Eldercare and Workplace Violence

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Many of us have, or will have, to live through the process of finding care for our aging elders who are battling age-related dementia, such as Alzheimer’s disease. Most of us are unable to provide the escalating level of care that is required for our parents or grandparents with this disease, so that they can live safely in their own homes. As a result, we have to make the difficult decision to move our elders into a healthcare facility, such as a nursing or long-term care home.

As we know from multiple media sources, the demand for eldercare, especially critical care, far exceeds the availability of facilities and spaces for this aging and growing demographic. Public healthcare services are simply not able to keep up with the demand. Not only are the facilities filled to full capacity, the services needed once the elderly are in care are at maximum demand. Adding to this pressure for demand, the needs of those afflicted with Alzheimer’s disease can vary tremendously depending on the level or progress of the disease.

Included in the litany of miseries that comes with Alzheimer’s disease is the change in the affected person’s behaviour. People who have spent their adult lives as loving and thoughtful parents or grandparents, often turn into violent, aggressive, and abusive individuals. The cause for this dramatic and devastating change is the disease. While we know that the person who is raging abuse, and hurling objects at anyone who enters the room, is ‘not themselves’, the impact of the violent or aggressive behaviour is devastating to the person who is the subject of that abuse. Getting slapped, kicked, or punched feels the same on the receiving end, no matter what the age or mental state of the person doing the slapping, kicking, or punching.

In 2017, the results of a poll showed the impact of the escalating levels of workplace violence experienced by healthcare workers from patients in the Ottawa area. This risk of harm to workers increases for those who care for patients who have to move into extended healthcare programs, hospitals, and facilities.

Typically, people who have to live in long-term care facilities are not there by choice. Healthcare workers in these facilities find themselves working with patients in a closed environment—meaning that patients cannot leave—who may be easily triggered by the routines the workers must abide by in order to do their jobs. When coping with numerous patients suffering from Alzheimer’s disease, these triggers can multiply and range in level of severity, depending on any number of differing variables.

It is no wonder that the healthcare sector finds itself in need of more resources and training tools to reduce the risk of harm for both healthcare workers and the persons entrusted to their care.

In the fall of 2019, the Ontario government published ‘Workplace violence prevention in health care: A guide to the law for hospitals, long-term care homes and home care.’ While this document reinforces the regulatory requirements of the Occupational Health and Safety Act, it also emphasizes the need for employers in the healthcare sector to train and support their workers, and instructs supervisors on how to work safely in the face of an increasingly unsafe workplace environment. A brief legal analysis of the guide is provided by the Canadian HR Reporter.

As noted in the analysis, the time for a cultural shift in healthcare, with the implementation of proactive workplace safety measures, is at hand. All of us will be the better for it.

Discussion Questions:

  1. As the Health and Safety leader in a healthcare workplace environment, how will you balance the rights of workers with the need to provide appropriate services to patients who may be violent?
  2. What are specific and proactive steps you could implement to reduce the risk of harm to healthcare workers in a long-term care home?