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Uncovering the rest of the iceberg

In early January, a Montreal senior took a fall and had to be taken to hospital by ambulance, where a nurse stitched up her wound. However, the cut soon began to bleed and though it was re-stitched, it did not heal properly.

In a letter to The Senior Times, Lisa N. (not her real name) describes several encounters with medical professionals at various clinics and hospitals where her pleas to have her injury looked at went unheeded. She was scolded, “patted on the head,” told to check her blood pressure and sent to another institution. At one clinic, she writes, “the doctor was very rude and did not even look at the wound. I was embarrassed that the doctor would ridicule me and not even look.”

It was not until two weeks and several visits later that a nurse responded to her request to have her injury seen. “She finally checked the wound and told me that it was smelly and infected. She cleaned it and had me come back the next day to see the doctor, who put me on antibiotics. I’m very upset that the nurses and doctors would not take me seriously.”

Treating seniors like children and ignoring their specific requests is one subtle form of elder abuse. Other forms may be more dramatic, as expressed in a collective formal complaint by family members of residents in a long-term care facility: “The caregiver-resident ratio reflects chronic understaffing. It appears that the residence is aiming to provide the lowest-cost care for the least amount of care time. Bells often go unanswered. Residents are left sitting for hours in front of the dining room. Residents wait for food, wait for toileting, go un-bathed and are isolated and neglected because of inadequate staffing. (One of our ill parents had to call his daughter in Toronto to beg her to phone the staff on his unit so that they would reply to his call bell, as his need to urinate went so long unattended).”

The letter goes on to say that the facility is “a terrible place to die” as the inadequacy of medical care causes “preventable pain” to the palliative care patient.

Though the situations described in these testimonials are dire, the fact that they were expressed is reason to feel hopeful, says Helen Wavroch, executive director of the Réseau Québecois pour contrer les abus contre les ainés.

“Because of public awareness campaigns, people are talking about it more and we hear of more cases. Statistically, we’ve had 150,000 cases a year. We’ve always said that that was just the tip of the iceberg, those who come forth. But how many are too afraid, or shy and don’t want to deal with it publicly? If now we have 200,000, I think it’s the same 50,000 that were silent the year before.”

The National Seniors Council on Elder Abuse estimates that in Canada 4-10% of seniors experience some form of abuse, with financial abuse being the most prevalent and much unreported abuse taking place in the home.

Which is why, in June, to mark World Elder Abuse Awareness Day 2008, the CSSS Cavendish (Health and Social Service Centre), NDG Community Committee on Elder Abuse, NDG Senior Citizens’ Council and Extra Miles Friendly Visiting Program organized activities to entertain, inform and empower seniors. The event featured workshops on telemarketing fraud, Alzheimer’s Disease and the Impact of Elder Abuse on Society.

CSSS Cavendish includes the CLSC René Cassin, CLSC de NDG–Montréal-Ouest, the Richardson Hospital and the Henri Bradet Residential Centre, a long-term care residence. It serves 117,650 people and has the highest percentage of people over 65 on its territory, 19.2% compared to 15.3% on the island of Montreal.

The CSSS features several programs and services for seniors such as homecare, the Elder Abuse Info line, and the Care-Ring Voice tele-workshops for caregivers. It must also provide front-line services to the rest of the population.

Francine Dupuis, Executive Director of the CSSS Cavendish, says that since the government stated that homecare is a priority, things have been easier, but that essentially the organization is underfunded. “You want people to stay in the community for as long as possible, but there is never enough money to meet the demand.”

Part of the problem, she explains, is that her organization does not get to keep all the funds it receives. “With the new budget we receive a little more but 50% goes to other areas outside Montreal because historically they were receiving less. It will take several years until things even out.”

Dupuis says the government doesn’t allow for the complexity and uniqueness of Montreal’s problems. “It may be true per capita but in Montreal there are complex problems that are more acute, and we should be allowed to keep every penny of development budget that we are allocated.”

A recent study by the Agence de la Santé et des services sociaux revealed that of 10,808 respondents, including those living at home or in a public long-term care centre and their caregivers, 95% were satisfied with the services they received from Montreal’s 12 CSSS.

Meanwhile, the waiting lists get longer and the variety of services offered decreases, notes Dupuis. “Do I give more services to a few or less to a larger number of people? It’s not easy to decide because you’re always penalizing someone. We make these decisions every day.”

If you experience or suspect elder abuse, call the Elder Abuse Info Line at 514-489-2287.



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