Nova Scotia nursing home residents were hit, spat on, reports reveal

HALIFAX – Nursing home staff hit, spit and in one instance used a pen to draw on a resident, according to Nova Scotia government summaries of abuse at homes over the past 20 months.

But the frequency of abuse against nursing home residents has fallen notably over the past two years when compared with similar government reports in 2007-08.

An update of the abuse cases obtained by The Canadian Press through access-to-information legislation shows there were 20 incidents of abuse — including 15 involving staff — at nursing homes from Oct. 1, 2008 until this June. In all, Health Department investigators probed 61 complaints of abuse.

There were also two cases of abuse at residential care facilities, which offer long-term care to seniors but with fewer medical staff.

The cases include physical, emotional, sexual and financial abuse.

The numbers are down from the 30 cases of abuse between September 2007 and September 2008 — the first year of the province’s Protection of Persons in Care Act, which requires all abuse in nursing homes to be reported.

Nonetheless, some cases are disturbing, says Jeanne Desveaux, a Halifax lawyer whose practice includes elder abuse.

“We want zero cases,” said Desveaux, who is also a former geriatric nurse and past president of the province’s Alzheimer’s Society.

“I find it troubling. It’s totally inappropriate behaviour which I can’t explain away.”

In November 2009, the Health Department received a complaint that a staff member “allegedly spit on a resident and made inappropriate comments” at the Debert Court nursing home in central Nova Scotia. Investigators confirmed the incident happened, according to the documents.

Shannex, a private chain of nursing homes that owns Debert, said it was an isolated occurrence. In an email, Shannex said the employee was suspended for five days without pay and required to take courses on abuse.

In February of this year, a staff member at the Mahone Nursing Home in Mahone Bay used a pen to draw a moustache above a resident’s mouth during feeding, and showed this to other staff “while laughing.”

Brian MacLeod, the owner of the home, said the staff member was dismissed shortly after the incident.

He said while the incident was regarded as a very serious one, he doesn’t believe that the perpetrator was being malicious.

“It doesn’t seem to be mean-spirited,” he said. “There was no hitting or anything like that. The individuals involved made some bad judgments and thought they were helping the person have some fun.”

An October 2008 report says a staff member at Northwoodcare Ltd. in Halifax hit a resident on the side of the head when the resident made a negative comment about her jewelry.

The staff member was ordered to attend a mandatory abuse training session, but instead quit her job.

There were also seven nursing home cases and one residential care facility case that were classified as “neglect,” where the institution involved failed to provide proper care.

A March 2009 report says a senior manager told staff not to provide overnight care for a resident at an unnamed residential care facility. The manager has since quit.

Another report says in January, staff at Harbour View Haven nursing home in Lunenburg didn’t call a doctor for a resident suspected of having a heart attack, and “delayed sending the resident to hospital.”

Procedures were reviewed and “management took immediate action against staff involved with the allegation,” though the report did not elaborate.

Repeated calls to Harbour View’s director were not returned.

Health Minister Maureen MacDonald, who introduced the Protection of Persons in Care Act as a member of the Opposition, said progress on curtailing abuse is being made.

“The intention was to ensure that incidents of abuse in residential care facilities wouldn’t be covered up and hidden, but would be reported and acted upon,” she said.

“The number of incidents in this last time frame is reduced, which is good. But frankly, any incident of abuse is one too many, and we need to consistently continue to monitor and do what’s necessary to protect people who are vulnerable.”

Robert Lafferty, the director of investigations and monitoring at the department, said in most instances, nursing homes educate new staff about the act when they’re hired.

But the key to further decreasing abuse will be more frequent training for staff, particularly if the person is suffering from dementia, said Desveaux.

She also said screening of staff during hiring may be key.

“Are they (nursing homes) screening people enough on the front end? If they’re hiring appropriately trained staff and providing ongoing staff training and support, you’re not going to have this many incidents,” she said.

Dr. Ellen Jost, a Halifax physician who has worked in nursing homes for two decades, said staff trainingon dementia could be improved, given the rising number of patients with Alzheimer’s disease.

“Working on dementia units can be hard on the head,” she said. “A lot of staff … deal with a lot of resistant behaviour.”

Day to day, patients don’t recognize their personal caregivers and may strike out in reaction to being bathed or changed, she said.

Training can be a challenge when there is a high turnover rate, she added.

“You get a lot of new people in and you think they’ve had the sessions, they’re educated. But then three months later you have a whole new group of people coming in.”