Protecting Our Elderly from Harm: Long-Term Vision Needed in Long-Term Care

Long-Term Care Resident

Elizabeth Wettlaufer, a former registered nurse practicing in Ontario for over 21 years at several long-term care homes has been formally charged with first-degree murder in the deaths of 8 elderly residents.

The alleged serial murders occurred between August 2007 and August 2014 through the suspected administering of an insulin overdose. Police have not ruled out other murder victims but investigations are ongoing.

Seven of the reported deaths occurred at Caressant Care located in Woodstock, Ontario.  The eighth alleged murder occurred at the Meadow Park Long Term Care Home in London, Ontario.

CTV News has reported that investigators advised the victims’ families that these deaths were not done out of mercy, but because the victims simply “pissed Wettlaufer off”.

Sadly, it is situations like this that exhibit just how vulnerable elderly residents of long term care homes and their families can be. As such, a greater sense of awareness and urgency is required in understanding long-term care homes as the population ages.

The State of Long-Term Care in Ontario

According to a recent Ministry of Finance study, the number of Ontario seniors is projected to more than double from 2.2 million (16 % of the population) to over than 4.5 million (25.3% of the population) by 2041. With a booming senior population on the horizon, demands for senior placements in long-term care homes will continue to soar.

With more than 600 long-term care homes in Ontario comprising of more than 80,000 residents, the demand for long-term senior care means huge profits for many facilities intent on servicing this profitable yet vulnerable demographic. The demand for elderly care has outstripped the supply of long-term care beds available.

With opportunities abound, most long-term care facilities are profit-driven enterprises intent on filling beds and doing what is necessary to cut costs and meet financial targets. Whatever takes away from the “bottom line” may often be considered an afterthought in a competitive market.

A recent study carried out by the Bruyere Research Institute referenced in an October 7, 2015 Toronto Star article found that mortality rates among residents of “for profit” nursing homes were “16% higher” and had a hospitalization rate of “33% higher” than non-profit facilities.

Dr. Peter Tanuseputro, the lead author of this study noted that staffing levels are lower in the “for-profit sector”, which may be a contributing factor. It was also noted in the article that that not for-profit facilities are not in it for the money so “all surplus, if there is any, goes back into the home.”

Ontario’s Long-Term Care Homes Act

Regardless of how the homes are run, they must be in compliance with Ontario’s Long-Term Care Homes Act, 2007, S.O. 2007, c. 8 (LTCHA).

The LTCHA came into force on July 1, 2010 and replaces the Nursing Homes Act, the Homes for the Aged and Rest Homes Act, Charitable Institutions Act, and the regulations under those acts.  The consequence is that all long-term care homes in the province of Ontario are now regulated by one piece of legislation, which strives to ensure that residents of long-term care homes receive consistent, safe and high quality care with a resident centred approach.

Amongst the measures implemented through the LTCHA include: strong statements of principles to denounce abuse and neglect; screening, orientation and training to staff and volunteers; the provision of specialized units; whistle-blowing protection; and mandatory reporting of abuse and neglect.

The LTCHA also codifies a Residents’ Bill of Rights in section 3, which addresses the personal well-being, dignity and safety of residents. The Bill of Rights is also enforceable as if the resident and the facility entered into a binding contract.

Some of the rights in place include the right to live in a safe and clean environment, the right to have family and friends present 24 hours a day if the resident is dying or very ill, the right to be protected from abuse and the right not to be neglected by the home or its staff.

While the measures in place are well-intentioned, it will likely take many more years to fully evaluate the success of these changes to determine what further improvements are needed.

Section 215(4) of the regulation under the LTHCA requires that every staff member or volunteer provide the home with a signed declaration disclosing every criminal offence the person has been charged with and the outcome. It also requires the disclosure of every probation order, firearms prohibition order or any restraining order made under criminal or family law.

While at first glance this sounds quite scrupulous, there are concerns. For example, section 215 (7) of the regulation specifically excludes medical directors and physicians or registered nurses from the scrutiny of this screening requirement; the very same individuals providing around-the-clock medical care (including accused serial killer Elizabeth Wettlaufer).

Elderly residents are one of the most vulnerable – yet fastest growing – demographics in the country. It is imperative that long-term care homes be held to account for any negligence inflicted on vulnerable residents whom are often unable to voice their own concerns due to cognitive or other health challenges. Long-term care homes always have a choice in deciding whether or not to admit residents into their care. If residents are accepted into their care, there should be no excuse for failing to meet the basic standards expected of them. The legal standards should also be evaluated regularly in this developing area of law to ensure that elderly residents of long term care homes are enjoying their golden years with the dignity, care and respect they deserve.

Lawson Hennick
Written by

Lawson is the creator of LawBubble.com, an online blog exploring legal issues, trends, and developments.

He received his Bachelor of Science degree in Biology from York University, and then attended University of Ottawa’s Faculty of Law graduating with a Bachelor of Laws degree in 2009 before being called to the Ontario Bar in 2010.

Lawson articled with a boutique litigation firm where he gained experience in a variety of practice areas including representing Indian Residential School survivors to obtain compensation through the Independent Assessment Process for sexual and physical harms suffered.

Since his call to the bar, Lawson has devoted his legal practice exclusively to the area of personal injury law before joining Yermus & Associates where he regularly acts for clients on injury claims including motor vehicle accidents, slip and falls, product liability and dog bite cases. He regularly appears before the Superior Court of Justice and has also appeared before the Financial Services Commission of Ontario (FSCO).