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Resident on Resident Abuse in Personal Care Homes: My Family’s Personal Experience

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Since Mom was admitted into a personal care home early last April, she has experienced verbal and physical abuse by two other residents on two separate occasions within the span of six months. Both incidents also occurred in separate homes but the response by staff and management were similar in both cases.

The first situation occurred after Mom was admitted into the first senior’s care facility after finishing her stay at the rehab hospital. The roommate Mom was assigned to share a room with had a known history in the home of abusing other roommates. We were never told this woman had abused two other roommates previously. In fact, we were told by the admissions staff that they personally selected roommates for residents based on personality and compatibility to make sure they were a good fit. The staff also reassured us that the PCH had a zero-tolerance policy for resident abuse.

At the time, the care home had very a restrictive COVID-19 visitation schedule so we could only see Mom every second day during set times on weekdays. Weekend visits were not permitted. During our visits, the roommate was always pleasant and at times, quite chatty. Nothing looked out of the ordinary. 

We found out Mom was being abused by her roommate three weeks after Mom was admitted to the geriatric centre. A nurse witnessed the roommate abusing Mom one Saturday and intervened. The nurse then reported the abuse to the resident manager and phoned my brother on the Sunday to let the family know what happened. 

After my brother finished talking to the nurse, he called me immediately to tell me of what happened. It was shocking and devastating to hear that our beloved Mom was being abused, especially in a place where Mom should have been safe. It was even more difficult because we couldn’t go see her or protect her ourselves. With the strict COVID-19 visitation policies, we were not allowed into the nursing home.

I immediately called Mom to talk to her about the situation. During our conversation, I found out that the abuse started after Mom arrived at the home and it was progressively getting worse. Mom feared the woman was going to physically attack her.

I also found out that staff heard the roommate repeatedly abuse Mom and did nothing. The only person to do something was the nurse who intervened and reported it.

After talking to Mom, I called the resident manager who confirmed she knew about the situation. She tried to reassure me that she had dealt with it by talking to the roommate. She stated she told the roommate that she had to use her ‘nice words’. She also stated that they would be monitoring the roommate by checking in the room every ten to 15 minutes.

That was not good enough. Knowing this woman’s history and the lack of action by the staff, I would not leave mom in a room with a known abuser. I told the resident manager that I wanted that woman out of mom’s room and that I told Mom if it happens again, she’s to call me immediately and I will call the police.  The resident manager told me that they only act when family says something. Because I said something, they would look into moving the roommate to another room. The roommate was moved to a smaller single occupancy room on another floor within ten minutes after my phone call with the resident manager.

The most recent incident started soon after a new roommate was admitted into Mom’s room in the personal care home she is currently residing in. This new roommate had dementia and was very verbal, always complaining that her hand hurt or she was cold. On the second day, Mom was crying while I was on the phone with her because the new roommate, although not acting abusive, wouldn’t leave Mom alone. Mom talked to a staff member about the situation while I was on the phone with her.

As the days passed, the roommate started verbally abusing and bullying mom. I talked to the nursing manager about it one Friday during my visit with Mom. Because of her behaviour, the roommate could not be in a room with another person.

Rather than move the roommate, the staff asked Mom to consider moving to another room on different unit. The room they showed her was much smaller and, as Mom stated, dingier and dirtier. She found the new room depressing and the unit very loud.  We asked why mom should be the one to move when this woman’s behaviour was the issue. The response was that they had to take everyone into consideration and look at the bigger picture.

By Saturday, the situation escalated to dangerous. The roommate was not only verbally abusing and threatening Mom all day, but she was also trying to physically hit and shove Mom with her walker. The staff could hear the abuse and Mom’s distress but did not intervene.

My brother called Mom early evening for their daily chat. Hearing Mom cry while the roommate openly abused her was very alarming and upsetting. He was angry to find out that no one was stepping into to stop the physical and verbal abuse. My brother told mom to call a staff member into the room while he was on the phone. He spoke to a healthcare aide and the head nurse about the abuse. He demanded the roommate be removed immediately and told the nurse if roommate wasn’t taken out of the room and away from Mom immediately, he would call the police. The roommate was moved to her own room soon after the call. She is now under constant supervision by staff.

In both instances, staff could hear the roommates’ behaviour and threats but nothing to stop the abuse or protect Mom. Staff intervened in both cases only after we threatened to call the police.

The care home Mom currently resides in has also stated they do not act on situations unless family become involved.  Throughout these two incidents, we have seen firsthand how personal care homes, while they claim to have a zero-tolerance policy for abuse, are not prepared to respond to or protect the residents from abuse by another resident. And in both situations, if we had not intervened and threatened to involve the police, Mom would have been left in the horrific situation where she would have been at the mercy of an abusive roommate. That realization sickens me.

Mom never told us about the abuse because she didn’t want to bother us or put more work on our shoulders. As an independent woman who lived on her own and cared for herself for decades before the stroke, Mom felt bad that we had to look after her affairs. She didn’t want to be a burden to us because of her current circumstances. She also felt embarrassed and ashamed that she was in such a situation.

Since the first incident, we have had many conversations with Mom and are continually reassuring her that she will never be a burden to us. We also reassure her that we will always be there to protect her and look out for her best interests and she can talk to us about anything.  

As family, we put our trust in the staff and policies of personal care homes to look after our loved ones. When situations of abuse happen and those in charge do nothing to stop it, it is devastating and breaks that trust.

While this is our family’s story, we know that Mom is not alone. Over one third of residents in long term care facilities are abused. Those are the known cases. There are likely many more cases that are not reported. While many cases involve staff abusing resident, residents abusing residents is happening more often than the public realize. We have seen firsthand that many PCHs are not prepared to deal with resident-on-resident abuse.

As for our family, Mom’s safety and wellbeing will always be our priority. We hope it never happens again but if Mom is ever put in an abusive situation again, we won’t threaten to call the police, we’ll just do it. We don’t care what the reason is for the resident’s behaviour, abuse cannot and should never be tolerated or excused.

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Thanksgiving: Finding New Ways to Celebrate When Your Loved Ones Reside in a Personal Care Home

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It’s Thanksgiving weekend in Canada. Traditionally, we would gather as a family for a turkey dinner today (Sunday) at Mom’s. But that hasn’t happened in three years. The COVID-19 pandemic restricted family gatherings during the last two Thanksgiving celebrations.

This weekend we don’t have to worry about COVID-19. Now that all the restrictions are gone, life as we know is back to a more normal routine. But while many families are happily getting together for their holiday dinners, our family won’t be. My sister is not well enough to leave the personal care home. Due to her failing health, she has spent every major holiday and once-in-a-lifetime event in the hospital since March 2020.

This is the first Thanksgiving weekend since Mom had her stroke and was admitted into a PCH.  While I’m more than happy to plan a dinner at my place, Mom can’t get into my wheelchair inaccessible home. I suggested going to a restaurant for Thanksgiving dinner instead, but Mom declined. It’s not as easy for her to go from place to place the way she used to.

Living in a senior’s care home, she doesn’t have the independence and freedom to up and leave whenever she wants like she did in her own home. Staff have to be informed, extra personal, medical and transportation arrangements must be made and the place we are going to must be wheelchair accessible. All that work and preparation makes going out uncomfortable for Mom. She doesn’t like the hassle as she calls it, so she chose to stay in the care home this weekend.

While most of the world has resumed normal activities, senior’s homes haven’t.  Pre COVID, families could book time in a designated family to enjoy holiday and special occasion gatherings with their loved ones. The number of people allowed at these events were based on room size. But today, most personal care homes still follow strict COVID-19 protocols that impact who can visit, how many visitors each resident can have at one time and where outside visitors can meet with their loved ones in the facility. Masks are still mandatory so eating and other activities that require masks to be removed are also not allowed.

So, this Thanksgiving, we’re not gathering for our traditional family dinner. It definitely doesn’t feel the same. It’s strange, it’s sad, and it doesn’t feel like a holiday weekend. We all feel the loss. Commercials, news stories, social media posts and store advertisements further emphasize the fact that our family will not be together this holiday season.

As difficult as it is for us, her children, spouses, and grandchildren, it’s equally if not more difficult for Mom. She never thought she would spend her senior years in a personal care home. She never wanted to lose her house. Spending the holidays in a senior’s home is difficult for her. She misses cooking, baking, and being in her apartment. Holidays highlight what has been lost.

My sister has missed more special events than she cares to remember. This Thanksgiving is another holiday she cannot celebrate with her family. She misses the gatherings, the meals and the life she once took for granted.

Rather than focus on the negative, we are choosing to find ways to celebrate the holiday separately but together. It’s not only important for us as a family, but it is essential for Mom and my sister’s mental health and well being. This holiday should feel special regardless of where they reside. After all, there is still a lot to be thankful for and most importantly, we are very grateful that our mom and sister are still with us. While we can’t gather as one large group, we can still spend time with our loved ones. Whether it is a smaller dinner in our own home and immediate family or a visit at the seniors care home, we are together during this Thanksgiving weekend. And for that, despite feeling the loss of what can no longer be, I, along with my family, are very thankful for what we still have.

I’m a Mixed Bag of Emotions Over My Sister Moving to a Personal Care Home

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Mixed emotions

My sister moved into the personal care home on Monday. I’m happy to report everything went smoothly and she’s feeling good about the change.  She was discharged from the hospital at 10:00 am and transferred to the care home where her husband met her to complete the admissions process. Once alle the paperwork was finalized, administrator, helped her settle into her new room and meet her roommate and some of the staff.

Like many care homes here, there are less single person rooms than shared rooms available, so most residents share a room when they are first admitted. Once someone moves into the facility, they are put on a waiting list for an individual room and eventually moved.

As a new admission, my sister is also on a mandatory 14-day COVID-19 quarantine period. She can’t leave her room for the next two weeks, but people can visit her. I went to see her later Monday afternoon to see how she was doing.

I haven’t seen her since early July, so it was nice to finally sit and chat in person again. Between my own busy schedule, visitation hour times, COVID-19 restrictions that are still in place in certain wards and facilities, and distance from the hospitals to my home, visiting her wasn’t easy.

As I drove to the care home to visit Mom first then my sister, I felt relieved that the rollercoaster of frequent hospital admissions and discharges she’s been on for the last 30 months is finally over. Now that she is in a more permanent place, my sister will finally have the stability, routine and ongoing care that she’s needed for a long time. It’s a relief knowing she won’t be going through the endless turmoil that was jeopardizing her health and life further anymore. Before this admission, every time she was rushed back to a hospital after a short stay in her home, we never knew if she was going to live or die. There were many stress filled days of uncertainty and fear. Knowing that part of hers and our journey was finally over was a positive thing.

But as I sat talking to my sister, grateful that she is still here and finally where she needs to be, I also felt a deep sense of sadness that I didn’t expect. I’ve been so focused on trying to make sure she received the ongoing and proper care she needs, I never thought about what that would actually look like.

And now, here we were, late Monday afternoon, sitting in the care home room she would now call hers and talking about the day’s events, personal care items she still needed, what we could get to personalize her side of the room, and her ongoing health issues. As I sat look at and listening to her, all I could feel was complete sadness.

Adding to my sorrow was her physical appearance. She doesn’t even look like the sister I’ve known all my life anymore. Disease and continued poor health, the permanent effects of the strokes, and the side-effects from the medications she is on have changed her appearance and physical abilities drastically. Her face and body are swollen from the fluid retention, her hair needed to be cut, her fluid filled arms lay limply across her wheelchair tray and the ravages of the last few years have aged her far beyond her years. It’s hard seeing someone so young, she’s only in her late 50’s, in such declined state.

As I sat there listening to her slowed speech, I couldn’t help but wonder if at a subconscious level, she regrets the decisions she has made. My sister’s health decline is completely self-inflicted.  As I mentioned in my last blog, she and her husband spent most of their nearly 30 years’ marriage living a horrible lifestyle where exercise and healthy eating were almost non-existent. The decades of eating a horrible diet of processed and fast food almost daily has taken its toll on both of their health.

But if I’m honest, asking even her subconscious would likely be fruitless. My sister has known for years that if she continued to neglect her health, she would suffer the consequences. I remember talks we had about the importance of maintaining a healthy diet and exercise regularly was when she was first diagnosed with diabetes 20 years ago, but her response was always “I know, I know”. She would never take mine or other’s concerns seriously.

When she first started having health problems several years ago, doctors warned her of the more serious consequences she would face if she didn’t take better care of herself. She still didn’t listen and, after years of the same poor diet and lifestyle habits, it’s finally taken its toll.  

Denial and the belief that ‘it will never happen to me’ are strong dictators that have far too much influence on many people’s lives and my sister is no exception. Thankfully, she is finally in a facility that will regulate her diet. For that, I’m very grateful.

As I sat there talking to her, I remembered the last trip we went on three years ago and the trips we wanted to go on in the future. I remembered the shopping trips, family gatherings, dinners, and get-together’s she used to enjoy. I remembered how much she and Mom used to enjoy going to play Bingo every week and her dogs that she adored but had to be rehomed due to her declining health. I remembered the happy, lively person she once was. That person is gone. She will never enjoy a life of independence and choice again and that realization filled me with a deep sorrow. It’s such an unnecessary loss. I can’t even begin to imagine losing everything I love so much about life.   

But for all the relief, gratitude, frustration, worry, stress and sorrow that I have and continue to feel, there are many emotions I don’t feel. I don’t feel angry, bitter, resentful or disgusted at my sister or her unhealthy life choices that resulted in her current situation. But I also don’t feel sympathetic or pity for her circumstances either. I know she’s done this to herself and no warnings, words of advice or supports changed her behaviour. She’s living with the consequences of her decisions, she is reaping what she has sewn and it’s just sad.

As I adjust to having two family members in the same personal care home, I’m filled with many mixed emotions. From relief that my mom and sister are both safe, happiness that they can finally see each other again, gratitude that they are both still here with us, to resignation that they both are now living in a personal care facility, helpless to stop these changes, and sadness for the lives of independence, good health, and freedom of personal choice in their own home and community are forever gone.  

Age vs Need in Personal Care Home Admissions, A Personal Experience

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I got a phone call Friday from my mom’s personal care home to inform me that my sister has now been accepted and would be moving into the facility on Monday. In a couple of days, and within the span of less than six months, we will have two family members living in the same care home.

The difference between the two situations is very notable. Mom had a stroke last December. It affected her right side as well as her short term and work memory.  Last March, the medical staff at the rehab hospital she was admitted to deemed it mandatory that Mom spend the rest of her life in a personal care home. Their rationale was that her short and working memory impairments made it too unsafe for her to live in her apartment without 24-hour supervision.

To give some history, six weeks after her stroke, Mom spent ten weeks at stroke rehab hospital where she participated in regular physical, occupational and speech therapy sessions. She learned to walk again using a walker, was working on improving her memory impairments and was strengthening the right side of her body while learning to write with and use her left hand more.

Yet, despite surpassing staff expectations with her improvements and accomplishments, the medical team informed us during the family planning meeting that Mom needed to be panelled into a personal care home. The professionals stated that her working and short-term memory loss made it impossible for Mom to live safely on her own.

As a family, we were devastated. We had fully expected Mom to go back to her own apartment and were planning the post-hospital supports that she would need. After we were told that she would need to move into a care home, we still tried to come up with alternative options so Mom could remain in her apartment. However, we were always met with resistance and refusal by the medical team. During one conversation with the social worker, I was told that I was not facing reality. She informed me that I needed to accept their decision that Mom needed to be in a care home because there was no other alternative.

I cried often. Having worked in personal care homes during my late teens and early 20s, I had vowed that Mom would never live in a care home. And now, several years later, I was helpless to stop it.

It’s also extremely hard on her grandsons. To know that they could never visit Grandma in her home again was difficult to accept. As grateful as we are that Mom is still with us, we mourn the life she has lost. As a family, we used to spend every Friday night at Mom’s. It was a ritual that we have been doing for years. But that’s another blog for another day.

My sister’s situation is different. Decades of poor lifestyle and dietary choices have caught up with her. In March 2020, my sister had her first stroke. Since then, she has had nine strokes. She also has Congestive Heart Failure and is in the early stages of renal failure and will eventually need dialysis.

There has been an ongoing pattern since her first stroke in March 2020. She’ll spend several months in a hospital. Once her health is stabilized, hospital staff discharge her home with homecare. She’s home for less than two months before ending up in a hospital again because she’s had another stroke or other life-threatening incident. Every time she is admitted, it is to a different hospital with different staff looking at different medical conditions and medications who then prescribe different treatments and medication changes. Once her immediate health needs are stable, she is discharged home once again. While these measures have resulted in short term stabilization, her health has steadily declined with each stroke and hospital admission.

This past spring, two years after this ordeal started, my sister had her eighth stroke while at home. She spent four months in the hospital. During her stay, she had her nineth stroke. The damage is very notable and permanent. She has limited mobility and requires full assistance for all her personal care including dressing, washing, hair and teeth-brushing and eating. She has difficulty speaking, memory and critical thinking impairments and is partially blind. She cannot change positions in bed, sit up, get out of bed, stand, or take a step without assistance. She requires a wheelchair to get around.

With all her ongoing health issues, my sister needs to be in a facility where she has 24-hour medical care. So during her family planning meeting during her last hospital stay prior, I spoke openly about her needs and requirements. Don’t get me wrong, I don’t want my sister in a personal care home and if there was another option, I would have been in full support of her living in the community instead of a care home. After all, she is only in her mid 50’s, she’s young.  But we have been living through this for well over two years. The current plan does not work. It has failed her every time. My sister, myself and the family realize that for my sister to live as long as possible and have the highest quality of life, it can only happen if she is in a place where she has round-the-clock care.

Despite my input and knowledge, the healthcare team at the hospital was determined my sister was going home to the same care plan. They had no interest in listening to our concerns and fully expected her family and husband to attend to all her needs. The social worker even asked why I couldn’t go to my sister’s place every day to help her. The fact that I have a full time job and my own home and family to look after meant little.

After my sister was discharged from the hospital, she lasted four days at home before being rushed to the hospital again. So, after two and half years of this roller coaster, my sister has been panelled for a personal care home. The social worker who was part of the health care team that was adamant that my sister go home received an unpleasant voicemail message from me.

There are very clear differences between my mom’s situation vs my sister’s. Mom was panelled immediately but it took well over two years and near death for the healthcare professionals to panel my sister. My sister’s physical and medical needs have always been greater than my moms. The other significant difference is age. Mom is 20 years older than her daughter.  

Our family has experienced firsthand the system’s ageism. Despite my sister’s more serious medical needs, the healthcare professionals would not admit that she needed more care than what was offered in the community. This is a very stark contrast to the care and planning Mom received. In her case, the healthcare team saw a personal care home admission as her only option and refused to discuss other community-based alternatives.  According to the Canadian Institute for Health Information, one in nine seniors living in personal care homes could have remained in their own home with the right supports system. As a family, we fully believe Mom was the one in nine.