Neglect and abuse in Ontario’s long term care facilities

To the Expositor:

Is there hope for consistent, excellent care for residents in long term care (LTC) facilities such as nursing homes?

This week, France Gélinas, Nickel Belt MPP, cautioned that a week doesn’t go by that family members contact her office about their frustrations with the poor care or abuse that their family member is receiving in a LTC facility. In addition, the family fears vindictive attacks by staff against their family member if they complain about the care received.

Ministry of Health and Long Term Care (MOHLTC) will receive complaints about any LTC facility from anybody, and will do a confidential investigation, revealing neither who complained, nor which resident the complaint concerned. While not perfect, it can be used effectively as a last resort.

LTC facilities have become “professionalized.” In the past, most LTC staff were hired as inexperienced workers who learned on-the-job. Today, a greater percentage of LTC staff are trained and licenced PSWs (personal support workers), RPNs (registered practical nurses), RNs (registered nurses), and administrators. All of these LTC jobs are very busy, sometimes frustrating, and often require faster and more effective efforts than similar job titles working in hospitals. Fortunately, it can be a rewarding career, and many of these LTC staff members are dedicated to giving their residents the best possible care on a consistent basis.

To do these LTC jobs effectively, staff require excellent processes, and adequate resources. Unfortunately these minimum requirements don’t always exist, or aren’t as good as they could be. Often these systemic shortfalls frustrate, hinder, or prevent the health care workers from delivering the compassionate care they’d like to provide, and that the residents deserve.

LTC facilities need a supportive culture and clear expectations at all levels of the organization, where everybody works together as a team to deliver the residents’ care every hour of every day. Continuous improvement by every staff member and every support system is essential. If the improvements don’t get done, the systems slowly deteriorate, hinder, and hurt everybody.

Human nature being what it is, there will always be a tendency for staff to get tired, let their personal lives affect their work performance, or lose focus, resulting in one more of the thousands of details for quality care to slip away. While not true for all staff, there will be a natural tendency by some staff to deliver the minimum effort that management permits and accepts. When the quality of care starts to backslide, that is when management must be instantly aware, helping the staff recognize the gap in the care provided today, then help them restore the systems and the resident’s care immediately.

Too often, it is the management and the board members of a LTC facility who are unaware and disengaged from the day-to-day realities of the resident’s care. In some cases, they turn a blind eye and a deaf ear to the staff’s concerns and requests for help. The laissez faire attitude of these irresponsible managers allows the disintegration of resident care standards enforced at their LTC facility to slowly drift into neglect.

Unless there is a complaint, MOHLTC audits LTC facilities on an infrequent basis. Therefore the MOHLTC is usually the last to realize these is a problem in a LTC facility. It is LTC management and their board who have a solemn duty to audit the staff and the systems of their LTC facility on a frequent basis so as to prevent problems. If, in spite of their best efforts a problem occurs, these regular audits will discover the problem (and opportunities), then help get them fixed immediately.

Are all LTC managers and board members willing to understand their full duties, get the training they need, and protect their staff and residents? If not, these negligent persons should immediately resign and find a job elsewhere where they can’t hurt people; neither our caring health care professionals nor the residents they care for.

Glenn Black

Providence Bay