nursing home abuse | From The Heart

COVID-19: What I’ve Learned from Outbreaks at Mom’s Personal Care Homes

It’s no secret that personal care homes have been severely affected by the COVID-19 pandemic. News stories from across the country highlighted significant flaws in the care and management of nursing homes in the early stages of the pandemic. This resulted in numerous outbreaks in several homes throughout the country with tragic outcomes.

Since the news first broke about the inadequate care in PCHs that led to the widespread outbreaks in many homes in 2020, there has been a very guarded and cautious approach at almost all long-term care centres to make sure these tragedies don’t happen again.

As the world opens and society goes back to pre-pandemic normalcy, long term care facilities keep many restrictions in place in an attempt to protect the residents.

For-Profit Care Home COVID-19 Restrictions

In the first, for profit care centre Mom was admitted to, the administrator proudly boasted their facility had the strictest COVID-19 protocols in the province. When mom first arrived at the centre, she was quarantined for 14 days, a standard practice with nursing homes. After the quarantine period, Mom was only allowed two designated visitors, my brother and I, to visit her. We had to take the home’s mandatory COVID-19 training session to see her. If we didn’t attend this session, we were not allowed in the building. Visitation was only allowed every second day Monday to Friday between the hours of 11:30 am to 1pm and 4:30 to 6:30 pm. We were screened upon entrance and forced to wear masks and face shields during our visit. If we didn’t follow the protocols, we were not allowed into the building. Her stay at this for-profit place was not during a public outbreak. In fact, public case counts were on the decline and society had already eased almost all of the public restrictions.

After the first month, she was allowed to see other friends and family. Visitors had to book an appointment and were restricted to visiting Mom in a room on the main floor. Staff monitored closely, often walking into the room during the 30-minute visit to ensure all visitors kept their face shields and masks on. Visitors who didn’t follow the rules were not allowed back into the building.

Despite the overly strict protocols in place at the profitable PCH, they had two separate COVID-19 outbreaks among patients and staff during the six weeks Mom stayed there. Sadly, one patient died during the second outbreak.

Government Run Centre’s COVID-19 Protocols

The government run facility my mom and sister are currently residing in now also has strict policies in place. Two people are allowed to visit at a time between 11 am to 7 pm weekdays and 9 am to 5 pm weekends. Visitors can only visit with their loved ones in their rooms or outside in the home’s enclosed garden. Visitors are screened upon entering the facility to make sure they are not symptomatic, exposed to COVID, travelled recently out of country or told to isolate. Masks are mandatory.

Three weeks ago, two residents on one of the three units started to display COVID symptoms. The PCH went into immediate lockdown while they tested the residents. Family, friends, and outsiders were not allowed to visit the facility and residents were isolated to their units and rooms only. It was soon confirmed that the two individuals had COVID and the facility has been under lockdown ever since.

Despite the strict lockdown policies put in place immediately, the virus spread. So far, eight people have contracted the virus from two different units.

Mom has COVID

Mom is one of the eight. She started displaying symptoms a week ago and was tested immediately. The second test confirmed she was COVID positive.

We worried about her having the virus because she is older and has comorbidities. COVID is one of those viruses that is unpredictable. We’ve had COVID in my house and know friends, family, and coworkers who have had COVID. While there are standard symptoms of the virus, everyone reacts differently so you don’t know from one person to the next how the virus is going to affect them in the short and long term.

Mom received excellent care and after a few days of severe symptoms, started feeling better. It’s been a week now since her first symptoms and while she’s still weak and has minimal appetite, the worst of the symptoms have passed.

Closure and Spread of the Virus

Despite the closure of the government run PCH to the public, the virus has spread to two separate units. It has gone from two possible cases to eight confirmed and two possible cases. The PCH has less than 80 people residing there so, while the case counts seem low, the population is also lower than most facilities.

COVID and My Sister

My sister, who resides in the same home on a different unit, has not contracted COVID-19 thankfully. It has not made its way to her ward to date. With her severe health issues, we worry about how the virus would affect her.

A Few Observations About COVID-19 Protocols

Despite the strict COVID-19 protocols that personal care homes have, both facilities have experienced outbreaks. While my mom and sister were not in a nursing home during the height of the pandemic, my sister was in and out of hospitals since March 2020. The difference in restrictions between hospitals and nursing homes is noticeable. While personal protective equipment and screening were still in place, visitation rules were not as strict.

While I agree that residents in personal care homes must be protected, I wonder how effective the strict restrictions are in actually keeping the virus out. In both facilities, it was not family and friends that spread the virus. The public was banned from visiting the nursing home three weeks ago as soon as the first two residents showed symptoms of COVID. Yet, despite the lockdown, the virus has spread to two out of three units. Eight residents out of 80 have contracted the virus and two were symptomatic as of three days ago.

It’s hard not to question the effectiveness of the policies since the virus is still getting into the facility and spreading despite strict restrictions and lockdown policies. If personal care homes want to protect their residents from this and other viruses, I would like the care centre to re-evaluate their policies and create guidelines that protect those residing in the homes without isolating and segregating them from their loved ones.

When Mom first contracted COVID, she commented how, even once she’s better, she won’t be going home. That was heartbreaking to hear. Like many residents, she mourns the life and home she has lost. For those of us who have never been forced from our homes, it’s hard to understand the grief that comes with moving into a healthcare facility. We take our life for granted without truly realizing how easily and quickly we can lose it.

After Mom’s test confirmed she had COVID, her roommate was moved to another room almost immediately to protect her from the virus. While understandable, I question why the nursing home staff reacted so quickly to protect a resident from the virus but did not take the same response to protect my mom from abuse.

As I wrote in my last blog, my mom was verbally and physically abused by a roommate in both care homes she stayed at. In both situations, staff heard and saw the abuse but did not do anything until my brother and I threatened to call the police. Despite zero tolerance policies in place at personal care homes, staff did not respond in either situation to protect Mom until we threatened police involvement. Yet they quickly and strategically protect residents from the COVID-19 virus. I find the difference in their response between a virus and abuse shocking and inexcusable. I’ve tried contacting the home’s social worker to further discuss this but so far have not spoken to her.

Closing Thoughts

I have observed firsthand how personal care homes respond to COVID-19 through my family’s own personal experiences and those experiences shared by friends and colleagues who have loved ones in care homes throughout the city and country. I appreciate and respect the attempts to protect adults residing in personal care homes from the COVID-19 virus, but, after seeing how easily and quickly the virus gets into care homes and spreads, despite the rigid policies, I question how effective those restrictions really are.

Not only has the virus spread despite the lockdown, but the restrictions also affect the mental, emotional, and physical health of the residents. Aside from being separated from their loved ones, residents are not allowed to leave their rooms so they can’t visit with each other. Because they can’t leave their room, they are not allowed a weekly bath or shower nor do not get their physiotherapy or reactional activities. They just sit alone in their room. Mom has a TV and phone, and my sister has her phone. That helps break the monotony of the day. However, many residents don’t have devices, so they just sit. I don’t need a degree to recognize how unhealthy that is.

I’ve also noticed the stark difference in the type of care residents receive in homes. I’m grateful for the immediate and aggressive medical care Mom received when she was first diagnosed. It made a significant difference in how she felt during the worst days and her recovery. I have seen this not only when my mom got COVID, but also in my sister’s ongoing care since she has moved into this personal care centre. Without question, the medical care is fantastic. But the same cannot be said for their rehabilitative care response to their own policies around abuse. As both places have stated, they do anything unless family get involved and say something. That’s not acceptable.

Mom never contracted COVID living in her own home. She had control over where and when she went out, so she could control her own level of risk and exposure. She has no control over the risk factors in the nursing home.

As someone who believes that not all senior’s should be automatically panelled into a personal care home when they lose their ability to live independently, I believe that this is yet another reason why we as a society need to develop strategies of care so senior’s can remain in their homes and communities for as long as possible.

Getting older should not be a life sentence into an institution. Other countries have implemented changes in housing and home care so seniors can stay in their home and community for as long as possible. There are proven benefits to keeping people in their homes and out of care centres.

My province is working on implementing change. I will continue to do my part to advocate for change in our current system for our aging population.

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

Posted on October 23 by Admin

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.