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Elder abuse, nursing home negligence goes back decades | Jana Schilder

Friday, October 30, 2020 @ 2:30 PM | By Jana Schilder


Jana Schilder %>
Jana Schilder
The COVID-19 pandemic is affecting residents in nursing homes particularly hard. Prime Minister Justin Trudeau sent in the military in April to help out in nursing homes amid accusations of abuse, neglect and cruelty. The Oct. 23 episode of CBC’s investigative show Marketplace found that 85 per cent of Ontario nursing homes break the law repeatedly with almost no consequences.

Between 2015 and 2019 inclusive, CBC’s Marketplace reviewed 10,000 inspection reports and found over 30,000 “written notices” or violations of the Long-Term Care Homes Act and Regulations.

Here’s a newsflash: the abuse, neglect and sometimes cruelty in nursing homes and long-term care homes goes back decades, to the 1970s and perhaps even earlier.

In the summer of 1978, I was 17 and in Grade 12. I was looking for my first job in Beacon Hill, a middle-class suburb in Ottawa’s east end. My options were limited: flipping burgers at the local Dairy Queen, being a cashier at Zeller’s (formerly owned by Hudson’s Bay and now defunct) or standing at the beauty counter at Shopper’s Drug Mart. But I didn’t get hired by any of them.

There was another option: a local nursing home. I was hired as a nurse’s aide about two weeks after my interview. My first lesson in the working world: the first two weeks of my paycheque went to buying nursing uniforms and nursing shoes.

At the time, my father wasn’t in favour of me working at a nursing home. “It isn’t the best idea for a young person just starting life to see what the end of life is like,” he told me. He was worried about me and had discovered that understatement often worked better than parental edicts. Undaunted, I went to work at the home on the 3:30 p.m. to 11:30 p.m. shift and clocked about 30 hours a week.

In the eight months I worked at the nursing home (which has been hit particularly hard by the pandemic), I witnessed some pretty awful things: at least seven people died during my tenure, many from cancer, complications from diabetes and other conditions; many people suffered from chronic pain — no amount of painkillers was enough; people who were suffering from dementia so severe that they ate their own feces and were no longer verbal; and people who needed help going to the toilet, getting dressed and getting around.

For the most part, people spent their days in wheelchairs, staring into space. The lucky ones read books, magazines and newspapers, and watched TV, including the news. The really lucky ones had someone who would visit every weekend — a little bit of joy and relevance in their lives.

Here’s what I know for sure about what went on at that nursing home back in 1978 — and it seems that not enough has changed:

Long-term care homes are chronically understaffed — pun intended. For an entire floor of 60 residents, we had one nurse and a combination of three nurse’s aides and orderlies. The majority of the time, one of the nurse’s aides or orderlies would not bother to show up for work. So, that was just three people per shift.

The nurse was responsible for preparing medication for all residents, checking blood pressure, changing wound dressings and liaising with doctors for medical appointments. The nurse’s aides and orderlies were responsible for helping patients with everything else: getting residents dressed and undressed; helping them on and off toilets; getting them showered or bathed once a week; cleaning up and changing all bedding when residents were incontinent; daily laundry organization; and serving all meals to residents (there was always one meal plus one snack per shift), plus cleanup.

Looking after elderly patients with chronic conditions, disabilities and various forms of dementia is both physically demanding and emotionally exhausting. As a result, there is both a high burnout rate and high turnover.

Long-term care homes do not attract people looking for a rewarding career in health care or elder care as nurse’s aides or orderlies, but rather immigrants (legal or not) who desperately need the pittance that long-term care homes offer as wages.

Getting good staff in long-term care homes is a problem. In the summer of 1978, I worked with Nurse Braithwaite, who was from Jamaica. I was pretty sure she was in Canada working on her permanent residency (PR) and sending money back to needy relatives. After just eight months, I was a senior nurse’s aide, largely by default.

On-the-job-training is minimal. My training was barely three days. The most important training was learning how to properly lift someone using your legs and not your back. Many residents needed two people to lift them safely.

Theft was a problem. Prescription medication (uppers, downers, strong painkillers) would go missing from the dispensary; orderlies would always know when the nurse was attending an emergency of some kind and the dispensary was left unattended. (I assumed these were sold at a profit.) Personal items belonging to residents frequently went missing.

Food is awful. It was awful back in 1978 and just looking at current Google Reviews, bad food is the norm. 

Many residents never had visitors, not even for Mother’s Day or Father’s Day. People are busy, but many feel guilty about having to put their parents and relatives in long-term care homes. On the other hand, many adult children make zero effort to see their elderly parents or relatives.

The 1940s film icon Bette Davis was right: “Old age is no place for sissies.” Jane Fonda, 82, and Betty White, 98, are the exceptions, not the rules. My family doctor tells me that most people in their 80s have some form of dementia or Alzheimer’s, diagnosed or not.  

Jana Schilder is co-founder of The Legal A Team, a marketing, public relations and social media agency for lawyers and law firms. She also wrote the book on public relations for lawyers, available at Lexis Practice Advisor (LPA). Reach her at jana@janaschilder.com, or 416-831-9154.

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