VICTORIA – British Columbia’s advocate for seniors has recommended the provincial government review staffing levels in elderly care homes after examining hundreds of incidents of residents harming each other.
Isobel Mackenzie probed 422 incidents of aggression between residents in licensed care homes last year and found they mostly occurred in facilities housing many seniors with complex needs.
Her report determined that staff in homes with higher incidents spent fewer hours providing direct care, but also included more residents with psychiatric diagnoses and antipsychotic drug use.
Mackenzie said she is concerned by the finding that minimum guidelines around the number of staff members’ hours with residents were not met at all homes.
“Residents assessed as having aggressive behaviour, cognitive deficits, and psychiatric symptoms tend to make up a greater share of the resident population at facilities that have reported incidents,” says the report.
“Given that these facilities have slightly less direct care hours than facilities with no incidents … further study of facility funding with regard to care hours and resident profiles is warranted.”
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The province has put a greater focus on elderly aggression since an 84-year-old woman died last July after being pushed by a resident with dementia in a licensed home in the Interior.
About 27,000 elderly live in B.C.’s licensed care facilities. A total of 304 homes were examined for the report and 177 had no recorded incidents.
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Among the aggressive acts tallied, the report said one-third occurred in residents’ rooms and the rest happened in shared areas, such as the dining room. It found most aggression occurred between 4 p.m. and 8 p.m.
Forty per cent of incidents involved hitting.
The Hospital Employees’ Union said it supports the advocate’s call for a review and is pushing the government to ensure all facilities are funded to at least basic staffing levels.
“In many facilities it’s become typical for care aides, who provide the vast amount of direct personal care, to try and meet the needs of their often frail, elderly residents without being given enough time to do their job,” union spokeswoman Jennifer Whiteside said in a news release.
The Ministry of Health said in an email that it was reviewing Mackenzie’s report and planning to work with the advocate’s office and health authorities to prevent incidents of aggression.
It said staff members are trained in techniques to defuse situations while preserving residents’ dignity, and efforts are being undertaken to look at funding, staffing, care models and patient care needs.
Mackenzie’s report also recommends more comprehensive training for staff around dealing with aggressive behaviours, and it suggested facilities explore strategies to mitigate aggressive behaviours, such locking systems for private rooms to prevent wandering.
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