Violent senior deaths greater than reported

Today the Canadian Press wrote about eight elderly Nova Scotians who died violent deaths in Nova Scotia care facilities. The CP article barely touches the depth of the problem.

A representative for the Department of Health says the department doesn’t publicly release deaths because there doesn’t appear to be an intent to kill. “Often times these cases may not be violent. They (residents) push them (other residents) out of way and … it may not be a level of violence.”

How do we know that? How does the government? Until someone shines a light on a problem, most things are hidden and allowed to fester. Nova Scotia is great at protecting the reputations of executives, not so great at protecting people. Remember Westray?

For over a decade the Halifax-based Advocates for the Care of the Elderly (ACE) have attempted to get government action about nursing home care standards and conditions. It’s been an uphill struggle.

ACE have addressed: falls, nourishment, incontinency, bathing, physiotherapy, supplies, facility infections and violence.

According to ACE, “During the past ten years there have been 60 deaths that have occurred in nursing homes that were declared homicides without anyone being held accountable, leaving families of victims without closure to the loss of their loved one.”

This violence includes resident-to-resident and resident-to-staff violence. In a nursing home all patients become part of a general population. Some can be physically frail, some can be made docile from heavy medication. Some may have dementia, others can have addiction issues (which they came with or developed in care) or become aggressive because of reactions to medications. And some may have criminal backgrounds and have a history of violence.

Sixty homicides in a decade equates to a death every two months. That suggests a far greater problem than the Department of Health wants us to know about. A death every eight weeks is almost an epidemic. What is the plan of action and when will it be implemented?



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1 Response to Violent senior deaths greater than reported

  1. Bubbie says:

    When it comes to death in nursing homes, they are treated in an almost nonchalant manner where it seems animals in animal shelters get better treatment. With animal cruelty, if a perpetrator is caught, they either get hefty fines or even jail time. Not so in nursing homes.

    It has been said that falls are the most common cause of death in nursing homes. Many of these deaths are declared “unnatural”, meaning the death has been caused as a result of an incident with another resident or the resident tripped over a piece of equipment or fell out bed or chair. The Medical Examiner’s report will state, “Death due to a fall”. This happened in the case of my 73-year-old aunt. She was fairly active and walked the corridors for hours on end. One day she encountered another resident in a wheelchair who quickly crossed my aunts path as she was navigating the corridor causing my aunt to fall, resulting in a fractured hip and broken collar bone.

    The medical examiner wrote up her report stating, “Death due to a fall.” She even took the trouble to advise me to have the incident investigated, but being familiar with how bureaucratic investigations work, didn’t think it would result in anything that would bring closure for me and my family, and would only cause further frustration.

    That being said, my ACE Team and I have been advocating for greater patient-centred care that would prevent or at least reduce the number of fatal injuries resulting from falls and resident to resident violence.

    Nurses are also limited to what they can do for residents in long-term care facilities. They cannot practise to the full extent of what they are trained for, like their counterparts employed in acute care. In my mind this adds to further neglect for the elderly.

    One former CEO of long term care stated in a private conversation with me that nursing homes will never be turned into mini hospitals where the elderly can enjoy full medical treatment, as they should. Care by Design, implemented by Dr. Barry Clark, five years ago, was suppose to change that rational and enhance the level of care to that of acute care facilities, but has never attained that goal.

    I can give many examples based on accounts from some of my ACE Team members. One such incident involved the father of one of my members who was a patient at the Aberdeen Hospital about six years ago. Her father had Alzheimer’s Disease and required a sitter while a patient at the hospital. Due to his illness, he was difficult to handle. Hospital staff were not trained in how to approach a patient who was difficult due to Alzheimer’s Disease. Consequently, they could not control him.

    The sitter quickly jumped in and manhandled the man shoving him into a equipment room housing gurneys, IVs and other medical equipment resulting in horrible facial and body bruising that would make any boxer proud. The ACE Team met with then Premier Darrell Dexter who only offered his “Sincerest apology” to the family.

    Speaking to a lawyer who represented a well-known long-term facility concerning a homicide, I questioned the strength of the “Protection of Person’s in Care” act. He only offered that the act was adequate in doing the job of protecting people in long term care, to which I replied that it was a joke.

    As this story is once again garnering attention in the media, my ACE Team and I are in the process of planning to meet with Health and Wellness Minister Leo Glavine regarding his response to my recent letter, Crises In Care, which was addressed to him. His initial response was refer me to the Persons in Care Act. Earlier in this commentary I referred to this Act as a joke. Several people on my ACE Team recently contacted the people behind the Persons in Care Act for which they received absolutely no satisfaction whatsoever. These people receive six figure salaries to protect people residing in long-term care facilities from harm and to work on side with families should an incident result in harm to a loved one. It is my opinion that the people behind the Protection for the Persons in Care Act only exist to protect the owners of long-term care facilities and the government from any kind of legal action resulting from harm to a loved one.

    There is no transparency or accountability on the part of nursing homes when it comes to care for the elderly. Like any private business, staffing and supplies for these facilities are kept at a minimum for the sake of being profitable. As a result the residents suffer from neglect which truly is the main cause of deaths in long-term care facilities. The Protection for the Persons in Care Act does nothing to create an atmosphere where the elderly get high-quality patient-centred care and is only a tool that creates road blocks for the government and the facilities to hide behind. Accountability does not exist when it comes to investigating questionable incidents that occur in nursing homes resulting in death for many residents.

    The question needs to be asked about the accountability of the people who oversee the Protection for the Persons in Care Act. How many cases did the people in that department receive, to what extent were the incidents investigated and were there any outcomes where a facility or persons were ever prosecuted resulting in a justified outcome for the families? To my knowledge I have not heard of any cases ever investigated that a brought a favourable outcome or closure for families of loved ones who died an “unnatural death” in a long term care facility. Minister Glavine says his government has a five-year long-term plan that will answer many of the questions arising from the latest report. I have been waiting for fifteen years.

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