Hot! Ontario needs strategy for boom in elderly with dementia

TheStar.com – Opinion/Editorials – As the number of elderly people with dementia increases, Ontario’s nursing homes will struggle to control aggressive residents.
Jan 12 2014.   Editorial

Imagine, for just a moment, how it would feel to be elderly and living in a nursing home, terrified of a resident down the hall who suffers from dementia with all of its unpredictable rage.

Whether that resident is diagnosed with Alzheimer’s disease, other forms of dementia or a pre-existing mental illness, he or she will live among fragile men and women because in Ontario’s health care system, there’s nowhere else to go.

Simply put, the province is not prepared to manage the serious mental health problems in its rapidly growing demographic of elderly people. Roughly 200,000 Ontarians currently suffer from dementia and by 2020 that number is expected to jump to 250,000. Its cost to society, especially nursing homes, will be staggering.

Look at it this way: the longer we all live, the greater the odds of developing dementia. That fact should put fear in the hearts of boomers who are starting to realize the eventuality of a nursing home isn’t that far off. Combined with estimates showing that some 8,500 of Ontario’s 78,000 long-term care residents are quite aggressive, the final years aren’t looking very peaceful.

Swift action is needed. Ontario’s minister of health, Deb Matthews, must create a dementia strategy to battle the problem on several fronts:

First, some alternative housing is needed for residents with dementia, to focus on their needs — without using harmful anti-psychotic drugs as a chemical restraint. Nursing homes aren’t equipped to act as de facto psychiatric units — especially when most front-line staff have less than a year of training.

Another long-time problem is lack of staffing. The lack of it has brought together an unlikely coalition of nursing home owners, union leaders and seniors’ advocates under the name Staffing Alliance For Every Resident (SAFER). Jane Meadus, coalition member and lawyer with the Advocacy Centre for the Elderly, says the current staffing formula must be changed because it doesn’t take into account the time demands of residents with unpredictable behaviour.

No doubt a government trying to pay down an $11.7-billion deficit by 2017-18 will balk at these added costs but, given the circumstances, Matthews must give it serious consideration. Policy changes like this can save lives.

When aggression spins out of control, fragile residents are severely injured and sometimes die. A 2011 Star investigation found numerous examples of resident-on-resident attacks, some were beatings, others were sexual assaults. According to the SAFER coalition, 29 Ontario nursing home residents were killed between 2003 and 2012. As attested by two additional fatal beatings in Toronto last year, the tragedy of dementia has far-reaching consequences. Families placing a loved one in a nursing home have every right to expect good care, not beatings or murder.

Last March, 72-year-old Joycelyn Dickson was beaten to death and 91-year-old Lourdes Missier was assaulted by a male resident at Scarborough’s The Wexford Residence. Witnesses said he went on a rampage, during which staff inexplicably left him unattended.

And in November, an elderly male resident of Toronto’s Castleview Wychwood Towers was charged with second-degree murder after 87-year-old Francisco DaSilva died from injuries to his head. Of course, those extreme cases don’t tell the story of daily terror, the trauma of bruises, broken bones and emotional scars that diminish the final years.

To be clear, Health Minister Matthews has not ignored the file. Since 2011, the health ministry hired 600 workers — for 634 long-term care homes — to provide supports for residents with behavioural problems. That’s a good start.

But, it’s fair to say that until safe accommodations are created or additional staff is hired and properly trained, residents in Ontario’s long term care homes face increasing risks.

Advocates have long warned about the incoming tsunami of dementia, but without political will to create improvements, old age will grow increasingly precarious. A dementia strategy, and the staff to implement it, is long overdue.

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