Raise concerns if something isn’t right.
That’s the advice a B.C. seniors advocate is giving after the death of a 90-year-old Kelowna woman following a care-home incident just before Christmas.
On December 18, Kelowna RCMP said an altercation happened between two seniors in a care home. The woman was treated in hospital for undisclosed injuries but died the next day after her release.
“The Kelowna RCMP and the B.C. Coroners Service are continuing their investigation,” Cpl. Dan Moskaluk said on Thursday.
Isobel Mackenzie, a seniors advocate for the province of B.C., called it “a very tragic incident.”
“It’s traumatic for a lot of people,” Mackenzie said in an interview with Global News. “And it’s also very often devastating on the staff.
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“This type of incident is rare, but it does happen.”
She added that seniors in care homes are “overwhelmingly safe and secure in the facility they’re in.”
“The best thing that a family member can do is pick up the phone and talk to their loved one, or go in and visit their loved one if they can, and talk to them about their life in the care home,” she said.
“If those family members sense that something is not as it should be, they should be raising those concerns.”
Mackenzie says the Office of the Seniors Advocate for B.C. tracks aggression incidents in care homes.
“In a given year, there are roughly 425 to 450 reported incidents of resident-to-resident aggression that resulted in a degree of harm,” said Mackenzie. “And the degree of harm that needs to occur is one that requires first aid and/or a trip to a hospital. You don’t necessarily have to go to the hospital, but you would have needed some kind of first aid.
Those 425 incidents occur in a population of 27,000 residents, with more than half of facilities reporting no incidents in a given year, she said.
“So it does happen. It’s not prolific.”
Mackenzie said a survey of care homes and family members of people in care homes in B.C. found that 88 per cent of residents said they felt safe.
“But here’s the other interesting thing: We asked family members, ‘Have you seen residents behave aggressively in the home?’ And almost half of them, 46 per cent, said they have seen residents behave aggressively in the home. … Whether they result in harm to another person, that’s another step, but they are seeing some of these behaviours.”
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Mackenzie said they also asked family members if staff in the care home handled aggressive behaviours appropriately, and 88 per cent said yes, they did.
“When they happen, for the most part, although not exclusively, staff are able to defuse the situation and not escalate the aggression.”
Mackenzie also said “you can’t always predict when or who might become aggressive.”
“What you’re seeing is someone who might have been a passive person all their life,” she said. “Because of the neurological changes that are happening as a result of the disease, they can become aggressive.
“And you don’t know they’re going to be aggressive until the first time they become aggressive. So that’s part of the challenge.”
Mackenzie said how staff work with aggressive behaviours can defuse the situation to a large extent, and that there are some environmental conditions that will create opportunities for aggression. She also noted that there are links, albeit not strong, between staffing levels and incidents of aggression.
“The only one that had a strong correlation was if they have a diagnosis of aggressive behaviour issues,” said Mackenzie. “They are far more likely to engage in an incident of resident-to-resident aggression.
“We know that males are more likely than females (to engage in aggression). We know that younger residents are more likely than older residents, in part because they are more mobile.”
Mackenzie also noted that time of day has some impact, with the highest spike being between 4 p.m. and 8 p.m. Mackenzie would like that time window narrowed, as “there’s a lot happening between 4 and 8 p.m.: getting dinner and going to bed.”
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This type of incident isn’t the leading cause of concerns from seniors in care homes.
“What we hear from seniors in the Okanagan is, first and foremost, some issues about being able to stay at home before they have to go into a care home,” Mackenzie said. “Are supports and services available, or more precisely not available to them as they would like and need. And for some people, there are issues around access to the appropriate kind of care facility they would like to be in.
“In the Interior, you sometimes see people placed in a facility further away from home than you might see if they lived in a city like Vancouver or Victoria, where there are more facilities.
“And within facilities, it’s basically split 50-50. About half the people are very happy and about half the people are not so happy. And so we hear usually from the people and family members who are not so happy. And the kinds of things we hear about are that they would like more help, they want to get baths more frequently, they want better interaction with people.”
Mackenzie added that all of the care homes that are contracted by Interior Health are funded at 3.15 hours of care per resident per day. The goal is 3.36 hours within two years.
“At the end of the day, this incident could have happened in any care home with any population,” Mackenzie said. “We are monitoring how often these incidents occur. We are looking at training of staff to ensure that we put everything in place that we can to make our care homes as safe and secure as possible.
“But, at the end of the day, we’re talking about human behaviour that can be unpredictable.”
For more about the Office of the Seniors Advocate for B.C., click here.