirement in Ontario for cases of suspected abuse to be reported to the responsible ministry. Why, for instance, would a family need to go so far as to install its own camera to monitor care?
She said some studies (not in Ontario) have found that as many as 36 per cent of care staff had witnessed some form of abuse against a resident. Yet, at the Armstrong facility, the city said it received 26 complaints in 2016 (mostly minor) and had only one confirmed case of verbal abuse.
Disturbed? Sure we should be. But worse, how have we learned to live with such a broad, unspoken failure?