Senior Abuse

THE PROBLEM

Like every other afternoon, Ruth Adria was in the middle of a meeting when her home phone rang. She answered the phone and put the call on speaker. Immediately, a broken man began pouring his heart out about the abuse his mother was suffering at a nursing home.

In Alberta, Adria has witnessed countless Albertans unsuspectingly fall victim to abuse in Alberta’s long-term care facilities in part due to a blissful ignorance surrounding the abuse present in long-term care facilities.

Now, people are fighting back. Organizations like the Elder Advocates Society of Alberta are giving a voice to those who have nowhere left to turn. After almost 30 years of investigations, lawsuits, and documenting abuse cases, Adria, the head of the organization, is leading the charge for change – loudly fighting back against a system that she believes is at fault for much of the abuse present in long-term care facilities.

Before Adria started giving examples of the abuse that she has witnessed, she prefaced saying, “This isn’t believable, and in all these stories, if it would have been a dog, criminal charges would have been laid. It would be front-page coverage for several days, and somebody would probably be jailed.”

In the late ‘80s, Adria took a job as a nurse caring for elderly people in a long-term care facility.

“It was a shocking place, I wasn’t prepared for what had happened, or what was happening there. A man committed suicide by jumping out the third-floor window. A man was scalded to death and died three weeks in the university hospital, there was a drug overdose. It was an awful, awful place. And I was shocked. And after that, I kept complaining. And I couldn’t believe that nobody, none of the agencies would hear me.”

Adria started the Elder Advocates of Alberta Society with her husband in 1992. Since then, she has helped thousands of seniors directly and indirectly, by legally fighting back against abuse in court, and in extreme cases, putting herself on the line, even if it means being dragged out of a nursing home with handcuffs on.

WHO IT’S AFFECTING

All over Alberta, people suffer through abuse and neglect in the same facilities repeatedly, but whenever families call attention to the problems, they feel as though no one listens. Elizabeth Hertz, Shauna Mcharg, and Mary Bochenko have all had support from The Elder Advocates of Alberta Society in their respective battles with nursing homes over the abuse of their parents.

McHarg placed her mom in a nursing home when she was diagnosed with Alzheimer’s. McHarg is a teacher and couldn’t provide her mom the 24/7 that she needed, but whenever she could, she would go to the nursing home to visit her mom.

“For the first couple of weeks, I was there all the time, helping make my mom comfortable, but suddenly, that became a problem. Like I was overstepping my boundaries. One of the things they said to me was, if your mom was on the Asian floor, it would be okay to be there as much as you are. But, this is not common in Canada, so you’re overstepping. You’re not Asian, don’t act like an Asian daughter,” said McHarg.

Shortly after these conversations with the staff, McHarg was forbidden from stepping onto the nursing home’s property. McHarg teared up saying, “I was banned from visiting my loved ones.”

For the 10 years that her mom was in care, McHarg was in a constant battle with her facility. Since her mom’s passing, McHarg has kept that battle going as her claims, which were deemed to be unfounded by AHS, have now grown into a full-blown human rights complaint and lawsuit.

McHarg believes that the processes currently in place for reporting abuse are designed to be purposefully complex and slow in order to avoid an outcome within the resident’s tenure at the nursing home.

“My mom cried out, ‘help me’ for two and a half weeks before she died. Nobody helped her, nobody comforted her.”

Elizabeth Hertz

“I’m starting a lawsuit. This shouldn’t be how you solve problems to see your loved ones. They have these processes that are designed to give the illusion of working through processes to find a resolution. I have a letter that shows the processes I tried to follow. Ultimately, the head of the facility banned me, because that’s who can ban you, as the head of the facility. Each of the processes defers to the head of the facility, that the person who made the decision is the same person who decides if she’s going to correct it, and that the person who made the decision is the same person who decides if she’s going to correct it. That’s so unjust,” said McHarg.

Elizabeth Hertz had a similar issue. Hertz’s mother was placed in a nursing home during the COVID-19 pandemic. Before her mom ever tested positive for COVID-19, she saw her mother’s deterioration. She saw the heavy toll that the facility was taking.

Hertz’s mom tested positive for COVID-19, and Hertz got an exception to go into the facility with personal protective equipment (PPE) on to help care for her mother who at that point was dying. Hertz’s mother had health requirements that needed hourly supervision, but Hertz feels as though they used COVID-19 as an excuse to justify the lack of care her mother was receiving.

“I had to go to the door, which was open and put PPE on, go into the room, and see my mom. But if I had to leave the room for any reason, I had to take it off and re-put new PPE on. But meanwhile, a staff member came running in from the kitchen to deliver food, but she didn’t put PPE on, and then she delivered food to the other people. This is somebody that I witnessed coming into the room without PPE and running out. This shows you how ridiculous it was, because meanwhile, they’ve got a woman next to my mum and a curtain in between them, and she doesn’t have COVID. I will never in my life understand that.”

Hertz went filed a report with Protection for Persons in care but felt they provided little help and despite the investigation into abuse, there was no change in her mother’s situation.

“My mom cried out, “help me” for two and a half weeks before she died. Nobody helped her, nobody comforted her, they only allowed eight people in a huge facility… I think that my mom died of neglect, not of COVID. So that’s 100 per cent my feeling on what I witnessed and how I feel,” said Hertz.

“I’m in Canada. And I’m trying to get help for my mom. And everybody’s basically slamming the door in my face. I had no idea this was coming. I’ve talked to many people who have had the exact same experience. I am trying to stop these facilities from hiding what’s going on. They might be short-staffed, but then we need to look into that and help them. Don’t just leave them be like that. There’s been a lot of hard times for everybody, but there should have been more help there,” said Hertz.

Bochenko, was in a similar situation. She tried and failed in getting her home out of abusive care for over ten years before she passed away. However, Bochenko is not stopping her fight for retribution against the system that she feels kept her mother in the hands of her abuser.

“I just don’t even know where to begin to tell you what’s wrong with the system because I think the systems are not about taking care of people. It’s about making money,” said Bochenko, who despite going to the RCMP, and the Elder Advocates Society of Alberta, was unsuccessful in getting her mom out of abusive care for years before she eventually passed away.

Every day, Adria’s phone rings constantly as many people like Hertz, McHarg, and Bockenko who have exhausted all avenues for help, reach out to her with nowhere else to turn. Adria is one of the few resources available actively fighting to save their loved ones from neglect and abuse in long-term care facilities.

HOW THE ALBERTA GOVERNMENT HANDLES ABUSE ALLEGATIONS

The Alberta government annually publishes the Protections for Persons in Care (PPC) report, which provides insight into the abuse suffered at public nursing homes under the Personal Protections and Cares Act. The PPCA was established in Alberta on July 1, 2010, with the purpose of acting as a safeguard against abuse for adults receiving services from publicly funded agencies.

The PPC report states that, for an act to be considered abuse in their eyes beyond the obvious criteria such as sexual assault allegations, for any allegation to be taken seriously by the government, the abuse needs to have caused an elderly serious bodily harm, or serious emotional harm. Alberta has been posting the decisions for allegations that underwent investigation and were deemed legitimate since 2015.

Despite having what looks to be a solid system for addressing allegations on the outside, if the allegations are “founded” after an investigation, the most common outcome in all of the acknowledged abuse cases by the government post-investigation, is to provide education to staff who committed abuse.

2019-20 had 21 reports in the AHS Calgary Zone, where the reported abuse can range from noise complaints to sexual assault on residents. In every single report that AHS deemed “founded” the recommended response was to educate the staff. The primary response to physical and emotional abuse allegations was education. In most cases, the staff that committed the abuse continued to work at the establishments in which they had victimized at least one individual.

An extreme case happened In December of 2004 at the Jubilee Lodge Nursing Home in Edmonton, when Jenny Nelson, an Alzheimer’s patient, was placed in a bath chair and slowly lowered into a tub of scalding hot water and eventually, died as a result.

“No one was held accountable, the explanation the nursing home gave the paper was that it would be inquiring into the maintenance man. Even though it was a widely known case, and the Criminal Code is very clear, it’s just never applied when it is an elderly person,” said Adria.

A decade and a half later, in the 2019 report, there are founded allegations of the exact same abuse, where a staff member knowingly uses water with temperatures that can cause serious bodily harm to the individual.

“When someone has harmed an elderly or physically handicapped person, the assault, whether it be physical or sexual assault, is deemed to be elder abuse. Some administrative body will conduct an investigation into the institution. But the remedy will be an administrative remedy, such as someone will be fired or maybe nothing at all, no remedy at all,” said Adria.

While the PPCA is a good step to eradicating abuse at nursing homes, many barriers still need to be eliminated in the reporting process. When there are consequences, they often don’t serve justice for the action and allow for the abuse to continue unchecked. People such as McHarg feel as though they are not dealing with the abuse head-on and enabling the cycle to continue.

While AHS routinely cancels its contracts with nursing homes that receive abuse allegations, there is rarely any legal justice for the victims that suffered through abuse.

In 2020, Adria had gotten multiple reports of neglect at the Millrise Seniors’ Village and yet again felt as though no justice would be served.

“This was about February or so, during COVID. There it was found that the kitchen was closed and the staff was no longer looking after clients. They were just left to die literally. We wrote to the CEO of Alberta of Health Services, and they always send a letter but it’s meaningless. Again, no one was held accountable.”

On April 1, 2021, in a letter addressed to Adria from Lori Anderson, the chief zone officer of Alberta Health Services, as a response to Adria’s numerous complaints on behalf of the family members of residents.

Anderson wrote, “AHS is ending its contract for the provision of health care services with Millrise Seniors Village 3 Limited Partnership at Millrise Seniors Village, after serving a six-month notice to the ownership group in January of 2021.”

Anderson noted that AHS would facilitate a six-month transition from their services to those of AgeCare, but said that AHS would continue to work with the Millrise Seniors Village, providing a long-term solution for the care of residents.

This was the type of response that Adria had become accustomed to. An acknowledgment of fault, but no consequences. Adria told AHS in her response, “we do not find the response satisfactory, admittedly it was a response intended to placate us. The reply indicates that you intend to disregard the deadly neglect of elderly clients by Millrise Seniors Village.”

Adria wanted to see much more harsh consequences for the abuse. She wanted the Millrise Seniors Village facility to be shuttered, their license revoked. But, beyond confrontational letters, Adria says that in all of these cases any allegations of abuse you cannot go to the police because they consider it to be a civil issue, not a criminal one.

CHANGE IS COMING

Even as a business, facilities are still responsible to uphold basic human rights, and many people who have seen the system up close say there has been a failure to do so. Despite being an abundant problem. Those who have had issues with the system can see many easy solutions that the province could make that would further eliminate senior abuse at nursing homes in Alberta.

“They need to be constantly going into every facility all the time, unannounced, and checking in, seeing what’s going on, and making reports on it. That would make a huge difference,” said Hertz.

One idea floated by a participant in a recent digital town hall meeting with Alberta’s current minister of health, Jason Copping, was to develop a seniors bill of rights similar to that in Ontario, a separate bill exclusively meant to uphold the basic human rights that are far too often.

Ontario has a provincial organization called Elder Abuse Prevention Ontario (EAPO). The EAPO coordinates with the provincial government on multiple levels with the stated goal of creating an Ontario where seniors are free from abuse, have a strong voice and are safe and respected. This organization takes the reporting process out of the hands of provincial health services and the homes themselves and streamlines the process in a straightforward manner.

EAPO offers an abuse report hotline and has a privately run third party, known as the Retirement Home Authority, conduct abuse investigations. A lot of the problems with Alberta’s system are that it is overly complex and the investigations are conducted by government officials rather than a third party.

“You can’t make a complaint to the ombudsman until you’ve made a complaint to the patient concerns officer. So these processes are convoluted and confusing. I went to a talk once that was run by an AHS person who said that there are 30 different complaint processes. Everyone’s making it difficult, it’s just chaos. That’s not how you do a real complaint process,” said McHarg.

When the NDP formed the provincial government, the Elder Advocate of Alberta Society met with then-Justice Minister Kathleen Ganley on multiple occasions to try and start the process of changing the senior abuse laws in the courts. Nothing ever came of it. However, that hasn’t slowed Adria down. She is determined to do whatever it takes to help stop abuse and make seniors’ lives safer in the future.

“So much of this is hidden. Though people are sent to us, when it’s all finished, the agencies silence it. I have been arrested and handcuffed and whatever. But I’m kinda used to it. Often, others…can’t handle it. I’ll be sued. You know, and I say, “come and get me.” That’s the attitude