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The reports to the Chief Coroner

Every year, the Geriatric and Long Term Care Review Committee to the Chief Coroner of Ontario prepares a report, meant to draw attention to areas of concern in the province's system of care for the elderly. The following links point to those reports for the years 1993 through 2006,

For most years, we have added yellow highlighting to mark items connected with resident-on-resident violence in nursing homes. (The 2005 report is not currently available in electronic form. We hope to post it here shortly.)

1993 (See p.22 recommendation on identifying "factors for aggressive behaviour")
1994 (See p.9 recommendation against sending patients to homes without appropriate staff or facilities)
1995 (See p.7 recommendation for policies to ensure individualized treatment for behaviourally disturbed residents)
1996 (See p.10 recommendation for ongoing observation and intervention in cases of behaviour change)
1997 (See p.7 recommendation for extensive communication within care team in cases of behavioural problems)
1998 (See p.10 recommendation for provincial policies and strategy "to manage physically aggressive demented patients")
1999 (See p.14 recommendation for ongoing staff training in management of aggressive behaviours)
2000 (See p.10 recommendation against first-line use of drugs to control behavioural problems)
2001 (See p.16 note: "with increasing frequency, long term care facilities are being challenged by demented residents with aggressive tendencies")
2002 (See p.8 recommendation for improved documentation standards for Incident Reports)
2003 (See p.18 recommendation that elderly patients with unsafe behaviour only be discharged to facilities that can provide "safe environment and level of supervision")
2004 (See p.15 recommendation for comprehensive assessment tool to identify unsafe behaviours before elderly patients are placed in long term care facilities)
2006 (See extensive p.10 recommendations on placement of behaviourally problematic patients)

Posted on October 17, 2007
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Comments - Share your thoughts

What a disappointment. You did more damage than good in this program. The research was poor and the interviewing worse. Long Term Care needs more staff, more education of staff. A proportion of demented elderly have the potential to be violent and where are the geriatricians? Very few in Canada. They are not paid adequately so few physicians choose this path. Demented elderly are shipped to emergency departments where overworked and under educated psychiatrists medicate them to the point of causing death. Answers lie in respect for the elderly , huge improvements to Home Care, reinstatement of Public Health programs to support families dealing with elderly members, supportive education for the dedicated front line workers in nursing homes, MORE frontline workers. Why scare those who need to place their loved ones. You have done a disservice in the name of getting viewers. Posted by: H.J. Hamilton | Oct 18, 07 10:44 AM

I agree with the posting by HJ Hamilton. There are many issues that need to be addressed in terms of staffing/funding by the MOHLTC, lack of geriatricians in Canada, and improving home care availability and funding. Front line workers are underpaid and undervalued. Unfortunately, while so much wonderful, caring, and dedicated work does goes on every day in the majority of long term care homes in Ontario, it is these types of media reports that paint nursing homes in Ontario equivalent to living in hell. This report paints all nursing homes as dreadful and dangerous places to live. My advisc to those looking to place family or friends: get past the waterfall displays at the 'front of the house' and spend a day at the home interacting with residents and their family and the staff in the home. Hang out in the resident home common areas, have a meal, and ask lots of questions. It won't take long to identify the homes that offer wonderful care! Posted by: RAS | Oct 18, 07 04:09 PM

This evening I watched with interest your documentary about violence in nursing home. One solution offered was that violent residents be transferred to a separate facility, the assumption being that those violent now would continue to be violent. In the case of my own husband,now in the late stages of Alzheimer's Disease, violence was a stage through which he passed during a specific stage of his own mental deterioration. For a period of perhaps four months he wandered into other residents' room, physically resisting those who objected (both staff and other residents,) by kicking, biting, hitting, etc. Bureaucracy being what it is, by the time he had been moved into a more secure facility, that phase would have passed inevitably. The solution lies, I think, in providing adequate staff in nursing homes and in not being afraid to prescribe more potent anti-psychotic medications. Posted by: Jean Rae Baxter | Oct 20, 07 08:39 PM

I work in a LTC home in Manitoba . We have just over 100 residents and the staff ratio is : 6 nurses & 15 aides divided by 3 floors on the day shift, less on evenings. We had 7 aides & 1 nurse on nights (we will be cut to 6 aides). The Manitoba gov't says we are overstaffed, but we need more staff to give proper care. The staff ratio is based on 1970 or 1980 statistics, when the residents were more independent, not so many suffering from dementia. Someone needs to convince our government that our seniors are entitled to the proper care (not just adequate) they deserve. These residents are all intermingled & the potential is very high for violence. Posted by: jeri parrott | Oct 21, 07 09:59 PM

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