All is not well in nursing homes

Provided by: Canadian PressWritten by: Alison Auld, THE CANADIAN PRESS
HALIFAX -

Almost half the residents at several nursing homes in Nova Scotia exhibited aggressive behaviour that ranged from outright violence to resisting help, according to a new study that buttresses concerns over the risks care-providers face on the job.

The report, released Thursday by the Canadian Institute of Health Information, also showed that many of the behaviours were linked to a handful of health conditions, including dementia, delirium and depression among the elderly.
Nancy White, the institute's manager of home and continuing care, said the findings shed light on how nursing home residents behave and why they might lash out.

"What we found was that certain types of behaviours are associated with certain underlying health conditions," she said from Ottawa. "Knowing this and understanding these conditions is really the first step to treatment and prevention."

In the survey of five facilities in the province from 2003 to 2007, the most common aggressive behaviour was resisting care, which could include pushing away a worker trying to administer medicine or change a diaper.
About 45 per cent of the 700 residents - or two out of five - showed behavioural symptoms, with a third of the residents resisting help. About 16 per cent were verbally abusive and 14 per cent engaged in "socially inappropriate" actions, like screaming.
About 10 per cent of the residents were physically abusive, which included hitting, scratching or sexually abusing others.
Doreen Charman, a long-term care provider at a Halifax nursing home, said the report backs up what care workers have been saying for years - that aggressive behaviour is a part of daily life.
"It's a day-to-day issue in dealing with aggression and fear and residents who are reacting to their environment," she said, adding that she's been kicked, punched and scratched on the job.
"It's not the person doing it - it's the condition that they're dealing with."
Charman, who's been in the sector for 21 years, said staff need more education on how to deal with challenging behaviour, and more resources to help over-taxed, weary workers.
"This report is reinforcing what we've been saying all along in long-term care - we need more education and we need more staff," she said.
Albert Banerjee, who led a recent study on abuse suffered by care providers, said the institute's findings corroborate a number of reports outlining the challenges of working in nursing homes.
Banerjee, a doctoral candidate in the sociology department at York University in Toronto, found that long-term workers in Canada are seven times more likely to be physically abused by elderly residents than their peers in Nordic countries.
"In Canada there seems to be a myth that this is just part of the job and what this shows is that it's not necessary," he said, referring to his study released earlier this month that surveyed workers in Ontario, Nova Scotia and Manitoba.
"But you need legislation to guarantee minimum standards of care, so documenting the needs of residents and workers is the first step."
White said the five nursing homes in Nova Scotia used a new model of assessing residents when they first entered the facility, giving workers a better handle on what health conditions they might need to address.
"Having good assessment information on these residents is a very important way of preventing behaviours or for dealing with them in a more effective manner," she said.
Nova Scotia was the first province to tabulate its findings for the institute and eight others, including British Columbia, Ontario and Saskatchewan, are going to provide information for the database.
White said the Nova Scotia rates appeared to be similar to other provinces, but added that the data will be used to track trends in the future.