During the course of this CBC News investigation, the stories kept coming. The more we talked to family members, advocates and experts about the state of long-term care across the country, the more we discovered problems.

There is the story of Nancy Mueller's mother, Belva Hodson. Her life was full of joy. Belva enjoyed gardening and took pride in her yard. So much pride that people would ask to have their wedding pictures snapped amid the vibrant colours. And on a hot summer's day, there was nothing better than taking in a Toronto Blue Jays baseball game.

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But then her behaviour began to change, going from merely "dippy" to behaviour so unpredictable that she needed medication. Belva eventually ended up in a home, and that's where the nightmare began. Nancy had to become her mother's most vocal advocate, pushing for change and making demands when change was slow to come.

And then there is the story of Bernice Eklund, Trudy Dorie's mother. Bernice's life took a turn for the worse after the Alzheimer's set in. The Multiple sclerosis only made matters worse. Trudy believed that a nursing home in their northern B.C. community of Fort St. John was the best answer. She was wrong.

A patient from a psychiatric ward in the province's Lower Mainland was transferred to a special floor in the nursing home reserved for patients with behavioural problems such as extreme aggression.

One day Bernice was walking past the patient. He leapt from the floor and broke her nose. Bernice spent five days in hospital. It was only after Trudy told her story to the local media out of sheer frustration that the nursing home felt pressure to remove the troublesome patient who had been terrorizing other residents as well.

Trudy and Nancy may live in different parts of the country, but they share similar experiences with each other and many Canadian families with loved ones in nursing homes.

Statistics tell the story

Ken LeClair has been watching this scenario unfold from his home base in Kingston, Ont., where he works as a geriatric psychiatrist, something he's been doing for 20 years. He teaches at Queen's University and is co-chair of an organization called the Canadian Coalition for Seniors Mental Health.

As a physician, academic and advocate, LeClair isn't given to hyperbole. More often than not, he talks in measured tones about the innovations in senior's care in provinces such as Nova Scotia and Ontario.

But he concedes that the records uncovered by CBC News document a national problem. LeClair even goes as far to suggest that the difficulties besetting seniors in nursing homes are so dire that the country needs a national summit comprised of health ministers, advocates and experts to discuss ways of dealing with an issue that has become a national shame.

Part of that high-level discussion might revolve around the inconsistent levels of care from one community to the next, one province to the next. A summit might help develop what LeClair refers to as a list of "indicators" that people shopping for nursing homes need when making decisions. An indicator could be an easy-to-understand evaluation of the patients with dementia, or the programs in place to deal with these patients, or the ratio between patients and staff. The indicators would give people a truer sense of what's happening in a home than they receive right now.

With our series, Beaten Down: Fear and Violence in Canada's Nursing Homes, we hope to continue a discussion that our colleagues at Marketplace began with their focus on the increasing violence between residents in nursing homes. Unfortunately, the violence is more than just resident-to-resident. To get an overall picture, provinces such as Ontario, Manitoba and British Columbia measure other categories of violence, such as incidents when residents attack staff and vice-versa.

'Dumping grounds'

This is a complex problem. There are many reasons why nursing homes are becoming increasingly dangerous places. For starters, certain homes, to use one advocate's phrase, have become dumping grounds for people who are mentally unstable, in most instances through no fault of their own. LeClair and other experts estimate that up to 70 per cent of nursing home residents fit into this category.

If we return for a moment to that attack at the nursing home in Fort St. John, B.C., Bernice wasn't the only victim of the resident's aggression. A nurse was also attacked. She took time off work. As a matter of fact, the volatility in nursing homes became so grave that WorkSafeBC, the organization responsible for workplace safety, commissioned a study in 2004 to find out what was happening. WorksafeBC and its counterpart in Ontario have increased their workplace inspections of nursing homes in order to protect the workers. In Ontario, certain nursing homes are part of the Ministry of Labour's watch list for dangerous workplaces.

The statistics also show that sometimes the tables are turned: staff abuse residents. Recent stories in Toronto and Ottawa of a personal support worker and a nurse, respectively, being charged with assault, are just two of the latest examples. Through our investigation, we discovered complaints of homes being short-staffed, and suffering from high turnover, as staff flee the low-paying, pressure-filled jobs. One former worker from B.C. told us that being short staffed puts pressure on all the workers in the home. Sometimes her co-workers took that frustration out on residents by physically abusing them.

Ontario municipalities recruit personal support workers from the ranks of people on social assistance and offer them training. They are the lucky ones. Only 20 per cent of personal support workers receive any training. The quality of the training people do receive has also become an issue, leading health care professionals, advocates such as Ken LeClair and family members to complain that workers are ill-equipped to deal with a nursing-home population that is older and sicker than it was even 10 years ago.

When you add all these categories of violence — resident-to-resident; staff-to-resident; resident-to-staff — the result is much starker than families would ever imagine.

The Ontario Ministry of Health and Long-Term Care investigated about three times as many violent incidents in 2006 than it did in 2003. For the most part, these numbers don't come from the routine inspections the province conducts in nursing homes every year. Rather, the numbers are culled from unusual occurrence reports, which are inspections that chronicle "unusual" or serious events that can put the residents' lives in danger. Violence incidents represent but one category in the unusual occurrence reports.

The database also tracks other incidents such as "injury resulting in transfer to hospital," "medication/treatment error," "alleged/actual fraud/theft," "missing/misappropriated drugs," and "disease outbreak." You can find those categories on the unusual occurrence blank form.

Searching for trends

We wanted to identify trends in some of these areas as well, and attempted to obtain the data through a provincial freedom-of-information request. Unfortunately, we were told that we couldn't have the data. So the trends in these other areas remain hidden from public view — for now. We will continue to fight for them.

The story is the same elsewhere. The British Columbia Ministry of Health claims it doesn't keep any data that you would find in Ontario's unusual occurrence reports. It sent us to the individual health authorities responsible for nursing homes. But that proved futile. The Vancouver Coastal Health Authority claimed it doesn't have a database and it would be too much work to compile statistics. With so many obstacles in the way, how are Canadians supposed to get a fuller picture of what's really going on inside nursing homes?

For the time being, we are able to tell the story of the increasing violence and fear in Canada's nursing homes. And this website will be a valuable one-stop shop to read the data and inspection reports that CBC News has obtained to date. Some of the inspections reports, such as those from British Columbia were obtained through provincial freedom-of-information requests. Others from provinces such as Alberta are routine inspections that are made public but not readily available in one location.

Ontario has a website that allows people to search by nursing home to find out general information about the violations that may have been committed. But again, this information is from routine inspections, not the inspections into unusual occurrences. The routine inspections don't necessarily catch bad behaviour because staff know the inspectors are coming. In one internal memo from an Ontario nursing home, an employee warns her co-workers to make sure everything is put right so that they can receive a passing grade. .

For its part, Quebec, too, has a website that tracks inspections. However, in Quebec there is no law that requires yearly inspections, meaning that homes are only inspected once every few years, or when there is a specific complaint. Still, the website is a slight improvement over Ontario's because people can read the inspection reports in pdf format. In Ontario, people only get general information about what went wrong. They won't find out if the home in question is currently meeting the ministry's standards. That's mainly because the ministry only updates the website periodically.

As you explore the contents on this site, we encourage you to share your stories, or suggest areas we should be investigating or helpful links we should be posting. It may not be the national summit that Ken LeClair dreams of, but let's start a discussion about a problem that has remained hidden for too long.

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