Employment & Labour, Legal Supplier

Inquiry to probe systemic issues in care facilities

By AdvocateDaily.com Staff

One of the most agonizing decisions people face is admitting a family member into a long-term care facility, Toronto workplace violence and elder abuse consultant Denise Koster writes in The Lawyer’s Daily.

Often, there is shame and guilt associated with placing a loved one in the care of “professional strangers,” says Koster, principal of Koster Consulting & Associates.

“This process is made even more difficult by the fact society believes that families should care for their elderly parents or relatives at home,” she says. “By default, families are forced to put faith and trust in the fact that their family member will be safe and well taken care of by health-care professionals.”

In the article, Koster says they should never have to learn that their relative was abused or murdered by a staff member of a highly regulated facility, as did the family and friends of the residents who were murdered by former nurse Elizabeth Wettlaufer.

While long-term care facilities have been understaffed for some time, she writes, now older adults — who are more physically and mentally compromised than ever before — are being admitted without any significant staffing modifications to reflect the changing resident profile.

“The vast majority of residents are unable to advocate for themselves or carry out their activities of daily living and therefore have to heavily rely on the health-care professionals for assistance,” Koster says.

It’s expected that the June 2018 Wettlaufer Public Inquiry will reveal that the current staffing levels in such facilities are not adequate to meet the complex needs of residents and that additional funding to hire more health-care professionals is required, she writes.

“The circumstances and systemic issues that may have contributed to the serial murders and attempted murders will also be revealed including the issue of ageism within the long-term care system," Koster says. “More staff and more ‘eyes’ in the home ultimately would lead to safer more comprehensive care which would also allow for the front-line staff and management to be more observant and responsive to better deal with issues that need to be addressed, such as incompetence and neglect or abuse.”

It is alleged in media reports that Wettlaufer's employers, co-workers and the professional body that regulated her knew of her dangerous clinical practices for many years, Koster writes.

“The inquiry evidence and case reviews presented will amplify the need for employers to actively screen out and protect residents from providers who are not professionally, ethically or morally competent to deliver a high standard of clinical services,” she says.

“Hiring practices need to be broadened not only to include credentials and possessing a high level of clinical skills but also proactively focus on the candidate’s level of emotional intelligence primarily the capacity to be aware of, control and appropriately express emotions, and to effectively and empathically handle interpersonal relationships.”

Koster says care facilities must be mandated to create an environment that is open and responsive to concerns when they are raised, and that fears of retaliation by complainants be dealt with confidentially and followed by a timely and unbiased investigation.

“By embracing a proactive approach to the hiring screening process, future tragic events can be decreased or ideally eliminated,” she writes.

Another issue expected to be raised through the inquiry process is the need for better collaboration among all stakeholders — the Ministry of Health and Long-Term Care, long-term care facilities, unions, regulated bodies, advocacy groups and family members — to foster a resident-focused culture, the article says.

“Strict accountability measures for abuse and neglect must be heightened which consists of sanctions up to and including dismissal and the immediate suspension or revoking of the licence of a regulated health professional,” Koster writes.

“Through ensuring transparency and compliance throughout the long-term care system pertaining to potential or actual abuse and neglect, the resident health and safety objectives of the Long-Term Care (Homes) Act can be met and sustained. The future work of the inquiry has the potential to truly honour and acknowledge the lives of those lost.”

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