Most stakeholders in long-term care homes agree there is a solution to the problems, but the remedy to cure our ills comes with a cost.
Nearly everybody involved in caring for the elderly says the cure is simple, more staff. Not more doctors or nurses, but more personal support workers.
While it doesn't look like anybody is eager to take on that expense, there's something you can do to help your loved ones get the best care possible - and it won't cost you anything but time.
Pam Malcolm is a personal support worker (PSW) who quit working in long-term care home because she says residents weren't getting the care or attention they deserve.
"We toilet them, face, hands and peri care. That is it. There is nothing else. It's a quick lick and a promise...We should be walking the residents. We should be doing extra things, their nails, whatever. Getting to know the resident...getting to know the person, because they're treated like animals."
The Ontario PSW Association says the biggest problem is staffing levels.
President Miranda Ferrier says "PSWs work one PSW to 25 to 30 [residents] on a lockdown ward at night - on the overnight. When they're all having their behaviours, there's one personal support worker!"
There are no regulated staffing ratios for PSWs or even nurses, but as an example, Ritz Lutheran Villa says their staffing ratio is about 10 residents to one member of nursing staff.
Every home has to have a registered nurse on duty on all shifts, which means there could be one nurse caring for 15, 30 or 60 residents, but when it comes to PSWs - the staff that provide the constant care - there's no minimum, just a requirent that a staffing plan is in place.
Lack of staff is one of the leading causes of violations, including missed baths, meals and recreational activies and errors in medication dosages, treatment and overall care.
Ferrier says "I don't think the public understands how vital a PSW is...There should be a regulated ratio. If you look at ECEs - early childhood educators - they have a ratio of one to five, that would be amazing! If PSWs had a ratio of one to five in long-term care, we could actually spend time with our resident. We could actually do things like range-of-motion exercises with our residents, we could actually have proper toiletting procedures with our residents!"
Every administrator says the same thing.
Dave Marr, warden for Elgin County, says, "We've told the province we would like to see more funding so we can hire more staff."
While Tanya MacDonald, the administrator at Ritz Lutheran Villa, says, "We need a higher level of funding."
The province has announced it's funding 75 more nurse practioners for long-term care homes - or about one for every eight homes in the province.
But as for whether Ontario plans to directly fund more PSWs or if a staffing ratio will be implemented, there are no plans in place right now.
Long-term care isn't likely to get better anytime soon, but Collier Saville makes sure her mother gets the best care possible.
She writes down what she sees on her visits to her mom and talks to staff - or even the Ministry of Health and Long-Term Care - about concerns.
A complaint she filed about poor medication practices led to changes at the home.
Without her notes, she says her mom "would've been just a person that was going to be swept underneath the carpet, no one would care."
Notes wouldn't have protected Ada Cuthbert from her latest attack, but her daughter hopes that by continuing to picket and lobby- she can make changes.
Carol Cuthbert says "This is not over just because my mom's bruises have healed. I'm going to continue to do this and I need the right people to follow me so that we can make a change in this."
But without big changes in the way homes are run, many who work in the field like Malcolm say they won't work in the homes, "It's a very sad situation. I'll never go back into a nursing home again."
As for how to choose a facility, before you make a decision talk to families, staff and residents there - but before you even walk into the home arm yourself with knowledge.
All inspection reports are publicly available on the Ministry website, so you can check to see how compliant the home has been and ask staff important questions about what they've done to fix problems.
It doesn't cost you a cent, but it could end up saving you and your family a lot of heartache.
